Free service? Ridiculous

Sunday, November 30, 2008

Recently, we were reimbursed $10.68 for 15 minutes of repair to oxygen equipment. We did find recent reimbursements for 17 out of 20 states within Jurisdiction D and have found the median reimbursement to be $14 per 15-minute increment. Reimbursements for E1340 varied wildly from $9.51 (Iowa) to $22.47 (Alaska) per 15 minutes. Unfortunately, since this is a universal repair code, states will have variable payments for different repairs. It is therefore impossible to obtain any substantial data to reason with-as is often the case with CMS.

In that light, we have contacted Medicare jurisdictions A, B, C and D to inquire about reimbursement rates/recently paid repairs, and confirmed the general opinion that these codes are no longer published nationwide. While discussing this subject with a representative at Jurisdiction B, we were informed that this is a hot topic and that CMS is currently looking into the feasibility of administering their recently released final rule.
It is obvious that very little coherent thought was given to the recent CMS final rule. My fear is that much of the impetus for this decision was to impose such damage to our industry that many providers will not recover, let alone survive.

It is utterly ridiculous for Secretary Michael Leavitt and Administrator Kerry Weems to expect providers to provide any oxygen service for patients if reimbursements won’t even cover the mandated paperwork, let alone the cost of procuring/maintaining delivery vehicles, paying trained/certified staff, maintaining inventory of equipment, obtaining/maintaining accreditation, and meeting other CMS mandated requirements.

We have been in this industry for many years and continue to see reimbursements reduced to levels that are simply no longer sustainable nor humane. HHS and CMS continue to implement both inaccurate and inadequate regulations that do more harm than good. I will be frank with you my friends: Not a single one of us is capable of standing alone. We must come together to voice sincere concern for our patients, and we must direct that voice respectfully to our new administrations.

Donald Adler, president/CEO and robert lee, health policy analyst and contract coordinator, Care Medical & Rehabilitation Equipment