Wayne Grau has been the director of rehab industry affairs for Pride Mobility Products and Quantum Rehab for just about two months, but what a two months they have been.
In that time, Grau has focused most of his efforts on building support for H.R. 3559, aka the “Medicare Durable Medical Equipment Access Act of 2005,” but more popularly known as the Hobson-Tanner bill in DME circles.
The bill was introduced by Rep. David Hobson (R-Ohio) and Rep. John Tanner (D-Tenn.) in July of last year. Among other things, the bill seeks to postpone national DME competitive bidding programs until quality standards are in place, exempt smaller communities from competitive bidding, and restore the right of participating providers to seek administrative and judicial review.
Grau says he’s been “on the road, lobbying for H.R. 3559, since (last) October,” a fact lauded by the American Association for Homecare (AAHomecare) at its Washington Update gathering at Medtrade Spring last month. “It’s been going pretty well,” Grau notes.
The director position, he adds, was created by Pride Mobility/Quantum Rehab CEO Scott Meuser and President Dan Meuser. “They felt the Hobson-Tanner bill was too important; we had to put somebody on it that could do it full time,” Grau explains. “What I’ve been doing is traveling the country and meeting in the districts with the (congressional) staff people. Staff people have a lot of influence over what the congressman thinks; you can imagine that congressmen can’t know everything about everything. So they rely heavily on their staff people. I set the meetings up and ask four or five dealers to attend the meetings.”
Local participation, Grau says, is critical: “You can imagine that a guy from New Jersey doesn’t want to hear from a guy in Pennsylvania. (Congresspeople) want to hear from people in their district, small businesspeople and the voters, on how competitive bidding is going to hurt them and hurt the patients. And what we can do to fix it.”
In fact, the meetings even include discussion on respiratory issues, such as the 36-month limit on home oxygen rentals. Grau says Scott and Dan Meuser “felt we had to do it (include oxygen issues in the discussions) because it affects our customers a great deal. We felt it was a very good idea to also bring up the oxygen cap issue, because it will have an adverse effect on our customers.”
The state associations also participate by helping to recruit dealers to attend the H.R. 3559 meetings, Grau says. He usually begins the meetings by making general comments or asking general questions “just to get (suppliers) into the flow of the meeting, and then a lot of them just start taking over from there,” Grau says. “That’s exactly what we want them to do.”
H.R. 3559 remains Grau’s main focus for now ù “Our goal, plain and simple, is to get Hobson-Tanner passed,” he says ù so after a few more rounds of local meetings, he will follow up in Washington, D.C. Much of his job right now consists of educating Congress.
“I’ll say, ‘What do you know about the DME business?'” Grau says. “They’ll say, ‘Not much.’ I let them know that this industry is based on service. It’s not based on price, because the price is set by CMS; it’s not based on the product. It’s based on how the dealers take care of those beneficiaries and referral sources. Then dealer will explain how (competitive bidding) will be devastating for 4,500 small companies being put out of business. That raises the awareness of that issue right then and there ù how it’s going to affect the elderly and the fact that they’re going to have no choice, there’s going to be cuts in services.”
In addition to working on Hobson-Tanner, Grau says, in the next six months he will also be working to build support for a Senate companion bill. “After that, we at Pride are creating a division that’s just going to be dealing with state issues,” Grau says. “It’s much harder to control; there’s one Medicare system, but there are 54 Medicaid systems, even though there are 50 states. We’re going to create a division to help dealers to lobby and facilitate and educate their state representatives on the value of home care ù because a number of dealers get a significant amount of revenue from Medicaid rather than Medicare, specifically rehab providers. We just want to have these things ready… we’re hearing about selective contracting in certain states, and we’ve already had some meetings with a number of legislators to educate them on how bad that could be. Medicaid and the insurance companies always follow suit from Medicare, so if Medicare is going to propose selective contracting or competitive bidding, then it’s just natural that the states are going to do it.”
So, Grau says, the need for education ù not only at the federal level, but also in suppliers’ own backyards ù continues. “We want to give our providers all the tools and all the support they need, so they can go out right now and proactively educate these folks. Home care is the answer, and you can’t have home care without home health equipment. That’s how we’re going to save you money.”