Ohio: Oxygen cuts averted

Friday, December 20, 2013

COLUMBUS, Ohio – A proposed Ohio Medicaid policy that would have set oxygen rates at 36% below the lowest Ohio Round 2 rate is now off the table.

“The rates will still be cut, but not to the point where it threatens the benefit,” said Carl Mulberry, president of Columbus Medical Equipment. “We were able to reason with them, and now we’re in a much better situation.”

Rates for oxygen concentrators (E1380), for example, will go from around $165 to $130 per month, as opposed to the initial proposed payment of $54.89 per month. The rates go into effect Jan. 1.  

“We’ve had several cycles of bidding in Ohio, and the presence of those bid rates led to extremely unacceptable, very deep cuts,” said Kam Yuricich, executive director of the Ohio Association of Medical Equipment Services. “However, they quickly learned that there’s a big difference between how much it costs to provide home care and long-term care.”

Despite the victory, OAMES isn’t ready to relax: The same state law requiring the oxygen policy change also calls for Ohio Medicaid to rethink its custom mobility policies.

“Oxygen was just phase one,” said Yuricich. “Now, we will work with them to explore the ‘purchase strategies’ the law calls for. It’s hard to do something brand new with the most complex benefit in DME.”