Press Releases
WASHINGTON, DC – U.S. Senator Pat Roberts (R-KS) today delivered the following remarks to the American Association of Homecare:
“We have a group of Kansans here today and I would like to recognize them: Velma Goertzen, JD Rein, Gerald Sloan, and Adrian Knight. Velma is not going to like this, but I am going to put her on the spot. Many years ago when I actually had hair and was a member of the House, Velma invited me to her home health shop in Hutchinson, Kansas.
“It was one of my first health care visits as the 1st District Congressman nearly 30 years ago, and it had such a dramatic impact on me and made me a true believer in the importance of home health care.
“Velma took me on one of her visits to an elderly patient and it was when Velma was earnestly listening to the patient, asking how she was feeling, and spent as much time with the patient as the patient needed, that the light bulb came on and I realized how valuable the personal touch of the home health industry is for a senior.
“This is especially true for a senior who may live alone or out in the country miles away from a local hospital or doctor’s office. The local home health provider is the only provider in the health care delivery system that is going to a patient’s home and checking in to make sure he or she is doing ok. And, I know that a family must take great comfort in knowing that if they can’t be there, the local home health provider is there caring for their mother, father, grandmother, grandfather, sister, or brother.
“However, all of you here today know that your industry is under attack. We have a perfect storm brewing. Home oxygen patients and providers are about to undergo tremendous change in the next several months due to the implementation of the competitive bidding program - which we all know has created confusion and exasperation among home health providers.
“Next January will also bring the end of certain monthly oxygen provider payments, and the transfer of equipment ownership to thousands of seniors.
“More disturbing is that the administration and some in Congress don’t feel that these massive changes are enough! They are coming after your industry again by proposing drastic cuts to home oxygen, nationwide rollout of the competitive bidding program, and possible freezes of your annual Medicare payments!
“Well, I am here to tell you that I am doing everything I can to make sure this doesn’t happen. I am using my position on the Senate Finance Committee and as co-chair of the Senate Rural Health Caucus to tell my Senate colleagues to stop, listen and understand what is happening to your industry before moving forward with further unnecessary cuts.
“On the competitive bidding front, I am glad your industry is pushing Secretary Leavitt to suspend the start of the program until a number of questions can be answered. I share your same concerns about the impact this program might have on forcing hundreds or thousands of home health providers out of Medicare, thereby ultimately hurting the very patients you are meant to serve.
“You have great ammunition with the publication of two recent reports that show competitive bidding is really not competitive at all. In fact the studies show what all of us fear in that competitive bidding will produce severe job loss in the home care industry, will drive prices up for some consumers, will lead to patient access problems and a decrease in the quality of care. It clearly seems to me that Congress needs to take a serious look at this program, and I stand ready to lend a helping hand to these efforts.
“I am also doing my part through the legislative process on the Finance Committee. I have been pushing Chairman Baucus and Ranking Member Grassley to include language which your industry supports to require CMS to determine the impact of the program on round 1 and the initial 10 MSA’s before CMS can implement round 2. Now that seems like a commonsense idea, doesn’t it? Actually studying the impact of a program before hastily expanding it?
“I am also pushing for stronger protections for our small suppliers, exemptions for our rural areas from the program entirely, and appeal rights for suppliers if their bids are rejected. I also want to require CMS to actually show that the competitive bidding program actually produces savings of at least 10% before it can be implemented. All of these provisions come straight from the Medicare Durable Medical Equipment Access Act - which I introduced with Senators Conrad and Hatch last year.
“On the home oxygen front, I joined forces with Sen. Blanche Lincoln and several of my colleagues last week to send a letter to the Budget Committee urging the committee to reject any cuts to home oxygen in the budget resolution. I am also working with my colleagues on the Finance Committee to reject any cuts to home oxygen as a way to pay for a Medicare physician fix.
“Just two weeks ago, I was in Garnett, Kansas at a town hall meeting. After the meeting, the local home health provider came up to me and told me that he and his wife are considering throwing in the towel and selling their business. They are already operating on razor thin margins and fear that Congress will approve even greater home oxygen cuts, which would devastate their business. This leaves them with little to no choice.
