Oxygen reimbursement safe for now

Sunday, August 31, 2008

COLUMBUS, Ohio--The HME industry in Ohio beat back another attempt by the state’s Medicaid program to cut oxygen reimbursement.

The Ohio Department of Job and Family Services has been trying to cut oxygen reimbursement since 2005. In its latest attempt, the state proposed paying providers about $105 per month for oxygen concentrators. That’s about 80% of $130, the reimbursement set for Cincinnati, one of the cities included in Round 1 of the now-delayed national competitive bidding program. The current reimbursement: $192.

At a June 2 hearing held by a legislative committee that reviews rule changes, the industry successfully argued that the cut went against Medicaid’s coverage criteria for providing oxygen, as well as its respiratory care license and HME facility rules.

“The reimbursement cuts would have been so severe that they would not have allowed providers to stay in compliance with those rules,” said Kam Yuricich, executive director of the Ohio Association of Medical Equipment Services.

With oxygen reimbursement safe, at least for now, the HME industry in Ohio planned to gear up for two hearings in August on competitively bidding incontinence supplies.

“It’s their intent to roll out competitive bidding for all (product categories), one product at a time,” Yuricich said. “So our challenge is not allowing providers who don’t do incontinence supplies to get lulled into some sense of safety.”