H.R. 1845 and its Senate companion, S. 1428: The Durable Medical Equipment Access Act seeks, among other things, to ensure beneficiary access to quality items under CMS' competitive bidding project and to protect home care providers, particularly small businesses.
The bills would:
- Exempt smaller, rural areas (MSAs with populations under 500,000);
- Allow all qualified providers to participate at the selected award price (the House and Senate versions of the bill define "qualified" provider differently);
- Restore the due process rights of providers to administrative and judicial review; and
- Exempt items and services unless CMS can demonstrate savings of at least 10 percent.
The House version of this bill, known as the Tanner-Hobson bill, also calls for Congress to reauthorize competitive bidding after completing its rollout in the first 10 bidding areas before it can be implemented elsewhere. In other words, Congress would specifically have to pass a law for it to continue.
With 109 cosponsors, the bill has been referred to the House Subcommittee on Health. Its Senate companion, known as the Hatch-Conrad bill, has 12 cosponsors and has been referred to the Senate Finance Committee.
--H.R. 2231: The Medicare Access to Complex Rehabilitation and Assistive Technology Act would exempt complex rehab and assistive technology from competitive bidding on the basis that it is highly individualized, would not result in significant savings for Medicare and beneficiary access would likely be compromised. Consistent with H.R. 1845, this bill recognizes that competitive bidding would have negative impacts on consumers by limiting their choice of provider and limiting access to high-quality products and services.
So far, H.R. 2231 has garnered 18 cosponsors. It has been referred to the House Subcommittee on Health.
--H.R. 621 and its Senate companion, S. 1484: The Home Oxygen Patient Protection Act would amend provisions in the Deficit Reduction Act to eliminate the 36-month oxygen rental cap and restore ownership of equipment to home oxygen providers. The DRA, which moved Medicare home oxygen from continuous rental to a rent-to-purchase model, requires beneficiaries to assume ownership of equipment after 36 months of rental.
"Under the Deficit Reduction Act of 2005, Congress merely considered the economic issues of home oxygen therapy, and not the clinical aspects. This legislation to repeal this provision of the DRA is in the best interest of patients, the medical community and Medicare," said Rep. Tom Price, R-Ga., a physician who introduced the House bill. "Home oxygen therapy provides an essential benefit to our seniors. Medical oxygen is complex and highly regulated, and requiring Medicare beneficiaries to own this equipment for their therapy raises numerous health and safety concerns."
Cosponsors for H.R. 621 currently number 112; the bill has been referred to the Subcommittee on Health. The Senate bill has five cosponsors and has been referred to the Senate Finance Committee.
--H.R. 2567 and its Senate companion, S. 870: The Home Infusion Therapy Medicare Coverage Act would amend the Social Security Act to extend coverage for home infusion services to Medicare beneficiaries, a benefit currently available to most patients in the private sector. This measure would require infusion supplies, equipment and professional services to be covered under Part B, with drugs covered under Part D.
When Congress passed the Medicare Modernization Act in 2003, lawmakers added coverage for home infusion drugs. But according to advocacy groups, CMS interpreted the law to cover only the drugs and not the services and supplies associated with home infusion.
The House bill has 28 cosponsors and has been referred to the Subcommittee on Health. Its Senate companion bill has been referred to the Senate Finance Committee.
--H.R. 1809: The Medicare Independent Living Act of 2007 would eliminate Medicare's "in the home" restriction for coverage of mobility devices for individuals with expected long-term needs.
Its authors, Reps. Jim Langevin, D-R.I., and Jim Ramstad, R-Minn., said the bill would improve community access for beneficiaries with mobility impairments by removing a restriction that bases coverage of mobility devices solely on an individual's mobility needs inside the home.
According to Langevin, the "in the home" statutory language was originally meant to define durable medical equipment as devices that were provided outside of a hospital or skilled nursing facility and, therefore, warranted separate reimbursement under Medicare Part B rather than Part A. However, Langevin said, over time Medicare "has chosen to interpret this language in a way that restricts coverage of mobility devices to only those that are reasonable and necessary in the individual's home."
The bill has bipartisan backing from 29 cosponsors and has been referred to the Subcommittee on Health. |
