Oxygen cap remains a mystery

Sunday, July 20, 2008

WASHINGTON - Providers participating in a teleconference on Friday afternoon pushed CMS officials for details on how they plan to pay for service and maintenance once the 36-month oxygen cap kicks in Jan. 1, 2009.

Providers discussed the cap during the call because a new law that delays national competitive bidding also allows providers to retain ownership of their oxygen equipment. As part of the cap, providers were supposed to transfer ownership to beneficiaries.

When Barry Johnson of Texas Medical asked how CMS would provide service and maintenance payments "under that scheme," Martha Kuespert, director of CMS's DMEPOS policy division said: "The statute says that we will be paying for maintenance and servicing payments as reasonable and necessary. That's the same language that was included in the previous statute."

Johnson: "Do you know when that fee schedule will be available to us?"

Kuespert: "We expect to have that out in our next update. I don't think the maintenance and servicing payments are going to be changing in any significant way. We're paying it now, so we'll continue to pay it."

Another provider asked whether CMS plans to continue paying for two 15-minute sessions every six months for backup oxygen equipment.

CMS officials responded that they expect to issue further guidance soon.

Two providers pointed out that there are only about five months until Jan. 1 and "time is of the essence."

To send questions to CMS, e-mail dmepos_qa@cms.hhs.gov.