“Unfortunately, seniors in Garnett don’t have the luxury of choosing from a variety of home health providers to get their home oxygen equipment or oxygen contents. This means that if he has to close up shop, seniors in Garnett will be left holding the title to their oxygen tanks, but no one to actually fill up their tanks so they can breathe. I call this the “blue-grey” syndrome. First the senior goes blue and then they go grey.
“Joking aside, I have serious concerns that under the banner of “cost containment” we are rationing health care.
“More concerning is that we are driving health providers out of the Medicare program. Sure, we can easily save some money by cutting oxygen payments or freezing annual payments, but we will be left with no providers willing or able to participate in the Medicare program - and what does that do for our seniors?
“On that note, I know all of you probably want to know what is going to happen with a possible Medicare package this year. As you know, in December Congress approved a short-term Medicare package to hold off the Medicare physician payment cuts until June 30 of this year. This means that the clock is ticking to get something done before June.
“It is my hope we’ll be able to come together and work in a bipartisan fashion to approve a Medicare package that makes some good improvements to the Medicare program, including needed changes to the competitive bidding program. However, we all have heard the rumors that House and Senate leadership would like to use the reconciliation process to get a Medicare package approved.
“I think this is very disappointing. I hope clearer heads prevail and my friends on the other side of the aisle won’t turn the Medicare legislation into a political stunt. Nothing good comes out of such a process.
“And pleased be assured that I am not going to stand by and let your industry be used as the bank to pay for other providers in the Medicare program. That’s just not right. I will also be encouraging my colleagues to join with me and do the same. This is why I need all of your help to be in touch with your senators and representatives to educate them on the value of home health care and the devastation further cuts would cause to your industry.
“Before I leave today, I also want to make it clear that one of my most important jobs in the Congress is to prevent bad legislation from passing. Often times, the law of unintended effects has us scrambling to pass what we refer to in Washington as a “technical corrections” bill. And this is certainly true for your industry.
“In fact, I generally hear more from constituents begging me to oppose a certain piece of legislation because of its consequences rather than asking me to pass more federal legislation. And I know all of you probably agree with that.
“I also regularly hear from our beleaguered home health providers, hospitals, doctors, pharmacists and every other health provider who are fed up with the unnecessary and burdensome regulations coming out of the Washington Medicare office. I couldn’t agree more.
“I will spare you my usual CMS rant - mainly because many of you in this room have heard it many times over - but I have long had concerns that sometimes their outfit is more concerned with balancing the books rather than truly understanding the needs of Medicare beneficiaries and providers. This is why I refer to them as the “bean counters”.
“I also often wonder what they do with all of that paperwork that they require you to do. I have often threatened just to show up at CMS and ask them to show me all of the paperwork and explain to me why they need all of this paperwork and how exactly they use it. I think they weigh it rather than read it.
“However, while we may not agree on every issue, I do have to work with CMS quite often in my role on the Finance Committee and Rural Health Caucus. So, I look to all of you here today to keep me informed as problems arise and I will do my best to reason with CMS to help them understand how their actions are affecting all of you in this room.
“In closing, I want to share a story about another one of the Kansans here today. Gerald Sloan recently met with my staff and retold a conversation he had with a fellow home health provider. Unfortunately, Gerald is one of the hundreds of providers in the Kansas City area affected by round 1 of the competitive bidding program. During their conversation, the other provider asked Gerald if he had done his budget for the year, and Gerald responded, “One budget?! I had to put together eight different budgets based on all of the different possibilities of what might happen this year.”
“This story could not be more telling as to what your industry is up against, and that is unfortunate. I have long said that government should be a partner, not an adversary. However, I am confident that if we continue beating the drum together we can show other members how critical your industry is and give you some relief so you can focus on caring for and serving your patients.
“I want to thank all of you for allowing me to join you this morning.”
Senator Roberts is a member of the Senate Finance Committee, the Senate Health, Education, Labor and Pensions Committee and is Co-Chairman of the Senate Rural Health Caucus.
