Oxygen document enrages providers

Sunday, March 5, 2006

WASHINGTON - A "misleading" document that proclaims little will change as a result of the recently passed 36-month cap on Medicare oxygen reimbursement has providers hopping mad.

"It made me sick," said Velma Goertzen, general manager of Health-E-Quip in Hutchinson, Kan. "It's a glowing report about how nothing will change when we don't know, yet, if that's true. How can they make a promise like that, when nothing has been set in stone? It's misleading."

Various congressmen are distributing the document, which was crafted by Rep. Bill Thomas, R-Calif., to placate Medicare beneficiaries who keep calling them with concerns, industry sources said.

The document states that only one thing will change under the new rule: Medicare beneficiaries will own their oxygen equipment after three years.

It goes on to state that Medicare will continue to pay for liquid or gas cylinders/tanks and portable equipment. It also states Medicare will continue to pay for supplies and accessories.

But the piece de resistance, providers say, is that the document states Medicare will continue to pay for "necessary and appropriate" service and maintenance--but only when service and maintenance is performed.

Providers argue they're still waiting for details on how the rule will be implemented. Service and maintenance is the biggest unknown.

Adding insult to injury, the document makes providers out to be the "bad guys, said Kim Brummett, vice president of contracting and reimbursement for Advanced Home Care in Greensboro, N.C. It implies providers--not Congress--are leaving beneficiaries in the lurch.

"(The document) says if a provider chooses not to help you, you can contact another provider," Brummett said.

Ironically, the existence of the document is more proof that the industry's grassroots efforts have "struck a chord," said Asela Cuervo, an attorney who co-chairs AAHomecare's regulatory committee.