For more industry news, features and highlights from our latest issue, please visit our Web site at www.homecaremag.com.

Headline News
Medtrade Spring Sees Strong Turnout, Continued Calls for Action
LAS VEGAS--The storm clouds that hovered above the Las Vegas Convention Center for much of last week at Medtrade Spring may have seemed a fitting symbol of the HME industry's current climate.

But neither the inclement weather nor the turbulence created by recent legislative setbacks kept providers from making a strong showing at the trade show, held March 21-23.

With every seat taken, providers lined the walls Wednesday at the American Association for Homecare's "Washington Update" as association Chair Tom Ryan took the opportunity to deliver a rallying call.

"We're in the battle of our lives, ladies and gentlemen," Ryan said. "The battle's going to get tougher, and without your support we're not going to win it."

In an industry still reeling from the passage of the Deficit Reduction Act--which caps Medicare rental of oxygen equipment at 36 months and rentals of most other DME at 13 months--the specter of competitive bidding still looms on the horizon.

But reminding providers that the DRA was passed by the narrowest of margins, Ryan praised them for their efforts in fighting the legislation and stressed the importance of patient involvement in that and future campaigns.

"We got the patients involved, finally," Ryan said. "And because we got the patients involved, what happened up on the Hill? We finally were heard."

Ryan urged providers to help obtain co-sponsors for the Hobson-Tanner bill (H.R. 3559), which makes changes to the Medicare Modernization Act's competitive bidding provision to ease some of its effects and ensure beneficiary access under the program.

"We need at least 200 [co-sponsors], but we're getting there. And we'll get there ... but we can't do it without the help of people in this room," Ryan said.

Ryan also said AAHomecare is working with two executive search firms to replace former CEO Kay Cox, who stepped down last month. The association hopes to have a new CEO in place by June.

Declaring his personal commitment to the home care industry, Ryan mentioned his 30 years of involvement in HME and said, "I'll be damned before I continue if I'm going to see this turn into a commodity industry. Not on my watch."

Updating providers about current developments on Capitol Hill, Asela Cuervo, who represents AAHomecare on the CMS Program Advisory and Oversight Committee for competitive bidding, said the fact that CMS was taking so long to deliver a notice of proposed rulemaking spoke to the initiative's complexity.

"We can't rush to implementation at this point," Cuervo said, later adding, "Let's not try to rush things at the end just to meet an arbitrary deadline that Congress set for 2007.'"

Cuervo said although CMS is expected to release the competitive bidding rule at the end of this month, it could be delayed longer. She also said HME provider quality standards are expected later this spring.

Acknowledging lawsuits that have been filed regarding the legality of the DRA (see "Consumer Group Challenges Constitutionality of DRA"), Cuervo said, "Be that as it may, the president has signed the law, and until a court invalidates that law we all proceed as it is in place, and I think that is the way we need to move forward."

At AAHomecare's session, some attendees expressed frustration with previous lobbying efforts. Responding to audience comments about lackluster turnout on Capitol Hill, Ryan said, "I agree. Every year this association has a fly-in, and why don't we have thousands of people there? I don't know. Go out on the floor and ask yourselves."

Medtrade/AAHomecare's 2006 Reimbursement Conference on Tuesday was also sold out with 250 attendees. And close to 400 packed the conference room for "Update on Mandatory Accreditation and Q&A with the Big Three," which featured representatives from the Accreditation Commission for Health Care (ACHC), the Community Health Accreditation Program (CHAP) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).

In all, VNU's Art Ellis, Medtrade director, said the show's educational conference attendance was up by 20 percent over last year's.

Consumer Group Challenges Constitutionality of DRA
WASHINGTON--A consumer-rights organization has filed a lawsuit that claims the Deficit Reduction Act is unconstitutional because the House of Representatives did not approve the version signed by President Bush.

Public Citizen, a consumer watchdog group founded by Ralph Nader, filed the suit last week in the U.S. District Court for the District of Columbia.

"The Congress and the president have to be brought to account for their rogue actions in moving to enact this very controversial legislation without complying with the Constitution," said Joan Claybrook, president of Public Citizen. "This time, they will have to answer for their actions."

The DRA cuts spending for Medicare, Medicaid and other mandatory programs by $38.8 billion over five years. Of greatest concern to the HME industry is a provision that caps Medicare rental of oxygen equipment at 36 months. Another provision caps other DME items, such as hospital beds and wheelchairs, at 13 months (see HomeCare Monday, Jan. 9).

As the legislation was passed back and forth between the House and Senate last year, a typo involving the DME rental cap was inserted into the House version. The Senate passed a version of the bill without the typo, which was then sent to the president.

