AAH casts doubt on proposed O2 reimbursement

Sunday, October 1, 2006

WASHINGTON - Establishing new payment amounts for different classes of oxygen equipment runs counter to preserving access to quality care and patient choice, AAHomecare warned Medicare last week.

The warning was part of the association's comments on a provision to significantly revamp how Medicare pays for oxygen. Under the provision, reimbursement for a stationary concentrator, for example, would fall from about $200 to $177 a month.

The provision stems from the new 36-month cap on oxygen reimbursement required by the Deficit Reduction Act of 2005 (See HME News September 2006).

In its comments, AAH stated:

- The proposed rule does not comply with the Congressional requirement that changes to oxygen payments be budget-neutral.

- The proposed rule compounds the flawed oxygen policy enacted by the DRA because it does not recognize the full array of professional, administrative and other non-equipment costs of furnishing oxygen to Medicare beneficiaries.

- The proposed rule runs counter to the goals of preserving beneficiary choice of equipment and modality, high-quality care, and continued development of new oxygen technology.

Among AAH's suggestions:

- Once CMS revises reimbursement policy to make it budget-neutral, it should reallocate the monthly payment amounts for oxygen equipment to support portable oxygen contents and the continuing development of new oxygen technologies. The policy should promote increased mobility for patients since that improves health and ability to perform activities of daily living.

- CMS should revise payments based on accurate and complete data on the current costs of providing oxygen therapy to Medicare beneficiaries in the home.

- CMS should delay implementation of the changes in the proposed rule and "grandfather" those beneficiaries currently on oxygen to promote a smooth transition to the new policies, avoid disruptions, minimize impact on providers, and allow CMS to work with stakeholders to revise the new methodology.