Cap rental proposals 'catastrophic' for providers, beneficiaries

YARMOUTH, Maine - Providers are looking ahead to what services they may have to cut to offset losses if Medicare caps reimbursement for oxygen concentrators, according to a recent HME NewsPoll. Nearly three quarters of the 209 poll respondents predicted they would drop respiratory therapist visits. Additionally, 64% would cut delivery and 62% would cut maintenance. "Capping respiratory services would be catastrophic for all providers," wrote in Tim Pederson, CEO of WestMed Rehab, in Rapid City, S.D. "We do not merely provide equipment; we provide respiratory service, upon which most of our patients depend." The OIG plans to conduct a study in 2006 that examines, among other things, the feasibility of capping reimbursement for oxygen concentrators (See HME NewsWire, 11/7/05). Many respondents agreed that capping oxygen would also have harsh consequences on vulnerable patients. "Liquid oxygen for Medicare beneficiaries would cease to exist," wrote in Greg Melloh, a manager at Iowa Health Home Care in Des Moines, Iowa. "Deliveries would stop. All repairs would be taken non-assigned, meaning that they pay up front. Those not in a position to do this would certainly be in trouble." Providers would also look to cut back on services and, in some cases, quality, if a U.S. Senate proposal to eliminate the capped rental option for DME is approved. "Cheaper products and less service here I come," wrote in Joel Holland, president of Holland Medical Equipment in Nashville, Tenn. While 40% of providers said they would lay off staff, services would take the biggest hit with 70% of respondents saying they would have to cut maintenance and another 43% suggesting delivery would be changed or eliminated. A small percentage, 7%, said they would sell the business and 11% said they would close branches. Again, despite the losses to providers, it is the patients who many feel will face the greatest hardships if the capped rental option is eliminated for DME. "The main impact will be on the reduction of services to beneficiaries," wrote in Kevin Fly Hill, president and general manager of CPS Medical in Tyler, Texas. "Most will not maintain their owned equipment at the levels we currently provide." Lack of maintenance and less personal contact with the patient will cost more in the long run, respondents said. "The lack of repairs to DME equipment could easily turn into an E.R. visit or hospital stay that would cost Medicare far more than the maintenance fee," wrote Joey Tart, president of Family Medical Supply in Dunn, N.C. "Home care is and always will be the least expensive and most desirable venue of care for the patient--that won't change, but the quality and quantity will, and I am afraid that will translate into an increase in readmits to the E.R. or unscheduled doctor visits," wrote Mark Barch, president/owner of Pulmonary Care Management Solutions, in Arlington, Texas.