Oxygen fight continues

Wednesday, September 30, 2009

AAHomecare submitted an oxygen reform plan to Congress last month that calls for reducing Medicare's current combined reimbursement rate for stationary and portable oxygen to 90% of the 2009 allowable.

The back-and-forth, often acrimonious, debate over what shape oxygen reform should take has divided the industry for months. In August, stakeholders reached a tentative compromise, but the plan AAHomecare submitted to Rep. Mike Ross, D-Ark., left some disappointed.

Specifically, some providers and industry groups are unhappy with the proposed 10% reduction, which they say had never been discussed in previous meetings (AAHomecare says it was). Some say that the 10% reduction, on top of this year's 9.5% cut, is too much for smaller independent HMEs to absorb and favors larger national providers.

"We have been clear and willing, and we've done just about everything we can to find consensus, and AAHomecare just isn't listening," said David Petsch, managing director of CSIHME. "I think they are threatening to do to this industry what we thought we were all trying to avoid: Destroy it."

Walt Gorski, AAHomecare's vice president of government affairs, acknowledged that the new plan does not satisfy everyone, but he called it the "most responsible option."

"We've reached a point where nobody is entirely happy," he said. "We agree on the vast majority of the package, and this is the only sticking point. AAHomecare had to make a decision because time is short. It is hard sometimes to take a leadership role, knowing that you are not going to make everybody happy."

With healthcare reform on the fast track, the industry had to get an oxygen reform plan to Ross sooner rather than later if he's to have any chance of including it in a House reform bill, Gorsk said.

The new plan attempts to:

* Eliminate the 36-month cap;

* Gain recognition for services provided to oxygen patients;

* Prevent further cuts to Medicare oxygen reimbursement;

* Demonstrate the costs involved in providing home oxygen; and

* Ensure certain basic patient protections.

In an "Open Letter to the Home Oxygen Community" e-mailed out Sept. 14, AAHomecare CEO Tyler Wilson wrote that the proposed oxygen reform legislation, which is budget neutral, is the "best option" the industry has to fend off a proposal in the U.S. Senate that calls for reducing oxygen reimbursement by $1 billion over 10 years.

"Without the Rep. Ross legislation on oxygen in the final House health reform package," Wilson wrote, "the oxygen community will be at the complete mercy of whatever final determination is made by Senate Finance negotiators." hme