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Home Health & Hospice Week

Reimbursement:

DME GETS A PASS FROM PRESIDENT,MEDPAC -- FOR NOW

Published on Mon Feb 09, 2009

Suppliers still have a lot of work to do, trade groups urge.

The beginning of the 2010 budget war is quiet for durable medical equipment suppliers. Is it a sign that lawmakers will leave the industry alone this year or merely the calm before the storm?

In his 2010 budget proposal, President Barack Obama laid out no new cuts for DME. The blueprint "did not address HME budget issues," notes the American Association for Homecare.

And for once, the Medicare Payment Advisory Commission also didn't make any DME-related recommendations in its March report to Congress, points out the National Association for Independent Medical Equipment Suppliers.

False sense of security: But those unusual steps shouldn't leave suppliers feeling safe this congressional session, experts warn. Lots could happen during the course of the session.

"It's much too early to know just how President Obama's budget will affect DME," says NAIMES's Wayne Stanfield in a message to members."The House and Senate input to the budget may be much more worrisome than what's in this budget outline."

When lawmakers get down to final negotiations near the end of the year, they will be looking for ways to pay for the Medicare changes they want to implement. And chances are they'll go back to the DME well for more funding, as they have in past years, suppliers fear.

Fight continues: Suppliers should also be busy fighting two huge changes that are already in motion -- competitive bidding and oxygen payment changes, industry reps say.

"The need to repeal competitive bidding for DME and eliminate the 36-month cap must be the focus of industry efforts over the coming months," NAIMES contends. "The industry ... must move forward with these two key goals within the next two to three months."

One hundred twenty-three members of Congress recently signed onto a letter to CMS asking the agency to revise its oxygen payment policies, according to the Council for Quality Respiratory Care, which represents large oxygen suppliers.

AAHomecare wants to ward off potential future cuts by taking aim at the Centers for Medicare & Medicaid Services' favorite excuse for them -- so-called rampant fraud and abuse in the industry.

AAHomecare continues to push its 13-step anti-fraud plan to curb fraud and abuse in the DME sector. "This action plan ... is a proactive solution that will be far more effective than unnecessary Medicare cuts to the home care medical equipment sector that only harm patients and seniors," AAHomecare's Tyler Wilson said when the trade group released its proposal.

The plan includes site inspections for all new suppliers, increased penalties for fraud, and more rigorous quality standards.

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