WASHINGTON - Reps. Jim Langevin, D-R.I., and Glenn Thompson, R-Pa., are circulating a Dear Colleague letter to support the industry's efforts to delay a provision that eliminates the first-month purchase option for standard power wheelchairs Jan. 1.
Stakeholders also expected to have a Dear Colleague letter circulated in the Senate this month.
"This gives us a good opportunity to quantify the level of support in Congress," said Seth Johnson, vice president of government affairs for Pride Mobility Products.
The industry seeks to delay the provision for one year in exchange for a 1% reduction in the consumer price index-urban update (CPI-U).
In addition to members of Congress, the industry's efforts have received support from numerous consumer groups, most recently the American Association of People With Disabilities.
Stakeholders hope this support will carry some weight when they approach members of key committees in the House and Senate about including the delay in one of the Medicare-related bills that are expected to move through Congress before the end of the year.
"We want to make sure we're in the best possible position to catch that train as it moves quickly through in the fall," Johnson said.
If the provision is implemented on Jan. 1, however, there's still a lot the industry still doesn't know. The biggest thing on the minds of providers: If a beneficiary doesn't need his wheelchair after, say, five months into the 13-month capped rental period, and a provider cleans the chair and puts it back out, does a new rental period start?
"That's the way traditional rentals of DME work, and I think that's the best-case scenario," Johnson said. "But there are a lot of unknowns right now. There are a lot of issues--what happens when there is a break in service, what kind of documentation will be required? We don't know."
Read Langevin and Thompson's letter here: http://www.aahomecare.org/associations/3208/files/DelayFirstMonthPurchaseOptionDC083110.pdf?utm_source=Members-Only+Updates&utm_campaign=c8ecd1ec49-Wednesday+in+Washington_Report_9_1_10&utm_medium=email
 

Some independent HME companies say hospitals are being more "aggressive" about referring patients to their own HME companies.
"It's been more intense lately," said Kathy Nichols, vice president of operations at Prestonburg, Ky.-based Cooley Medical Equipment, which competes with hospital-owned HME companies in a handful of its nine territories. "Everyone's trying to drive up their revenue."
From a legal standpoint, there's nothing stopping hospitals from referring patients to their own HME companies, say industry attorneys.
Still, some independent HME providers think it's bad form.
"I've had some of my patients go to a hospital-affiliated doctor for power wheelchairs and the next thing you know the patient's referred to their PT and their HME company," said Steve Bach, president of Springfield, Mo.-based Bach Medical Supply, which competes with two hospital-owned HME companies. "They say it's for continuance of care."
Some independent HME companies say they can't really blame patients, especially those who've never needed equipment before, for going with the flow and using a hospital-owned HME company.
"If you're getting out of the hospital and someone tells you that you need a wheelchair and that you can get it from someone you prefer to do business with or you can get it from the hospital-owned HME company--you have to be realistic," said Jeff Friedman, owner of New Orleans-based Total Health Solutions, which competes with one hospital-owned HME company. "Unless there's a prior relationship with an independent HME company, that company is invisible to the patient."
That's why both Nichols and Friedman ramp up their advertising presences in areas where they compete with hospital-owned HME companies. Friedman even created a handout that he distributes to patients that says: "You have a choice; if you're in the hospital and need services, you have the right to ask for us."
"We do have patients who are loyal to us and want to continue doing business with us," he said.
Hospital-owned HME companies say that they honor patient choice and that the playing field is no different for them.
"My physicians, right now, if I'm not over there marketing like all of the rest of the DME guys, I won't get the business," said Ron Burns, director of the rehab department at Springfield, Mo.-based CoxHealth Home Support Systems, part of CoxHealth. "It's a fight."
 

ELYRIA, Ohio - Dr. Steve Landers of the Cleveland Clinic said something very interesting last week at Invacare's annual Media Day. He called home care "futuristic."
That's not something you hear every day, especially with Medicare and other payers cutting reimbursement right and left, and refusing, for the most part, to recognize the important role home care plays in keeping patients happy, healthy and out of more expensive institutional care.
Landers specializes in home care at the Cleveland Clinic. By futuristic, he means that home care is the future on health care, or at least a key component. It's inevitable that more and more institutional care will transition to the more cost-effective home setting. Remote monitoring, mobile diagnostics and other technology is already paving the way for this, he said.
During his 30-minute talk, Landers also said that "home is integral to one's health and well being" and that "seniors fear nursing homes more than death."
Landers is a good guy for the HME industry to have on its side.
Here are a few more tidbits from Invacare's Media Day:
- During a panel discussion, one of the questions asked was: What's the biggest thing HMEs can do to become more efficient? The unanimous answer: Use technology to do more with less.
- Invacare is not an "altruistic" company," and won't lend money to just any old provider, said Carl Will, senior vice president of Invacare Homecare. Picking the right HMEs to work with will determine a great deal of Invacare's success. The publicly traded company will help providers develop business plans that address competitive bidding and other reimbursement cuts, but it's up to individual providers to execute the plan. Will did not mince words. Executing a new business plan can be "treacherous," but providers have no choice and those that succeed will "reap rewards."
- Don't ignore the Internet. Seniors spend, on average, 45 minutes a day online, and the majority of boomers use search engines to gather healthcare information, said Daniel Lee, Invacare's vice president of marketing. "People are shopping more online and want to know what their choices are," he said. "As needs increase, consumers will speak up more about access issues." 
- Even with reimbursement declining, the industry cannot cut corners, said Lou Slangen, senior vice president of worldwide market development. Manufacturers must make better products and maintain quality and reliability. Providers should consider outsourcing and other strategies to reduce costs and still meet patient needs.
- Mal Mixon, who suffered a mild stroke earlier this year, made a surprise appearance toward the end of the day. He started off by saying: "Hello, everybody, I've been wounded." Mixon has returned to his duties as chairman of the board, and while he's getting stronger every day, he's not sure if or when he'll resume his CEO duties. "I hope to come back, but I'm not sure that I will," he said.