Medical Device Daily Washington Writers

Sen. Edward Kennedy's (D-Massachusetts) office said last week that the Senate Health, Education, Labor and Pensions Committee will hold a confirmation hearing Thursday for Tom Daschle, President-elect Barack Obama's choice to head the Department of Health and Human Services (HHS).

The committee's hearing on Daschle will take place just two days after the 111th Congress convenes.

Kennedy, chairman of the committee, said Daschle's integrity, intelligence, experience and commitment to the American people have won him friends and admirers on both sides of the aisle.

Obama officially named Daschle as his pick to lead HHS on Dec. 11. However, rumors that the former South Dakota Democratic senator and former Senate majority leader was the president-elect's top choice for the HHS job had been circulating for several weeks prior to the announcement

Although not yet confirmed, Daschle already has been on the road for weeks touting the Obama administration's plans for reforming the nation's healthcare system. The HHS secretary-designate announced earlier in December at a summit in Denver that Obama's transition team would host so-called healthcare community discussions in homes across the nation to solicit recommendations and advice from the public for the president-elect's new health policy team.

The healthcare community discussions were modeled on platform committee meetings that the Obama campaign held throughout the U.S. last summer. Obama said the health forums were "a great way for the American people to have a direct say in our health care reform efforts."

The president-elect's transition team provided moderators and materials for anyone who enlisted on Obama's website to host a meeting. More than 8,500 such community meetings reportedly were planned, with many held over the last two weeks of 2008.

Daschle attended one of the community forums last week at a home in Dublin, Indiana, which hosted about 35 local residents who talked about the difficulties they have had in obtaining health insurance for their families or paying for expensive medications, according to information posted on Obama's transition website.

"When we combine all the stories we heard in this small town of Dublin and multiply that by 300 million people, we can begin to imagine the scope of the problem," Daschle said. The HHS chief-designate said he was hopeful that the country has come together to say, "Enough already. We have to fix this."

Home oxygen industry frets over changes

The home oxygen industry is looking to 2009 with unease due to significant Medicare policy changes that the industry says will present "many challenges to beneficiaries and providers alike."

Two new policies in the form of a 36-month cap on payments for home oxygen therapy and a 9.5% across-the-board payment cut took effect on Jan. 1, "deeply impacting a community that cares for more than 1.5 million elderly and chronically ill patients," said the Council for Quality Respiratory Care (CQRC; Washington).

"The provider community is extremely committed to making every effort to meet patient needs and provide uninterrupted services," said CQRC Chairman Peter Kelly. "However, it is difficult to comprehend how providers can maintain patient service levels on an uncompensated basis. Based on the magnitude of these cuts, the provider community cautions that service reductions may be unavoidable as a result of business failures or financial hardship and cause potential access problems for the vulnerable patient population we care for."

Under the new 36-month cap, Medicare will stop payment for stationary home oxygen therapy equipment and related services after the beneficiary reaches the three-year mark.

CQRC said that, despite the discontinuation of payments after 36 months, providers will still be required to continue all servicing of patient needs and equipment including patient-generated, non-routine emergency home visits and routine replacement of disposable oxygen supplies, such as tubing and masks. Providers also will be responsible for ensuring that patients are appropriately serviced even if the patient moves out of the provider's service area within or following the first 36 months of service.

Historically, CQRC said, the home oxygen benefit has been subject to repeated cuts. The implementation of the 36-month cap, enacted by Congress in the Deficit Reduction Act of 2005, and the 9.5% cut, part of the Medicare Improvements for Patients and Provider Act of 2008, translate to a 27%, or $845 million, cut in 2009 alone.

The CQRC is urging Centers for Medicare & Medicaid Services officials to exercise the Secretary of Health & Human Services' authority to create reasonable post-cap policies, including payments for emergency and non-routine services and reimbursement for disposable supplies after 36 months.

The council asks policymakers to closely monitor the effects of the cuts on both beneficiaries and providers to ensure that patient access to essential home oxygen care is not compromised.