Senate Approves Amendment to Discontinue Capped Rental Option; Power Wheelchairs Exempt
WASHINGTON--The Senate passed a fiscal 2006 budget reconciliation bill last week that calls for cutting $10 billion from Medicaid and Medicare over five years--and discontinuing the capped rental option for DME.

However, power wheelchairs would be exempt under an amendment from Sens. Rick Santorum, R-Pa., George Voinovich, R-Ohio, and several colleagues, and passed by the Senate late Thursday.

Language in the 2006 budget reconciliation bill calls for eliminating Medicare beneficiaries' choice to continue renting medical equipment in the capped rental category and would require transfer of title to patients for certain DME items after a 13-month rental. The proposal also would have moved beneficiaries' option to purchase power chairs from the first month to the tenth month. Under the Santorum-Voinovich amendment, the first-month purchase option for power wheelchairs was restored.

Industry leaders have opposed the move to discontinue the capped rental option for DME, claiming that it would shift maintenance and repair costs for medical equipment to Medicare beneficiaries (See HomeCare Monday, Oct. 31). Seth Johnson, director of government affairs for Pride Mobility and chair of AAHomecare's Rehab and Assistive Technology Council, pointed out that "the amendment only modifies the power wheelchair-specific language, and does not change the other portions of the capped rental changes impacting other DME items."

Another amendment to the bill by Sen. Jeff Bingaman, D-N.M., would ensure no state receives a cut of more than 0.5 percent of its federal Medicaid matching payments during fiscal 2006.

Next week, the House of Representatives is scheduled to consider its version of the reconciliation bill. After approval of its version, which includes no Medicare provisions, both the Senate and House bills will go to conference to reconcile differences, and a final bill will then be sent to the president for his signature.

CMS Denies FAMES' Request for Emergency Oxygen Waiver
ORLANDO, Fla.--In the aftermath of Hurricane Wilma, CMS has denied a request by the Florida Association of Medical Equipment Services to allow HME companies to provide emergency oxygen to Medicare beneficiaries without a prescription.

According to FAMES, CMS told the organization that it "is not blanketly extending hurricane waivers as we did for Katrina to Wilma-affected areas," and that providers should contact their regional office to report problems, which will be dealt with on an individual basis.

"FAMES is very concerned that the estimated 824,488 people in the East Coast hurricane zone who are eligible to be participating in the Medicare program will not receive timely or effective assistance if cases are being handled on an 'individual basis,'" the state association said last week.

"We're still pursuing CMS trying to get them to change their minds," said Heather Allan, the association's executive director. "This was a Category 3 hurricane that hit, and the counties at the south end of the peninsula took a beating. We're not sure that everyone understands how bad it was, because the aftermath of Wilma has not received much news coverage.

"When you look at the population of people in those areas that were affected--Broward, Dade, Monroe and Palm Beach counties--we question whether it is feasible for the regional office of CMS to attempt to handle those claims on a case-by-case basis," she said.

"I am greatly disappointed with CMS' lack of consideration regarding the victims of Wilma," said FAMES President Raul Lopez, director of operations for Bayshore Dura Medical, Miami. "I feel that CMS should re-evaluate the situation and take into consideration the fact that approximately 25 percent of Wilma victims are eligible for Medicare benefits.

"I believe that CMS has not realized the scope of the disaster that has affected South Florida," continued Lopez, who took over as association president in September. "CMS needs to realize that there are almost 900,000 Medicare-eligible recipients that have possibly suffered disruption of services due to the number of DME providers that were also affected by Wilma, many of whom are still not 100 percent operational."

FAMES is asking all of its members to contact their legislators about the issue. For more information, contact the FAMES office at (407) 895-5573 or via e-mail at info@famesonline.org.

Provider News
Walgreens To Acquire Home Pharmacy of California
DEERFIELD, Ill.--Walgreens Home Care announced last week that it will purchase Home Pharmacy of California. The nearly 20-year-old company, which operates pharmacies in Burbank, Corona and Ventura, provides home infusion, hospice and nutrition therapies, as well as specialty pharmacy services. The acquisition is expected to close later this year, pending regulatory approval.

"We are excited to make this announcement because of the new opportunities it creates to expand our services to the California marketplace," said Ron Allen, Walgreens vice president of home care services.

Walgreens Home Care, a division of Walgreens Health Initiatives, operates more than 40 branches in Arizona, Florida, Illinois, Indiana, New Mexico, Oklahoma, Texas and Wisconsin. WHI is a subsidiary of Walgreen Co., with fiscal 2005 sales of $42.2 billion and more than 5,000 stores in 45 states and Puerto Rico.