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“We have a group of Kansans here today and I would like to recognize them: Velma Goertzen, JD Rein, Gerald Sloan, and Adrian Knight. Velma is not going to like this, but I am going to put her on the spot. Many years ago when I actually had hair and was a member of the House, Velma invited me to her home health shop in Hutchinson, Kansas.
“It was one of my first health care visits as the 1st District Congressman nearly 30 years ago, and it had such a dramatic impact on me and made me a true believer in the importance of home health care.
“Velma took me on one of her visits to an elderly patient and it was when Velma was earnestly listening to the patient, asking how she was feeling, and spent as much time with the patient as the patient needed, that the light bulb came on and I realized how valuable the personal touch of the home health industry is for a senior.
“This is especially true for a senior who may live alone or out in the country miles away from a local hospital or doctor’s office. The local home health provider is the only provider in the health care delivery system that is going to a patient’s home and checking in to make sure he or she is doing ok. And, I know that a family must take great comfort in knowing that if they can’t be there, the local home health provider is there caring for their mother, father, grandmother, grandfather, sister, or brother.
“However, all of you here today know that your industry is under attack. We have a perfect storm brewing. Home oxygen patients and providers are about to undergo tremendous change in the next several months due to the implementation of the competitive bidding program - which we all know has created confusion and exasperation among home health providers.
“Next January will also bring the end of certain monthly oxygen provider payments, and the transfer of equipment ownership to thousands of seniors.
“More disturbing is that the administration and some in Congress don’t feel that these massive changes are enough! They are coming after your industry again by proposing drastic cuts to home oxygen, nationwide rollout of the competitive bidding program, and possible freezes of your annual Medicare payments!
“Well, I am here to tell you that I am doing everything I can to make sure this doesn’t happen. I am using my position on the Senate Finance Committee and as co-chair of the Senate Rural Health Caucus to tell my Senate colleagues to stop, listen and understand what is happening to your industry before moving forward with further unnecessary cuts.
“On the competitive bidding front, I am glad your industry is pushing Secretary Leavitt to suspend the start of the program until a number of questions can be answered. I share your same concerns about the impact this program might have on forcing hundreds or thousands of home health providers out of Medicare, thereby ultimately hurting the very patients you are meant to serve.
“You have great ammunition with the publication of two recent reports that show competitive bidding is really not competitive at all. In fact the studies show what all of us fear in that competitive bidding will produce severe job loss in the home care industry, will drive prices up for some consumers, will lead to patient access problems and a decrease in the quality of care. It clearly seems to me that Congress needs to take a serious look at this program, and I stand ready to lend a helping hand to these efforts.
“I am also doing my part through the legislative process on the Finance Committee. I have been pushing Chairman Baucus and Ranking Member Grassley to include language which your industry supports to require CMS to determine the impact of the program on round 1 and the initial 10 MSA’s before CMS can implement round 2. Now that seems like a commonsense idea, doesn’t it? Actually studying the impact of a program before hastily expanding it?
“I am also pushing for stronger protections for our small suppliers, exemptions for our rural areas from the program entirely, and appeal rights for suppliers if their bids are rejected. I also want to require CMS to actually show that the competitive bidding program actually produces savings of at least 10% before it can be implemented. All of these provisions come straight from the Medicare Durable Medical Equipment Access Act - which I introduced with Senators Conrad and Hatch last year.
“On the home oxygen front, I joined forces with Sen. Blanche Lincoln and several of my colleagues last week to send a letter to the Budget Committee urging the committee to reject any cuts to home oxygen in the budget resolution. I am also working with my colleagues on the Finance Committee to reject any cuts to home oxygen as a way to pay for a Medicare physician fix.
“Just two weeks ago, I was in Garnett, Kansas at a town hall meeting. After the meeting, the local home health provider came up to me and told me that he and his wife are considering throwing in the towel and selling their business. They are already operating on razor thin margins and fear that Congress will approve even greater home oxygen cuts, which would devastate their business. This leaves them with little to no choice.
