Home Care Cuts Working Their Way Through Congress

If Congress goes ahead with its health care reformSenate's cuts are slightly less drastic as compared to
package, home care providers will certainly feel thethose in the House bill. But both the ways will spell
heat. After the House and Senate passed theirpayment reductions for providers.
respective reform bills, Congress' ability to send oneMore trouble: The Senate bill contains a separate
approved reform bill to the US president is lookingprovision that could auger bad news for home care
positive.providers.
In order to get the legislation to the president's desk byThe Senate bill, besides out-and-out payment cuts, calls
his State of the Union soon, Democratic lawmakersfor an advisory body similar to the Medicare Payment
are talking about unconventional ways of getting the billAdvisory Commission to set payment levels for
passed.Medicare providers.
While both bills contain tens of billions of dollars in cutsThe Independent Payment Advisory Board (IPAB)
to home health agency and Medicare rates, observerswould be presidentially appointed. NAHC protests that
say that the Senate bill is friendlier to the industry. Thisthe bill would give IPAB too much power to the
time there are no reimbursement changes for 2010Executive branch. Moreover, IPAB would not have
and 1 percent reductions in the inflation update inbroad-based experience provided that it would
2011-2013.comprise only 15 members appointed by the president.
One of the routes to approval that lawmakers areMoreover, unpredictability would reign from year to
thinking about is having the House pass a bill with theyear as IPAB could change rules with little input from
changes made in the Senate version. This is owing toCongress or the public. In the meantime, as the health
the fact that the Senate had a much narrower marginreform package does not presently address durable
of victory for its legislation. After that, the Senatemedical equipment suppliers' main concerns this year -
would approve the House-passed version and it couldcompetitive bidding and oxygen caps - suppliers are
go to the president.rallying support for another bill, H.R 3790.
This could auger well for home care since the