"Today's lawsuit simply requests the court to uphold the Constitution," said Adina Rosenbaum, a Public Citizen attorney. "The entire law is invalid because the law the House passed is different from the law the Senate passed and the president signed."

The suit is the second that has been filed since Bush signed the DRA into law on Feb. 8.

Jim Zeigler, an Alabama attorney who specializes in Medicaid cases, filed a suit last month challenging the bill's constitutionality.

"I expect dozens of lawsuits against the DRA, because its constitutional flaw is clear and obvious," Zeigler said in response to the Public Citizen suit. "Millions of citizens and thousands of businesses are adversely affected by the DRA."

He also said he expects senior citizens dependent on oxygen to join the suits soon as plaintiffs. "They are clearly affected," he said. "Under the old law, they could receive Medicare oxygen for life. Under the new law, they are literally cut off ...."

To view the lawsuit, click here.

To read Zeigler's complaint, visit www.jimzeigler.com.

Hobson-Tanner Co-Sponsor Count Climbs
LAS VEGAS--The industry's hard push on H.R. 3559, also known as the Hobson-Tanner bill, continues.

"We are now up to 92 co-sponsors, and we have gotten another six verbal commitments, so that should bring the total to 98," said Pride Mobility's Wayne Grau, who is leading a nationwide effort to boost support for the measure. "We need about 100 to 105 co-sponsors in order to have the Senate write a companion bill," Grau said, adding that "we hope to get that process started in about two weeks."

Grau said anger from HME providers over the recently passed Deficit Reduction Act, which contains a 36-month rental cap on home oxygen equipment, has fueled grassroots interest in H.R. 3559. Since passage of the DRA, Grau said, "we're seeing more and more dealers getting involved--and that's what needs to happen."

Grau has been traveling the country to educate lawmakers about the Hobson-Tanner bill, which would soften the blow of DME competitive bidding. "We've held 170 meetings in 30 states, and by mid-April we will have 300 meetings done," he said.

When he meets with congressional representatives on a district level, Grau explained, "most say they have never met with anyone from the DME industry ... and they have absolutely no idea what we do, so we really have to go in and show them what we do and how we help patients and how we save the government money."

The meetings are having positive results, Grau said, especially when he is accompanied by local providers. The lawmakers "want to know how [competitive bidding] is going to hurt their constituents and hurt the patients in their district, and they want to hear from local businesses on how it is going to hurt them. It really gets the point across that it's not just one person that's unhappy about this--it's the whole industry," Grau said.

One of the most important things providers can do, he continued, is to educate their own member of Congress about H.R. 3559. "We're eventually going to need 200 co-signers for the House bill and at least 51 co-signers for the companion bill in the Senate" to have a chance at passage, he said.

"We're working closely with [the American Association for Homecare] to do the follow-up on these meetings, and with this two-pronged approach, we've really been able to see the number of co-sponsors rise," he said.

The text of H.R. 3559 is available at http://thomas.loc.gov.

For a list of current co-sponsors, visit www.aahomecare.org.

For more information on meetings with legislators, contact Wayne Grau at (603) 438-9169 or e-mail wgrau@pridemobility.com.

Rehab Carve-Out Introduced in Congress
WASHINGTON--Legislation that would carve out rehab and assistive technology from competitive bidding has been introduced in the House of Representatives.

Rep. Ron Lewis, R-Ky., recently introduced H.R. 4994, which would exclude complex rehabilitation and assistive technology products from Medicare's national competitive bidding program for DME. Bidding begins in 10 yet-to-be-announced metropolitan areas next year.

The legislation defines complex rehab and assistive technology products as medically necessary adaptive seating, positioning and mobility devices and speech-generating devices that are evaluated, fitted, configured, adjusted or programmed to meet the specific needs of an individual with a primary diagnosis resulting from injury or trauma, or which is neuromuscular in nature. According to the legislation, medical necessity must take into account the diagnosis, prognosis and functional need of the individual and the expected progression of the disease or disability involved.

"This legislation will be of great benefit for people with disabilities in ensuring that they will continue to have access to the medical equipment they need and the level of service required," said Rita Hostak, president of the National Coalition for Assistive and Rehab Technology. "We are excited and gratified that there is recognition of the unique needs that are addressed by rehab and assistive technology and that it deserves special consideration in the national competitive acquisition program."

To support the proposed legislation, NCART has rescheduled its second annual legislative fly-in for May 22-23. The two-day program will include the group's Rehab Technology Fair, featuring product demonstrations and displays to educate members of Congress and their aides about rehab equipment. Hill visits will be held Tuesday, May 23.

For more information on NCART or to register for the fly-in, visit www.ncart.us.

Last Chance for Patient Choice: Get on the Bus
LAS VEGAS--After its January protest outside Rep. Bill Thomas' office in Bakersfield, Calif., Last Chance for Patient Choice is planning another rally, this time in Washington, D.C.--and this time much bigger.

