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President's Proposed 2009 Medicare Budget Would Weaken Seniors' Access to Durable Medical Equipment and Therapies Required in the Home

ARLINGTON, Va., Feb. 4 /PRNewswire-USNewswire/ -- The American Association for Homecare opposes provisions in the President's proposed 2009 Medicare budget that would weaken the nation's homecare infrastructure, which provides medically prescribed oxygen, wheelchairs, and other durable medical equipment and therapies to millions of older and disabled Americans.

The President's proposal would heap new cuts on the nation's homecare community by requiring reductions to Medicare reimbursements to home oxygen therapy and wheelchairs. These homecare reductions come on top of numerous other cuts and freezes mandated by Congress in recent years.

"Homecare delivers value for every healthcare dollar, and it is clinically effective and preferred by patients and families," stated Tyler J. Wilson, president of the American Association for Homecare. "These proposed cuts show a complete disregard for the nation's homecare safety net. Some of the reimbursement mechanisms in Medicare should be improved so they align better with beneficiaries' needs. However, these proposed cuts do not improve Medicare and would be bad for patients and providers alike."

The durable medical equipment sector represents about 1.7 percent of the $400 billion-plus in total Medicare spending and is the slowest-growing sector in Medicare. There was 3.8 percent growth in durable medical equipment spending from 2005 to 2006 (the latest year for which figures are available), compared to 19 percent growth for the entire Medicare program spending during the same period.

Additionally, according to a December 2007 Harris survey of 1,000 adults, Americans overwhelmingly prefer to receive home-based care over that delivered by nursing homes and other institutions. Moreover, three out of four (74 percent) Americans agree with the statement, "Homecare is part of the solution to the problem of rapidly increasing Medicare spending for America's seniors." That result is consistent across Democratic and Republican party lines and across age groups.

Cuts to Home Oxygen in Medicare Will Impair Access to Life-Sustaining Therapy

The American Association for Homecare has long opposed the proposal that resurfaced again in the President's budget that would force Medicare patients to assume responsibility for owning and managing medical oxygen equipment in their homes after 13 months of rental. Oxygen is a prescription drug regulated by the FDA that requires strict adherence to clinical standards and appropriate monitoring to ensure patient compliance with treatment. Medicare policy does not recognize the cost of services required in providing oxygen therapy, and the Association is concerned that oxygen policy is increasingly at odds with the clinical needs of patients. Service costs for medical oxygen therapy in the home have been shown to exceed the cost of equipment by three to one.

The typical Medicare home oxygen beneficiary is a woman in her seventies who suffers from late-stage chronic obstructive pulmonary disease (COPD) and as a consequence has severe low levels of oxygen in her blood. Approximately 12 million Americans have been diagnosed with COPD and an additional 12 million more remain undiagnosed.

Oxygen therapy works best where there is a continuing, uninterrupted relationship between the oxygen patient and a qualified home oxygen provider. Prior to the Deficit Reduction Act of 2005 (DRA), the home oxygen benefit in Medicare provided for rental as long as the prescribed oxygen therapy was medically required. However, home oxygen has been the target of budget cuts for many years: Congress has reduced Medicare reimbursement for oxygen therapy by nearly 50 percent over the past 10 years. And deep additional cuts, apart from the President's proposal, are scheduled to take effect within the coming year.

Budget Proposal Would Reduce Access to Power Mobility for Disabled Americans

The Association also opposes a provision in the President's budget that would eliminate Medicare beneficiaries' option to purchase a power wheelchair in the first month and thereby establish a forced 13-month rental period. The Association believes that this change would reduce beneficiary access and increase costs to Medicare, requiring durable medical equipment companies to provide financing for a patient's wheelchair. In essence, the providers will become lending institutions for the federal government. Currently, Medicare permits a beneficiary to choose to purchase a power wheelchair when it is prescribed by a physician.

The American Association for Homecare is concerned that if the first-month purchase option is eliminated, access to wheelchairs will decrease since providers will not be able to secure the financing to cover the costs of the power wheelchair over a 13-month period. The Association urges Congress to reject the administration's proposal and maintain the first-month purchase option for power wheelchairs to ensure not only beneficiary access but also cost savings to the Medicare program.

The American Association for Homecare (AAHomecare) represents providers of durable medical equipment and related services and supplies as well as the manufacturers of that equipment. AAHomecare members serve the medical needs of millions of Americans who require home oxygen equipment, wheelchairs and other mobility products, hospital beds, medical supplies, inhalation drug therapy, home infusion, and other medical equipment, products, and services, delivered in the patient's home. AAHomecare's provider members operate more than 3,000 home care locations in all 50 states. See


Michael Reinemer, 703-535-1881;

Walt Gorski, 703-535-1894;

SOURCE American Association for Homecare
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