US Senate Approves Budget Bill That Hits Homecare

In a 51 to 50 vote this morning, the US Senate approved the budget reconciliation bill (S. 1932), which contains new policy for capped rental items that the homecare community has fought since the threat first emerged in October. The bill also includes a freeze on the home health payment rate for 2006. As expected, Vice President Dick Cheney returned from an overseas trip to cast the tie-breaking vote to approve the bill. Five Republican Senators voted "no" on the bill along with all Democrats in the Senate. The Republicans voting no were Senators Lincoln Chafee (RI), Susan Collins (ME) Mike DeWine (OH), Gordon Smith (OR), and Olympia Snowe (ME).



Because of several "points of order" raised by Sen. Kent Conrad (D-ND), ranking member of the Senate Budget Committee, the bill will need to be approved again by the House but most likely under procedures that will prevent revisiting the homecare provisions. Reportly, the U.S. House vote may be as early as tomorrow or in early January, after which the bill would go to the President for his signature.



Kay Cox, President and CEO of the American Association for Homecare (AAHomecare), stated, "Due to the close call on this bill, it's clear that these critical healthcare policy issues need to be reconsidered in 2006. In the months ahead, AAHomecare will continue to work with Congress to do all we can to strengthen homecare for our nation's seniors who depend on this critical benefit."



The key provisions that AAHomecare has fought include the following: The bill would transfer title to Medicare patients for capped rental HME items after 13 months, subject oxygen to capped rental with transfer to patients after 36 months, and freeze the home health payment rate for 2006.



"AAHomecare thanks our membership, the state associations, the manufacturers across the U.S., all homecare stakeholders who have worked tirelessly to protect homecare beneficiaries throughout this long legislative challenge," Cox stated. "Many Members of Congress stood up for homecare beneficiaries during this process, and we're very grateful for their efforts."



A summary of key homecare provisions of the final bill is below:



Subtitle B - Provisions Relating to Part B (S. 1932)

(1) Capped rental policy for DME


-- Beneficiary ownership of capped rental DME items begins after the 13th month of rental (for items for which rental begins after January 1, 2006.)


-- Subjects oxygen to capped rental. Beneficiary ownership of oxygen equipment begins after 36th month of rental.


-- Eliminates the service and maintenance fee for capped rental DME.


-- Continues the current law first month purchase option for power wheelchairs.



Subtitle C - Provisions Relating to Parts A and B (S. 1932)

(1) Home health payments


-- Provides a one year freeze in the home health payment rate for 2006.


-- Includes a 5 percent rural add-on for rural home health agencies for 2006.


-- Institutes quality reporting for home health in 2007. Agencies that report will receive the market basket update. Those that do not report will receive market basket minus 2 percentage points.



AAHomecare will continue to track all related issues and alert members about potential actions to influence homecare policy.

For details, see aahomecare.



American Association for Homecare

625 Slaters Lane, Suite 200

Alexandria, VA 22314-1171 703-535-1881

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