In brief: Oxygen efforts; ABNs for CPAP; CMS forum

Sunday, June 28, 2009

WASHINGTON -- A letter signed by 70 lawmakers was sent to the Ways and Means Committee June 16, asking its members to include oxygen reform language in healthcare reform legislation. The letter, circulated by Reps. Mike Ross, D-Ark., and Kendrick Meek, D-Fla., "is permanently open for signatures," according to AAHomecare, and providers should continue collecting signatures during the July 4th recess. On another front: H.R. 2373, a bill that would repeal the 36-month cap on Medicare oxygen reimbursement, has 54 co-sponsors, according to NAIMES. The association encourages providers to continue collecting co-sponsors during the recess.

Update: CPAPs and ABNs

BALTIMORE - The DME MACs provided additional information on using advanced beneficiary notices (ABNs) for CPAPs last week when it published a revised question and answer that were part of a previous bulletin. The question: Would it be considered use of a blanket ABN to have all new PAP patients sign an ABN at the beginning of therapy stating that if they do not get a face-to-face evaluation or refuse to get the follow-up re-examination by their treating physician between the 31st and 91st day that Medicare will deny the claim? The answer: Yes, it would be considered a "blanket" ABN if the notice was presented at the beginning of therapy. The supplier may, however, after day 60 following the dispensing of the PAP device, present an ABN to the beneficiary if the supplier has knowledge that the beneficiary has not yet met the policy criteria for continued coverage. This ABN should advise the beneficiary that if, by the 90th day of therapy, they do not meet the policy criteria for continued coverage, Medicare may deny their subsequent claim(s) and that the beneficiary will be liable for payment. The new guidance is effective for claims with initial dates of service on or after July 1, 2009.

CMS schedules forum

BALTIMORE - CMS announced last week that the next Open Door Forum for DME will be June 30 from 2 p.m. to 3 p.m. EST. To participate, call 7-800-837-1935 and use the conference ID 16841080.