Pols vote to cap oxygen
WASHINGTON - Rep. Bill Thomas, R-Calif., stuck it to the HME industry once again last month when he initiated a proposal that would cap Medicare oxygen reimbursement at 36 months and transfer title of the equipment to the beneficiary at that time.
The reimbursement change made it into a final 2006 Medicare/Medicaid spending plan that House and Senate negotiators agreed upon Dec. 19. The House approved the bill, which also eliminates the cap rental option for DME, and as of press time on Dec. 21, Senators had begun pre-vote debates.
If the Senate passes the bill and President Bush signs it, DME reimbursement will drop by $750 million over five years. As painful as that may be for providers, it could have been much worse. Originally, Thomas proposed capping oxygen reimbursement at 18 months. If that had happened, Medicare reimbursement for DME would have dropped by $2.9 billion over five years and by $8.3 billion over 10 years.
"I'm not kidding, my knees were trembling when I heard that $2 billion number," said Invacare CEO Mal Mixon. "We're the largest creditor in the industry. I've got God knows how much credit outstanding, and if my customers go bankrupt, there is no way I can survive."
Mixon took that message to his Ohio delegation of senators and representatives who threatened to vote against the bill if Thomas didn't back off his demand. Faced with that, Thomas compromised and reduced his demand for a cap on oxygen to 18 months.
When Invacare and Apria officials learned of Thomas' 18-month proposal Dec. 17, the companies' lobbying efforts shifted into high gear in an all out effort to mitigate the damage, Mixon said.
As hard as they fought to eliminate the oxygen cap, Thomas, a force behind many past HME reimbursement cuts, remained "adamant about converting ownership," said Cara Bachenheimer, Invacare's vice president of government relations.
As part of the campaign against the cap, Thomas and his cohorts described the industry as a bunch of crooks who put a concentrator in the field and then bill Medicare $250 a month forever without providing any service, Mixon said.
The proposal to eliminate the cap rental option for DME would transfer title to the beneficiary after 13 months of rental and eliminate the twice-yearly maintenance fee.
"I've had some providers who have said they will put a letter out to advise patients that they are only covered for 13 months and after that the are on their own for service and to call their Congressmen or Senators for service because they are the ones who eliminated it," Mixon said.
If the bill passes as is, Sen. George Voinovich, R-Ohio, has pledged to represent the industry to secure a fair reimbursement rate for repairs once the rental period ends, Mixon said.