Manufacturer News
Access Point Medical Purchases Rights to Bruno Scooters, Power Chairs
ST. LOUIS--Access Point Medical has purchased Bruno Independent Aids' scooter and power wheelchair product lines.

The transaction includes Bruno's Cub and SuperCub line of scooters, Bruno power wheelchairs and the transfer of intellectual property, regulatory approvals and engineering designs for the products. The equipment will be manufactured at APM facilities in China, and will be marketed with the APM brand.

"This purchase fulfills our commitment of offering power-mobility equipment by the end of 2005," said APM's CEO Hans Stover. "We're putting our belief into action--that providers shouldn't have to compromise on product quality in order to lower their acquisition costs."

In June, Oconomowoc, Wis.-based Bruno announced it would no longer make scooters and power chairs, citing low margins and competition to its American-made products from equipment produced overseas, and instead would focus on the vehicle lift and stair lift markets.

APM, which is headed by three veteran home care executives including Stover, Tom O'Donnell and Jerry Jones, a former Apria Healthcare CEO, set up shop in June. The company offers ambulatory, bath safety and mobility products and plans to introduce respiratory equipment by the end of the year.

eHealth In Brief
Most U.S. consumers support Internet based health records--as long as their privacy is protected, according to a new survey. The majority of the 800 Americans polled for the survey--72 percent--said they favored electronic health records. However, most want to be able to control who can access that information and when it can be shared. Also, 70 percent of those polled said employers should not have access to the records. Individuals of all ages, income levels, education and political affiliations consistently supported the online health records, according to the Markle Foundation, a technology advocacy group.

The HHS Office of the National Coordinator (ONC) for Health Information Technology is partnering with the George Washington University and Massachusetts General Hospital/Harvard Institute for Health Policy to measure the state of electronic health records adoption and determine the effectiveness of policies aimed at its acceleration. ONC said it will convene an expert consensus panel to study and develop guidelines for EHRs. HHS said the panel's first report will be published in the fall of 2006.

Two recent reports by the American Health Information Management Association concluded that health IT can help combat health care fraud. The reports, developed under contract to the HHS ONC, provide 10 recommendations for preventing fraud in the National Health Information Network, among them developing unified standards and using advanced analytics software. The ONC's goal is to implement President Bush's vision for widespread adoption of interoperable EHRs within 10 years.

The federal Commission on Systemic Interoperability has recommended that the government should develop a nationwide authentication standard for patients to protect personal health information and also offer financial incentives to providers to spur the electronic exchange of health care information. In its report, the commission, authorized by the Medicare Modernization Act and established by HHS, groups its recommendations into categories including adoption of technology, interoperability (the technical ability of different institutions to access the same electronic records) and connectivity among doctors, hospitals, clinics and patients.

Reps. Nancy Johnson, R-Conn., chair of the House Ways and Means Health Subcommittee, and Nathan Deal, R-Ga., chair of the Commerce Health Subcommittee, have introduced a bill that could allow HHS to develop a standardized system for health information privacy and security. In the proposed legislation (H.R. 4157), HHS would have 18 months to determine whether state and federal privacy laws need to be standardized for medical data transactions. If the agency found that such standards were necessary, Congress would be given three years to develop them, or HHS would have the authority to create a unified standards system. The bill would also allow hospitals and other providers to give physicians health IT software and hardware.

Last week, CMS issued a final rule for the electronic prescribing of drugs under Medicare's new Part D. Scheduled to go into effect Jan. 1, 2006, when the Medicare drug benefit begins, the rule is the first step in the adoption of final uniform standards. CMS will require providers who electronically prescribe or dispense Part D covered drugs to comply with the standards. CMS Administrator Mark McClellan said the new standards for e-prescribing will improve drug safety and reduce costs.

CMS Meetings and Forums
CMS will hold an E-Prescribing and Electronic Health Records--Anti-Kickback and Physician Self-Referral Proposals Open Door Forum Wednesday from 2 p.m. to? 4:30 p.m. EST. To participate, call (800) 837-1935 and reference conference ID 1567530.

CMS will hold a Pharmaceuticals, Pharmacy and Device Manufacturers Open Door Forum Nov. 15 from 2 p.m. to 3:30 p.m. EST.

CMS will hold a Home Health, Hospice and DME Open Door Forum Nov. 17 from 2 p.m. to 3 p.m. EST.

For more information and for conference ID numbers, which have yet to be released, visit www.cms.hhs.gov/opendoor/schedule.asp.