“Unfortunately, seniors in Garnett don’t have the luxury of choosing from a variety of home health providers to get their home oxygen equipment or oxygen contents. This means that if he has to close up shop, seniors in Garnett will be left holding the title to their oxygen tanks, but no one to actually fill up their tanks so they can breathe. I call this the “blue-grey” syndrome. First the senior goes blue and then they go grey.
“Joking aside, I have serious concerns that under the banner of “cost containment” we are rationing health care.
“More concerning is that we are driving health providers out of the Medicare program. Sure, we can easily save some money by cutting oxygen payments or freezing annual payments, but we will be left with no providers willing or able to participate in the Medicare program - and what does that do for our seniors?
“On that note, I know all of you probably want to know what is going to happen with a possible Medicare package this year. As you know, in December Congress approved a short-term Medicare package to hold off the Medicare physician payment cuts until June 30 of this year. This means that the clock is ticking to get something done before June.
“It is my hope we’ll be able to come together and work in a bipartisan fashion to approve a Medicare package that makes some good improvements to the Medicare program, including needed changes to the competitive bidding program. However, we all have heard the rumors that House and Senate leadership would like to use the reconciliation process to get a Medicare package approved.
“I think this is very disappointing. I hope clearer heads prevail and my friends on the other side of the aisle won’t turn the Medicare legislation into a political stunt. Nothing good comes out of such a process.
“And pleased be assured that I am not going to stand by and let your industry be used as the bank to pay for other providers in the Medicare program. That’s just not right. I will also be encouraging my colleagues to join with me and do the same. This is why I need all of your help to be in touch with your senators and representatives to educate them on the value of home health care and the devastation further cuts would cause to your industry.
“Before I leave today, I also want to make it clear that one of my most important jobs in the Congress is to prevent bad legislation from passing. Often times, the law of unintended effects has us scrambling to pass what we refer to in Washington as a “technical corrections” bill. And this is certainly true for your industry.
“In fact, I generally hear more from constituents begging me to oppose a certain piece of legislation because of its consequences rather than asking me to pass more federal legislation. And I know all of you probably agree with that.
“I also regularly hear from our beleaguered home health providers, hospitals, doctors, pharmacists and every other health provider who are fed up with the unnecessary and burdensome regulations coming out of the Washington Medicare office. I couldn’t agree more.
“I will spare you my usual CMS rant - mainly because many of you in this room have heard it many times over - but I have long had concerns that sometimes their outfit is more concerned with balancing the books rather than truly understanding the needs of Medicare beneficiaries and providers. This is why I refer to them as the “bean counters”.
“I also often wonder what they do with all of that paperwork that they require you to do. I have often threatened just to show up at CMS and ask them to show me all of the paperwork and explain to me why they need all of this paperwork and how exactly they use it. I think they weigh it rather than read it.
“However, while we may not agree on every issue, I do have to work with CMS quite often in my role on the Finance Committee and Rural Health Caucus. So, I look to all of you here today to keep me informed as problems arise and I will do my best to reason with CMS to help them understand how their actions are affecting all of you in this room.
“In closing, I want to share a story about another one of the Kansans here today. Gerald Sloan recently met with my staff and retold a conversation he had with a fellow home health provider. Unfortunately, Gerald is one of the hundreds of providers in the Kansas City area affected by round 1 of the competitive bidding program. During their conversation, the other provider asked Gerald if he had done his budget for the year, and Gerald responded, “One budget?! I had to put together eight different budgets based on all of the different possibilities of what might happen this year.”
“This story could not be more telling as to what your industry is up against, and that is unfortunate. I have long said that government should be a partner, not an adversary. However, I am confident that if we continue beating the drum together we can show other members how critical your industry is and give you some relief so you can focus on caring for and serving your patients.
“I want to thank all of you for allowing me to join you this morning.”
Senator Roberts is a member of the Senate Finance Committee, the Senate Health, Education, Labor and Pensions Committee and is Co-Chairman of the Senate Rural Health Caucus.
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