Oxygen reform efforts shift

Sunday, April 5, 2009

ARLINGTON, Va. - It looks like the industry's efforts to reform the Medicare home oxygen therapy benefit have hit a bump in the road.

The New Oxygen Coalition (NOC), the AAHomecare-created group charged with developing a plan to reform oxygen, made significant progress last month. After about 45 days, it had developed a revised plan and presented it to the industry at Medtrade Spring. It received good reviews.

But last week, two provisions were added to the plan, raising red flags with some NOC members. The provisions: to reclassify suppliers as providers and to require cost reporting. Both provisions had been part of a previous plan but dropped.

Supporters of the provisions seek to reclassify suppliers as providers as a way to get oxygen eliminated from national competitive bidding. The logic: Providers offer services--and equipment, not services, are competitively bid.

But opponents say the strategy could backfire. If the industry succeeds in getting oxygen eliminated from competitive bidding, members of Congress may seek to make up those savings with an across-the-board cut to the benefit, they say.

"One of the main concerns of the independent provider, when you talk about reform is, what is it going to do to the allowable," said Jason Rogers, a NOC member and vice president and billing manager for Care Medical in Athens, Ga. "Now they're essentially talking about working downward from the current allowables to pay for the competitive bidding elimination."

Rogers believes the industry should tackle eliminating oxygen from competitive bidding in separate legislation.

Wayne Stanfield, a NOC member and president and CEO of the National Association of Independent Medical Suppliers (NAIMES), echoed Rogers' concern in a position statement to members last week.

"There are too many unknowns and too many risks to move this quickly on a plan that could result in dangerous unintended consequences," he said.Others involved in the process were surprised by the added provisions but remain committed to moving forward, though they continue to seek additional information.

"The threats for future oxygen cuts are real and great, so doing nothing is worse than any change we could make at this point," said Karyn Estrella, executive director of the New England Medical Equipment Dealers. "It's crunch time."

The industry seeks to include a plan in any upcoming healthcare reform legislation, something members of Congress plan to craft before their August recess.

AAHomecare and the NOC have shared their plan with regional and state associations, who have, in turn, shared it with their boards of directors and members. This week, they plan to hold regional teleconferences to share the plan with an even larger number of stakeholders and providers.

"It's still a work in progress," said Michael Calcaterra, a NOC member and a branch manager for Norco Medical.