Oxygen reform: 'Industry is really gelling on this one'

Sunday, March 22, 2009

ARLINGTON, Va. - After nearly two months of discussions, AAHomecare's New Oxygen Coalition (NOC) has delivered a revised plan for oxygen reform to state association leaders.

Members of the NOC and state association leaders wouldn't talk specifics on Friday, but they said they're "very comfortable" with the revised plan to reform the Medicare oxygen benefit.

"I think there has been a good coming to the middle by all sides," said Mike Calcaterra, a member of the NOC and a branch manager for Norco Medical. "The industry is really gelling on this one."

The NOC has given state association leaders about one week to review the plan, share it with their board members, and provide comments and recommendations.

Time is of the essence, those involved say, because members of Congress plan to broach healthcare reform this summer, earlier than expected.

"We need to be mindful of the speed with which Congress is working and the potential for oxygen to be targeted for very severe cuts," said Walt Gorski, AAHomecare's vice president of government affairs. "If those cuts occur, there will be no oxygen benefit to reform."

As details of the revised plan emerge, those involved urge the industry not to be quick to pass judgment.

"The problem we have is that no plan will be 100% agreeable," said Rose Schafhausser, a member of the NOC and chairwoman of AAHomecare's State Leaders Council. "But this plan is within the structure of what already exists. What we're doing is just spelling out some of the details."

Once the NOC has a consensus, it will draft legislation and begin searching for a vehicle, those involved say.

The biggest stumbling block for the NOC so far has been how to best pay for oxygen. The first plan put on the table, developed by The Council for Quality Respiratory Care, entails putting patients into different reimbursement buckets based on ambulation and then adjusting reimbursement based on factors like liter flow.

Providers like Calcaterra and other industry stakeholders have worried that such a plan would be too administratively burdensome for small and independent providers.