Industry battles oxygen cap

Sunday, January 1, 2006

WASHINGTON -- After a relatively quiet period between Christmas and New Year's, look for HME leaders to rally the troops and begin an all-out push this week to defeat a bill that would cap oxygen reimbursement at 36 months.

House and Senate members approved the bill just before Christmas. But because the Senate made some minor changes, the House must vote on it again, most likely toward the end of this month when members return from their holiday break.

The additional time before the next vote gives the industry one more chance to convince congressmen who voted for the bill the first time, to change their vote.

The following is the language in the bill that caps oxygen at 36 months:

S.1932 Deficit Reduction Act of 2005 (Engrossed amendment as agreed to by Senate)


(1) IN GENERAL--Section 1834(a)(5) of such Act (42 U.S.C. 1395m(a)(5)) is amended--

(A) in subparagraph (A), by striking `and (E)' and inserting `(E), and (F)'; and

(B) by adding at the end the following new subparagraph:


(i) IN GENERAL--Payment for oxygen equipment (including portable oxygen equipment) under this paragraph may not extend over a period of continuous use (as determined by the Secretary) of longer than 36 months.


(I) TRANSFER OF TITLE--On the first day that begins after the 36th continuous month during which payment is made for the equipment under this paragraph, the supplier of the equipment shall transfer title to the equipment to the individual.

(II) PAYMENTS FOR OXYGEN AND MAINTENANCE AND SERVICING--After the supplier transfers title to the equipment under subclause (I)--

(aa) payments for oxygen shall continue to be made in the amount recognized for oxygen under paragraph (9) for the period of medical need; and

(bb) maintenance and servicing payments shall, if the Secretary determines such payments are reasonable and necessary, be made (for parts and labor not covered by the supplier's or manufacturer's warranty, as determined by the Secretary to be appropriate for the equipment), and such payments shall be in an amount determined to be appropriate by the Secretary.'.

(2) Effective date--

(A) IN GENERAL--The amendments made by paragraph (1) shall take effect on January 1, 2006.

(B) APPLICATION TO CERTAIN INDIVIDUALS- In the case of an individual receiving oxygen equipment on December 31, 2005, for which payment is made under section 1834(a) of the Social Security Act (42 U.S.C. 1395m(a)), the 36-month period described in paragraph (5)(F)(i) of such section, as added by paragraph (1), shall begin on January 1, 2006.