Ohio: Medicaid seeks steep oxygen cut

Friday, November 22, 2013

COLUMBUS, Ohio – Providers in Ohio are fighting the state’s plan to set Medicaid rates for oxygen to 36% below the lowest Round 2 rate in the state.

“With the cuts we’re already seeing from Medicare, if Medicaid also makes those cuts, it’s going to hamper the service we offer our patients,” said Jamie Blair, vice president of New Boston, Ohio-based Genesis Respiratory Services. 

Ohio Medicaid in September announced the cuts as part of a plan to move both oxygen and custom seating/wheelchairs from nursing home per diem rates into fee-for-service, effective Jan. 1, 2014. The proposal came about after providers, consumer groups and manufacturers encouraged Medicaid to carve out custom seating, since the nursing homes couldn’t provide the same level of care in that product category as HME providers. Unfortunately, the agency took the request further, including oxygen and proposing the rate cut. 

Provider Carl Mulberry in October hosted Medicaid officials at Columbus Medical Equipment to share concerns.

“We talked about what it takes to do oxygen in people’s homes,” said Mulberry, president. “You could probably get away with those lower prices if you have 10 concentrators in one room (at a nursing home), but visiting each home one at a time? That reimbursement is not enough to do a homecare business.”