Shifting the responsibility for maintaining complex medical equipment from the provider to the elderly or disabled Medicare beneficiary is unfair and potentially dangerous. Patients would need to learn when equipment requires servicing or repairs and assume the responsibility for scheduling repairs and making alternative arrangements for equipment needs if the repair or service requirements are extensive.
KEY MESSAGE
We strongly oppose the drastic policy changes for home medical equipment and the shift of oxygen equipment to a rent-to-own payment method. We are asking Representatives to vote "NO" on the budget bill.
Oxygen is a federal legend drug and the devices prescription only. Transferring the burden of maintenance and repair of sophisticated oxygen technologies to the patient and therefore the management of their home oxygen therapy presents a serious risk to patient safety and care. This will produce the undesired effect of unmonitored and regulated dispensing and distribution of the prescription item.
The only available action that will protect homecare beneficiaries and preserve the nation's robust and critical homecare infrastructure is to ask the U.S. House of Representatives to vote "NO" on the budget bill.
Here is a summary of key provisions:
Subtitle B - Provisions Relating to Part B (S. 1932)
- Capped rental policy for DME
- Beneficiary ownership of capped rental DME items begins after the 13th month of rental (for items for which rental begins after January 1, 2006.)
- Subjects oxygen to capped rental. Beneficiary ownership of oxygen equipment begins after 36th month of rental.
- Eliminates the service and maintenance fee for capped rental DME.
- Continues the current law first month purchase option for power wheelchairs.
Additional talking points:
A Huge Disruption for Seniors
The bill requires transfer of title to Medicare patients for certain durable medical equipment (DME) items, such as hospital beds, after a rental period. Shifting the responsibility for maintaining complex medical equipment from the provider to the elderly or disabled Medicare beneficiary is unfair and potentially dangerous, especially for equipment used for oxygen therapy. Patients would need to learn when equipment requires servicing or repairs and assume the responsibility for scheduling repairs and making alternative arrangements for equipment needs if the repair or service requirements are extensive.
If the medical equipment is purchased, the Medicare patient incurs additional fees for emergency support or to exchange malfunctioning equipment. As equipment becomes obsolete, replacement parts may no longer be manufactured, so repairs become more difficult. Under the current regulations, providers are required to service what they are renting. There is no requirement to service what they sell.
Medicare Beneficiaries Prefer Option of Renting
Home medical equipment providers are currently required to notify patients about the option to rent or purchase durable medical equipment in the capped-rental category, but the vast majority of Medicare beneficiaries prefer the rental option. Under the current capped-rental payment rules, the equipment provider must provide ongoing repairs, adjustments, preventive maintenance, and pick-up and delivery of equipment requiring repair. But the budget bill would shift this responsibility to the beneficiary. Most repairs are not conducted in the patient's home. Equipment is exchanged and brought back to the provider for repair. The budget bill would add an extra burden for Medicare patients, especially those in hard-to-service rural areas and those with large or complex items such as hospital beds.
Home Medical Equipment Reimbursement Has Already Been Cut
Reimbursement cuts for the majority of capped rental DME items have already occurred under the FEHB cuts that took effect at the beginning of 2005.
Current medical literature documents that homecare is by far the most cost-effective setting for healthcare in the United States. However, Congress has reduced homecare payments repeatedly including the FEHB-related cuts earlier this year mandated by the Medicare Modernization Act of 2003 and additional cuts from the 2007 implementation of "competitive acquisition" (aka restrictive contracting) also required by MMA).
H.R. 3559 Update |