"We hope to get about 300 to 800 beneficiaries from the Greater D.C. area--Maryland, Virginia and the New England states--and bring them in so that they have a chance to state their case," said LCPC's John Gallagher, vice president of government relations. Formed by The VGM Group, Waterloo, Iowa, LCPC is a non-profit organization that plans to file a federal lawsuit against DME competitive bidding provisions in the Medicare Modernization Act as soon as CMS announces the 10 cities where it plans to start the program.

As a leading proponent of competitive bidding--and the author of language in the Deficit Reduction Act that caps oxygen reimbursement at 36 months and transfers equipment ownership to the beneficiary--Thomas was the target of an LCPC rally on Jan. 24. With 50 marchers, the protest garnered national media attention, including coverage by NBC and ABC, and was combined with TV ads (which ran 384 times during a 10-day period) and newspaper inserts.

Now the group is gearing up for a rally in Washington to focus Congress' attention on "the onerous HME provisions of the MMA" and "the draconian oxygen cap," according to a flier.

"The [National Park Service] has given us approval to hold a rally on May 24 in Washington," said Gallagher. "The area we chose is right in back of the Capitol steps near the reflecting pond. More importantly, it's right across the street from [the Department of Health and Human Services].

"We want the secretary to be able to look out of his window and see these beneficiaries out there and understand that it's about the service that these patients receive and the fact that they are talking about taking away patient choice. They are talking about a cost shift in Medicare and Medicaid, and we're trying to educate the members of Congress about that.

"We're trying to get as many buses as we can coordinate," Gallagher continued. "We'll have first aid stations and air stations there for them, so everything will be set up for the beneficiaries."

For more information on Last Chance for Patient Choice, visit www.lastchanceforpatients.org or call (800) 642-6065.

CMS Expands O2 Coverage
BALTIMORE--CMS will expand Medicare home oxygen coverage criteria for beneficiaries enrolled in a CMS-approved clinical trial.

Under a final national coverage determination released last week, home oxygen will be covered for beneficiaries with arterial oxygen partial pressure measurements from 56 to 65 mmHg or oxygen saturation at or above 89 percent. These beneficiaries must be participants in a clinical trial sponsored by the National Heart, Lung & Blood Institute.

"This is an important opportunity to improve the care of our seniors, and to get better evidence on how doctors and patients can achieve the best outcomes for this serious and hard to treat condition," said CMS Administrator Mark McClellan.

Medicare currently provides coverage for home oxygen for beneficiaries with partial pressure measurements at or below 55 mmHg or oxygen saturation at or below 88 percent. If certain other diseases/conditions are present, coverage is provided for patients with an oxygen partial pressure of 56 to 60 mmHg or an oxygen saturation of 89 percent.

To view the decision memo, click here.

The list of covered clinical trials will be available at www.cms.hhs.gov/center/coverage.

CMS Announces HCPCS Meeting Dates
BALTIMORE--CMS is planning several public meetings this year on the 2006 Healthcare Common Procedure Coding System. The meetings, which will be held at CMS headquarters in Baltimore, provide a forum for those interested to make oral presentations or submit written comments in response to preliminary HCPCS coding and payment determinations.

The following meeting dates were announced last week:
--DME and accessories, April 25
--orthotics and prosthetics, April 26 and April 27
--supplies and other, May 4 and May 5

Draft agendas will be posted on the HCPCS Web site at least one month before each meeting.

To register, or for more information, click here.

Obituary
Bruno Founder Michael R. Bruno Dies
OCONOMOWOC, Wis.--Michael R. Bruno, founder and chairman of the lift company that bears his name, died last week after a long fight with cancer.

Bruno, 69, fulfilled his dream of owning his own business in 1984 when he launched Bruno Independent Living Aids. The company, which manufactures vehicle lifts, turning automotive seating and stairlifts, now has approximately 300 employees. In 2002, he expanded the business internationally by acquiring Autoadapt in Sweden.

In 1993, Bruno was named Wisconsin Entrepreneur of the Year. He also received five Metro Milwaukee Future Fifty awards, two Wisconsin Manufacturer of the Year Awards and several Governor's New Product Awards.

Although Bruno never continued formal education beyond high school, he was a strong supporter of education. He and his wife founded the Michael and Beverly Bruno Foundation in 2004, which awards five college scholarships each year to children of Bruno employees.

"It's a great loss for our family," said Bruno's eldest son, Michael R. Bruno II, president and CEO of the company. "My father was truly passionate about the mobility and accessibility industries and spent most of his life developing and selling innovative products to improve people's abilities to live independently."

To revisit this news any time during the week, go to www.homecaremonday.com.