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Mark J. Higley New England Medical Equipment Dealers Association December 7, 2006. You’ve probably seen this slide before…but again, the HME industry needs to emphasize that…. Homecare is the most cost-effective setting for healthcare…a fact that is amply documented in medical literature.
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New England Medical Equipment Dealers Association
December 7, 2006
home transfilling systems.
“Skirmish” NOT THE
OF CAP 13 on OXYGEN
FOR “DOC FIX” AFTER
ON THIS WIN?
(WRITTEN BEFORE THE ELECTION)….Democrats "plan to undo the Medicare drug program" if they win a majority of one or both chambers of Congress, Robert Goldberg, vice president for strategic initiatives at the Center for Medicine in the Public Interest, writes in a Washington Times opinion piece. According to Goldberg,
House Minority Leader Nancy Pelosi (D-Calif.)
recently "promised that if Democrats took control
of Congress, her party would eliminate the choice
of private-sector plans in favor of a single govern-
ment purchaser for seniors' medications &
medical equipment" Such a Program would reduce
costs“ only by drastically limiting the choice of
Medicines that doctors and seniors now have,“
adding that the Department of Veterans Affairs (VA) drug plan
"offers 30% fewer drugs than the average Medicare plan.“ ..“the Democrats will again push for a nationalized healthcare plan similar to the “Hillary Plan” of the early 1990’s.” (National Journal, 10/17)
(outgoing Chairman –
New Ranking Member)
(Former Chairman –
New Ranking Member)
On July 28, 2005, Congressmen David Hobson (R-OH) and John Tanner (D-TN) introduced The Medicare Durable Medical Equipment Access Act of 2005. This bill would remedy many of the “competitive acquisition” provisions of the Medicare Modernization Act of 2003 (MMA). In remarks at AAHomecare’s Congressional reception in June, Congressman Hobson said he had vetted HR 3559 through the Ways and Means Committee (Chairman Bill Thomas) with no major objections.
“ANY WILLING QUALIFIED PROVIDER”
Note: There were 149 Co-Sponsors to HR 3559 in the 109TH Congress!
H.R. 3559 would amend the MMA to protect patient access to homecare and allow qualified small providers to participate in the bidding program. The bill would:- Exempt smaller, rural (populations under 500,000) MSAs;
- Allow all qualified providers that are small businesses and that submitted a bid below the current allowable to participate at the selected award price;
- Restore the right of providers participating in the program to administrative and judicial review;
- Exempt items and services unless savings of at least 10 % can be demonstrated, compared to the fee schedule in effect January 1, 2005; - Protect beneficiary access to care by requiring CMS to conduct a comparability analysis for areas that are not competitively bid to ensure the rate is appropriate to costs and does not reduce access to care; - Subject the PAOC to the Federal Advisory Committee Act (FACA), which requires public access to meetings and proceedings.
IN THE SENATE OF THE UNITED STATES
September 21, 2006
Mr. HATCH (for himself and Mr. CONRAD) introduced the following bill; which was read twice and referred to the Committee on Finance
To amend part B of title XVIII of the Social Security Act to assure access to durable medical equipment under the Medicare Program.
Note: There were 2 Co-Sponsors to S. 3920 in the 109TH Congress
Note: Rep. Schwarz was defeated in the primary. However
Rep. Tom Price (R-GA), a physician, has indicated he will reintroduce the bill
Note: Senator Roberts has indicated he will reintroduce the bill
Title: To amend title XVIII of the Social Security Act to exempt complex rehabilitation products and assistive technology products from the Medicare competitive acquisition program. Sponsor: Rep Lewis, Ron [KY-2] (introduced 3/16/2006) Cosponsors (7) Latest Major Action: 3/16/2006 Referred to House committee. Status: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means
Alpine Home Medical Equipment, Peterson Medical receive "promise to study the issue" from Utah Senator during “MEET & GREET”
Local providers of home medical equipment set aside their competitive interests Tuesday and joined forces to lobby for help in stopping legislation deemed detrimental to the industry from taking effect early next year. Business owners and their patients met with Sen. Orrin Hatch, R-Utah, to encourage him to sponsor a bill that would prevent competitive bidding for home medical equipment, particularly oxygen, from becoming part of the Medicare program absent demonstrated cost savings and other quality control measures. A similar bill is making its way through the House of Representatives.
Connecticut (3 out of 5 = 66%)
Rep John Larson (D-1st Dist) Ways & Means
Rep Robert Simmons (R-2nd Dist) DEFEATED IN NOV
Rep Rose deLauro (D-3rd Dist) Budget
Rep. Christopher Shays (R-4th Dist)
Rep. Nancy Johnson (R-5th Dist) Ways & Means DEFEATED IN NOV
Rep.-Elect Joe Courtney (D—Conn.)
Replaced Rep. Robert Simmons
Residence: VernonBorn: April 6, 1953; Hartford, Conn.Religion: Roman CatholicFamily: Wife, Audrey Budarz Courtney; two childrenEducation: Tufts U., B.A. 1975 (history); U. of Connecticut, J.D. 1978Military Service: NoneCareer: Lawyer; public defenderPolitical Highlights: Conn. House, 1987-1995; Democratic nominee
for lieutenant governor, 1998; Democratic nominee for U.S. House, 2002
Rep.-Elect Christopher S. Murphy (D—Conn.)
