Ohio groups partner to protect O2
COLUMBUS, Ohio - The Ohio Association of Medical Equipment Services (OAMES) has joined forces with two of the state's nursing home associations to fight any detrimental changes to the state's coverage and reimbursement for oxygen.
The state recently released a draft of its new coverage criteria for oxygen used in nursing homes, and in June, OAMES had a meeting with the Ohio Academy of Nursing Homecare and the Advocate of Not-for-Profit Services for Older Ohioans to discuss strategy.
"We shared all of the issues that the draft was raising and there was nothing we were in disagreement on," said Kamela Yuricich, executive director of OAMES. "We may not always be on the same page, but right now, we are and that strengthens our position."
The week following the meeting, OAMES sent the state a letter requesting a draft of its new coverage criteria for oxygen used in homes. The association also requested a draft of its new reimbursement rates for oxygen. Only then can the groups determine the full impact of the changes, Yuricich said.
"For every coverage criteria in the rule, there's obviously a cost associated with it," she said. "So we can't make a judgment on one without the other."
For example, if the state decides to require prior authorization for oxygen, OAMES wants to know whether the state also plans to cut reimbursement rates. If so, the association would argue against requiring prior authorization, because the process would become too costly for providers.
Despite the mystery still surrounding reimbursement, OAMES was happy to see that the draft coverage criteria made no mention of an oxygen cap. In previous drafts, the state proposed capping oxygen at 10 months and cutting reimbursement by more than 50%.