Friday, August 28, 2009

AAHomecare Provides On-Air Rebuttal on C-SPAN to Vladeck’s False DME Statements

During C-SPAN’s “Washington Journal” program this morning, Michael Reinemer, Vice President for Communications and Policy for the American Association for Homecare, provided a rebuttal to Bruce Vladeck’s false statements about durable medical equipment sector. In an email read by the C-SPAN host, Reinemer pointed out that Congress has in fact cut oxygen substantially numerous times -- in 1997, 2003, 2005, and 2008. Separately in an on-air phone comment, Reinemer told C-SPAN viewers about the cuts to home medical equipment rates, the 9 percent cut required to pay for the delay in the bidding program, and the less-than-one percent growth rate in Medicare spending for home medical equipment.

Mr. Vladeck responded that he “misspoke” about cuts to DME and he misspoke about the cuts to oxygen.

To listen to AAHomecare’s rebuttal, visit the following link (around the 1:50 mark):

Thursday, August 27, 2009

Former Medicare Administrator Bruce Vladeck Makes Wildly Inaccurate Statements about Durable Medical Equipment on C-SPAN

Bruce Vladeck, former administrator of the Medicare and Medicaid programs during the Clinton Administration (1993-1997), grossly misrepresented recent Medicare history concerning certain Part B services during a segment on C-SPAN’s “Washington Journal” which aired on August 27, 2009.

Specifically, Vladeck said, “Every administrator of what used to be HCFA, it’s now Centers for Medicare and Medicaid Services, going back to the 1980s has tried to change what Medicare pays for durable medical equipment.… Every single time that the executive branch, under both Republican and Democratic presidents, has tried to change the system to eliminate those ridiculous overpayments, the Congress has prevented it.”

This is patently false. Congress has cut durable medical equipment (DME) payments in Medicare numerous times since Vladeck left his job: It was cut in the Balanced Budget Act of 1997, in the Medicare Modernization Act of 2003 (MMA), in the Deficit Reduction Act of 2005, and in the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). Moreover, Congress has approved competitive bidding for DME in two separate pieces of legislation that were signed into law – MMA in 2003 and MIPPA in 2008. This legislation, in combination, has resulted in reductions in oxygen therapy payments of more than 50 percent since the end of the 1990s when Mr. Vladeck left public office. The cost of treating COPD patients with oxygen therapy at home under Medicare is less than $7 per day.

Commenting about oxygen therapy provided in the homes of beneficiaries, Vladeck said Medicare pays, “$3 billion for air – because that’s all it really is.”

This is an extraordinarily cavalier comment. Medicare pays for medical oxygen and oxygen devices, both of which require prescriptions, as well as certain accompanying services which Mr. Vladeck chooses to ignore completely. Medical oxygen is a highly regulated prescription drug which more than one million Medicare beneficiaries depend on in order to breathe. The Food and Drug Administration, Department of Transportation, Department of Homeland Security, local fire authorities and state licensing boards are just a few of the groups that regulate or provide oversight to the home oxygen sector.

Vladeck also said, “And yet every effort for the last 20 some years to reduce Medicare payments for oxygen has run into a large lobbying campaign from the supplier industry generally organized to frighten beneficiaries to say, you know, if you let this go ahead, Congress is literally going to cut off your air supply. And Congress has stepped in to prevent reductions in oxygen payments every single time.”

This statement also is patently false, and the significant reductions to Medicare oxygen payments cited above are ample proof. The legislation from 2005 and 2008 alone reduced oxygen payments by over $900 million starting this year, bringing the annual total spending down into the low $2 billion range to support over one million frail Medicare beneficiaries at home for less than $7 per day. Vladeck’s description of advocacy efforts by the oxygen provider community is a grotesque distortion of the legitimate concerns that have been expressed not only by oxygen providers but by patient and consumer advocacy groups as well. We find it reprehensible that a former public official should make such reckless and inaccurate statements in a public forum such as C-SPAN.

Wednesday, August 26, 2009

Sunday New York Times Quotes Daschle on Value of Homecare

A front-page article in Sunday’s New York Times featured a quote from the American Association for Homecare’s July 21 roundtable discussion on the role of home medical equipment in healthcare reform. In the Times story, former Senate Majority Leader Tom Daschle is quoted saying, “My mother’s quality of life is a hundred times better given the fact that she can live at home rather than be institutionalized at 86.”

The article, which focuses on Daschle’s relationship with healthcare organizations, was triggered by a meeting last week between Daschle and President Obama. Daschle continues to play a role in the healthcare debate even though he took himself out of consideration to be Secretary of the Department of Health and Human Services earlier this year.

To read the full New York Times article, visit

Friday, August 14, 2009

President Obama Hails Homecare as “Cost-Efficient” Healthcare Solution

During a town hall meeting in late July, President Obama highlighted the role of home-based care in controlling Medicare costs and in keeping older people out of more expensive institutional care.

Discussing proposed Medicare reforms, Obama said, “It is not an exercise in just cutting reimbursement rates, in fact in some cases we may need higher reimbursement rates for certain aspects. I actually think home care ends up being cost-efficient in many cases rather than institutional care, and it helps keep people in their homes.”

The President made the remarks at a healthcare reform town hall meeting in Shaker Heights, Ohio on July 23.

The American Association for Homecare applauds the President’s recognition of homecare as a cost-effective alternative that reduces healthcare costs and allows millions of seniors to live in the comfort of their own homes. We urge Congress to recognize that homecare should be a critical component — not a casualty — of healthcare reform.

Video of the President’s remarks can be found here (at 2:15):

Thursday, August 13, 2009

New Economic Study Exposes Faults in Controversial Medicare Competitive Bidding Program Scheduled to Start this Fall

A new study released this week by Brian O’Roark, PhD, of Robert Morris University, exposes severe flaws in the Medicare competitive bidding program for durable medical equipment and services. The study found that the federal Centers for Medicare and Medicaid Services drastically misread the marketplace and that the current competitive bidding program reduces overall competition and hurts the quality of patient care.

The study analyzed the results for round one of the bidding program, which took place in ten areas nationwide last year. The bid program, which began on July 1, 2008, was delayed by Congress on July 15, 2008 because of serious flaws in the bidding process. O’Roark’s study revealed several shocking flaws in the competitive bidding program:

• During the bidding implementation, nearly 40 percent of companies awarded durable medical equipment contracts for Pittsburgh patients were located outside of Pennsylvania.

• Had the competitive bidding program continued, homecare providers would have had no choice but to cut service, lengthen patient response times and give up providing some equipment altogether. Contracts were also awarded to unlicensed providers, which would have violated state standards.

• Reduced access and declining quality of care under competitive bidding will force patients into institutionalized care. This will lead to higher long-term costs for Medicare—not lower as CMS suggests.

• One group that would benefit from competitive bidding is private insurance firms. Medicare reimbursement rates are the gold standard and the basis for reimbursement by all other forms of health insurance. An artificial lowering of Medicare rates is immediately followed by a lowering of all others. As price schedules fall, insurance firms’ costs fall with them.

Despite the glaring flaws identified in this study, the competitive bidding program is set to go into effect in late October, 2009.

“There is nothing competitive about this misconceived program,” says Tyler J. Wilson, president of the American Association for Homecare. “This study joins an extensive body of evidence showing that this bidding program will produce fewer competitors, fewer homecare services, and lowest-common-denominator healthcare for older Americans and people with disabilities who require medical care at home.”

The full report and summary of findings are at