Replaced Rep. Nancy Johnson
5th DistrictResidence: CheshireBorn: August 3, 1973; White Plains, N.Y.Religion: ProtestantFamily: Engaged to Cathy HolahanEducation: Williams College, B.A. 1996 (history & political science); U. of Connecticut, J.D. 2002Military Service: NoneCareer: Lawyer; state legislative and campaign aidePolitical Highlights: Southington Planning and Zoning Commission, 1997-99; Conn. House, 1999-03; Conn. Senate, 2003-present
Massachusetts (8 out of 10 = 80%)
Rep John Olver (D-1st Dist)
Rep. Richard Neal (D-2nd Dist) Ways & Means
Rep. James McGovern (D-3rd Dist)
Rep. Barney Frank (D-4th Dist)
Rep. Marty Meehan (D-5th Dist)
Rep. John Tierney (D-6th Dist)
Rep. Edward Markey (D-7th Dist) Energy & Commerce
Rep. Michael Capuano (D-8th Dist)
Rep. Stephen Lynch (D-9th Dist)
Rep. William Delahunt (D-10th Dist)
MAINE (2 out of 2 = 100%)
Rep Thomas Allen (D-1st Dist) ENERGY & COMMERCE
Rep. Michael Michaud (D-2nd)
New Hampshire CO-SPONSORS (1 out of 2 = 50%)
Rep Jeb Bradley (R-1st Dist) BUDGET DEFEATED IN NOV
Rep. Charles Bass (R-2nd Dist) Energy & Commerce DEFEATED IN NOV
Rep.-Elect Paul W. Hodes (D-N.H.)
Replaced Rep. Charlie Bass
2nd DistrictResidence: ConcordBorn: March 21, 1951; Manhattan, N.Y.Religion: JewishFamily: Wife, Peggo Horstmann Hodes; two childrenEducation: Dartmouth College, A.B. 1972 (French & drama); Boston College, J.D. 1978Military Service: NoneCareer: Lawyer; musician; state prosecutorPolitical Highlights: Democratic nominee for U.S. House, 2004
Rep.-Elect Carol Shea-Porter (D—N.H.)
Replaced Rep. Jeb Bradley
1st DistrictResidence: RochesterBorn: December 1952; New York, N.Y.Religion: Roman CatholicFamily: Husband, Gene; two childrenEducation: U. of New Hampshire, B.A. 1975 (social services), M.P.A. 1979Military Service: NoneCareer: Community college instructor; social workerPolitical Highlights: No previous office
Prognosis: Very Liberal
Rep Patrick Kennedy (D- 1st Dist)
Rep. James Langevin (D-2nd Dist)
Senator Lincoln Chafee (R-RI)DEFEATED IN NOV
Sen.-Elect Sheldon Whitehouse (D—R.I.)
Replaced Senator Lincoln Chafee
Residence: ProvidenceBorn: October 20, 1955; Manhattan, N.Y.Religion: EpiscopalianFamily: Wife, Sandra Whitehouse; two childrenEducation: Yale U., B.A. 1978 (architecture); U. of Virginia, J.D. 1982Military Service: NoneCareer: Lawyer; gubernatorial aidePolitical Highlights: R.I. Department of Business Regulation director, 1992-94; U.S. attorney, 1994-98; R.I. attorney general, 1999-2003; sought Democratic nomination for governor, 2002
Rep. Bernard Sanders (I – At Large) WON SENATE RACE
Senator James Jeffords (R-VT) Retired
New Member Profile: Rep.-Elect Peter Welch (D—Vt.)
Replaced Rep. Bernard Sanders
Residence: HartlandBorn: May 2, 1947; Springfield, Mass.Religion: Roman CatholicFamily: Widowed; five childrenEducation: College of the Holy Cross, A.B. 1969 (history); U. of California, Berkeley, J.D., 1973Military Service: NoneCareer: Lawyer; county public defenderPolitical Highlights: Vt. Senate, 1981-89 (minority leader 1983-85; president pro tempore, 1985-89); sought Democratic nomination for U.S. House, 1988; Democratic nominee for governor, 1990; Vt. Senate, 2002-present (president pro tempore, 2003-present)
1. You have chipped away at the benefit over the last three years, and this latest step ensures that people living with disabilities will get little help from Medicare when they need a power wheelchair to remain independent, and out of institutions.
San AntonioTampa, FLKansas City, MOVirginia Beach, VASt. LouisSan FranciscoClevelandDetroitBaltimorePhiladelphiaWashington, D.C.Boston.
Miami Riverside, CAPittsburghCincinnatiHoustonDallasCharlotte NCOrlandoSan Juan, PR Atlanta
Important Note: The actual cities will be selected using 2005 data. This data is not yet published.
Providers who are already accredited by one of the organizations chosen by CMS will be “grandfathered until their next accreditation cycle.Accreditation
On August 1 CMS released CMS 1540-F
This final rule:
Cost and Servicing was utilized in determining the number of beneficiaries that would be affected “post 36 months.”
Utilizing data from the OIG report CMS made the following determinations.
Based on the above data, the final rule establishes the following payments over the next 4 years.
delivery and contents.
36 month rental period a new rental period does not begin.