Power Ox: The greatest thing since sliced bread?

Friday, April 30, 2004

DECATUR, Ala. - The pulse oximetry testing system, Power Ox, unveiled by the Letco Companies in March has generated buzz for its apparent relief of the headache involved in qualifying Medicare patients for oxygen.

Power Ox allows providers to qualify oxygen patients using a hand-held palm pilot that collects data from the in-home pulse oximeter test. The DME then downloads the encrypted data to an independent diagnostic testing facility (IDTF), which reviews it and sends the results simultaneously to the DME and physician.

CMS guidelines require an IDTF to complete the qualifying test before Medicare can be billed for any oxygen therapy. However, pulse oximetry testing carries such a small reimbursement - around $20 - that many IDTFs are unwilling to commit much manpower and equipment to it, creating problems for DMEs.

“It’s an issue that cuts across all lines. There are just not enough IDTFs around that want to do this kind of work,” said Don White, president of Associated Healthcare Systems.

Power Ox is different because the DME completes the test itself with oximeters it has on site. The IDTF only reviews the test results.

Mickey Letson, president of Letco, said this simplfied system of testing works because of the many safeguards that seal it and make the collected data tamper proof.

“It’s a very, very secure package,” said Letson. That’s the reason why CMS was quick to allow it, he said.

Letco has received two letters of approval from CMS, in January and March, which say that the system meets Medicare guidelines, but still some providers remain cautious.

“As long as everything is legitimate, and we as an industry need to be as legitimate as we have ever been, then this sounds like a great tool,” said David Mills, president of First Choice in Homecare in Chesapeake, Virginia.

One question raised about the program surrounds the ownership of the pulse oximeter itself. CMS guidelines mandate that the device must be owned by the IDTF, but with Power Ox the oximeter is in the DME’s possession.

Letson said CMS has given permission for the IDTF to purchase pulse oximeters that work with the system that the DME already owns, but “that’s cutting the hairs pretty fine,” said White and other industry insiders.

The other concern is about the location of the IDTF, said one industry source. Currently only one IDTF, located in Detroit, Michigan, is compatible with the program.

“If the IDTF is in one state and if the patient’s data is coming in from other states does the IDTF have to be licensed in those states?” asked the source.

Letson says no. Medicare determinations are only concerned with where the data interpretation is done for billing, he said.

“I am a stickler for detail, and there is no way I was launching the program before I had Medicare approval,” said Letson. “It may sound too simple and too easy to be true, but it is a very good product and it is working very well.”

Letco is charging a $515 set up fee for the system, which includes the Tungsten palm pilot and programs, and an additional $50 per month subscription fee for the service. Letson said many DMEs are jumping on board.

Even the skeptics are eager for the Power Ox system to succeed.

“I think it is a wonderful program and great for the industry,” said one source. “If we can work out those two issues then it is going to make life easier for the DME and I will stand on the mountain top singing its praises as the greatest thing since sliced bread.”