In honor of World COPD Day, VGM, along with participating state associations, will be hosting a web-telethon entitled, Enough is Enough: Shut Down the Switchboard Day on November 14. All providers are urged to join VGM and state associations in rallying citizens to call the U.S. Capitol switchboard. The goal is to get 50,000 calls members of Congress to raise awareness of the HME industry, and urge them to co-sponsor bills HR 1845/S 1428 (the Medicare Durable Medical Equipment Access Act) and HR 621/S 1484 (the Home Oxygen Patient Protection Act). Callers are urged to also tell Congress that further cuts to oxygen and power mobility devices should not be included in any upcoming Medicare reform.

An interactive component will be featured on VGM’s home page (www.vgm.com). Those calling Congress will be urged to enter the number of times a particular member of Congress has been contacted. To assist callers, members of Congress will be listed by state on the Web site. A live commentary will be provided to keep participants fully informed of the day’s activities.

At least 217 co-sponsors are needed for both house bills (HR 1845 and HR 621) and 36 are needed for both Senate bills (S 1428 and S 1484). There has never been a more crucial time to speak out about these issues. Beneficiaries deserve the right to be able to choose their own local, small-business providers.

Summary: H.R. 1845 “Medicare Durable Medical Equipment Access Act of 2007”

Representatives John Tanner (D-TN) and Dave Hobson (R-OH) introduced in the House of Representatives on March 29, 2007, a new version of the “Medicare Durable Medical Equipment Access Act,” which would make significant changes to the Medicare Modernization Act’s provisions on competitive bidding for durable medical equipment. This bill would accomplish the following objectives: (1) Rationalize CMS’ implementation of competitive acquisition for DMEPOS; (2) Ensure beneficiary access to quality items; and (3) Minimize small business closures from competitive acquisition.

1. Quality Standards – Would require CMS to implement quality standards with the competitive bidding program. That is, all winning bidders would have to meet applicable Medicare quality standards. In addition, CMS would have to apply those standards to providers in and out of the bid areas.

2. Exempt Rural Areas – Would prohibit CMS from implementing competitive bidding in rural areas, defined as metropolitan statistical areas (MSAs) with fewer than 500,000 people.

3. Apply FACA to PAOC – Would apply provisions of the Federal Advisory Committee Act (FACA) to the Program Advisory and Oversight Committee (PAOC).

1. Qualified Supplier Participation – Would allow any Medicare part B supplier that meets the quality standards and submits a bid for an item or service (below the current allowable) to provide those items and services at the final bid rate.

2. Restore Due Process – Would allow for administrative or judicial review under the Social Security Act, consistent with generally available appeal rights of affected parties under the Medicare Program. (The MMA eliminated any and all appeal rights of all affected parties.)

3. Define Significant Savings – Would define the term “significant savings” as ten percent, in the context of the provision that allows CMS to exempt items and services "not likely to result in significant savings." Would require CMS to first demonstrate the probability of achieving “significant savings” before a product or product category can be included in the bidding process.

4. Comparability Analysis – Would require CMS first to conduct a comparability analysis before implementing competitive bid rates in non-bid areas, effective January 1, 2009. The analysis must be published in the Federal Register and must include an analysis of the relative costs of providing the items and services in the respective geographic areas, and assess whether application of the bid rate in the non-bid area would adversely impact beneficiary access to quality items and services.

5. Report on Quality and Access Impacts of Initial 10 Sites – After CMS fully implements the initial 10 competitive bidding sites, HHS must conduct a complete analysis of the impact in those geographic areas on beneficiary access to quality products, impact on HME providers and services. That analysis must be completed before CMS could expand the program beyond the initial 10 sites.

6. Congress Must Re-Authorize Competitive Bidding After the Initial 10 Sites: The Secretary can not extend competitive bidding beyond the initial 10 sites or apply bid rates to non-bid areas, unless specifically authorized by Congress.

Summary: H.R. 621 or “The Home Oxygen Patient Protection Act (HOPP Act)”

The Home Oxygen Patient Protection Act (HOPP Act), or H.R. 621 was introduced by physician Congressman Tom Price (R-GA) on January 22nd, 2007. The HOPP Act may help a million oxygen patients to breathe easier by easing the burdens placed on them by the Deficit Reduction Act of 2005 (DRA).

The HOPP Act would amend the Deficit Reduction Act by restoring Medicare treatment of ownership of oxygen equipment to the system that existed before the law was enacted. A provision in the DRA forces home oxygen patients to assume ownership of and responsibility for medical oxygen systems after 36 months of rental in Medicare.

That law effectively severs the patient provider relationship for home oxygen therapy under Medicare, which raises numerous patient safety issues. NEMED, The American Association for Homecare, the American Lung Association, and other patient and provider stakeholders vigorously opposed that change in Medicare policy.

Medical oxygen is a federal legend drug and the devices are prescription only. Transferring the burden of ownership to the beneficiary presents serious risks to patient safety. Moreover, medical oxygen therapy at home costs an average of $7.62 per day in Medicare. A typical inpatient hospital day in Medicare costs $4,603. Oxygen therapy requires more than a piece of equipment. Service costs for medical oxygen therapy in the home exceed the cost of equipment by three to one: 72 percent of the costs required for providing home oxygen therapy are related to services and operation (intake, delivery, maintenance, patient assessment and education, regulatory compliance, and other costs). The equipment represents just 28 percent of the costs of home oxygen therapy.