Ohio delays oxygen cap
COLUMBUS, Ohio - The state recently postponed its plan to make oxygen concentrators a capped rental item. But with a U.S. congressman's plan to cap oxygen reimbursement for Medicare beneficiaries nearly a done deal, the Ohio Association of Medical Equipment Services (OAMES) finds little comfort in the delay.
Rep. Bill Thomas, R-Calif., proposed in December capping oxygen reimbursement at 36 months and transferring the title of the equipment to the beneficiary at that time, as part of a Medicare/Medicaid spending package. Both the House and Senate approved the package, but because the Senate approved it with some changes, the House must vote on the package once more.
"This is a green light back to Medicaid," said Kamela Yuricich, association executive director.
Ohio Medicaid's plan to cap oxygen concentrators and cut reimbursement for the equipment by more than 50% was supposed to kick in Sept. 1, 2005. But it has been delayed three times--first to Jan. 1, 2006; then to April 1, 2006; and in December, to July 1, 2006. OAMES opposes capping oxygen because it would compromise the services suppliers provide, such as visits by respiratory therapists.
Jim Vana, who chairs the legislative and public relations committees for the Wisconsin Association of Medical Equipment Services (WAMES), also fears that, if Congress moves forward with capping oxygen, state Medicaid programs will follow suit.
"I wouldn't want to be a Medicare beneficiary right now, with this and the prescription drug plan," he said. "And beneficiaries aren't even aware of competitive bidding coming down the pike."
While OAMES awaits the state's final rule on oxygen, it has been working on another rule that's set to kick in April 1, 2006. This rule looks to implement volume purchasing, face-to-face exams, defined invoice prices and other initiatives, Yuricich said.
In comments submitted to the state by a Dec. 30 deadline, OAMES focused on volume purchasing, largely because it sounds like another initiative whose driving force was Rep. Thomas: competitive bidding.
"It sounds drop-ship like," Yuricich said. "If that's the case, our concerns are similar to those we have with competitive bidding: Providers will be eliminated, service will suffer, deliveries would be delayed. But it's one of those conversations that's impossible to have at this point, because we don't have all the details on what it is yet." HME