Oxygen cap: Industry pumps up efforts

Sunday, December 21, 2008

WASHINGTON - Two "dear colleague" letters that ask CMS to delay the 36-month oxygen cap were making the rounds among departing lawmakers last week.

The industry planned to send the letters--one written by Reps. Heath Shuler, D-N.C., and Tom Price, R-Ga., and signed by 98 representatives; and one written by Sen. Pat Roberts, R-Kan.--to CMS on Friday.

"CMS is being unrealistic," said Rose Schafhauser, executive director of the Midwest Association of Medical Equipment Suppliers, whose members helped to get Roberts involved.

The industry also gained traction last week, when the Small Business Administration (SBA) agreed with providers that CMS has failed to properly consider the impact of the cap on small businesses. In a Dec. 17 letter, the SBA's Office of Advocacy stated that, while CMS provided some analysis of the cap's impact, it "does not rise to the level" required by the Regulatory Flexibility Act.

But CMS is doing its own lobbying, industry stakeholders pointed out.

"CMS is out there telling Congress we are falsely leading beneficiaries and threatening to pull equipment," said John Gallagher, vice president of government relations for The VGM Group. "We need to beat the drum of positive PR."

In any event, it's probably too late to stop the cap before it starts on Jan. 1, said Wayne Stanfield, executive director of the National Association of Independent Medical Equipment Suppliers (NAIMES).

"Little else is going to happen under the 110th Congress," he said.

That's why NAIMES is focusing on the incoming class of freshmen lawmakers, mailing them informational packets.

Making matters worse, however, is that CMS will implement a 2.53% reimbursement cut to oxygen on Jan. 1, 2009, on top of the 9.5% nationwide cut. Why? To make the Medicare Improvements for Patients and Providers Act (MIPPA), which delayed national competitive bidding, budget neutral.

"That's a significant difference," Stanfield said. "It's going to add to the overall financial crisis in the industry."