Providers fear the worst

ORE CITY, Texas - When provider Jim Horn heard a faulty oxygen concentrator was behind a fire that killed five people here on Jan. 9, he couldn't help but think the worst--that the just passed oxygen cap will result in more people dying, or at least getting hurt, under the same circumstances. "If, for example, the internal filters on these things don't get changed regularly, they can get hot and overheat," said Horn, owner of Horn's Medical Supply in Athens, Texas. "It's so important that concentrators get serviced." But capping oxygen at 36 months and transferring title of the equipment to the beneficiary at that time puts service in danger, providers say. Right now, Medicare reimburses them about $200 per month to service and maintain oxygen concentrators. Providers worry that, with the cap now passed, it will be up to beneficiaries, who are often on fixed incomes, to pay out of pocket for services or, worse, perform some services themselves. Robert Fessler, the operations manager at Cape Medical Supply in Sandwich, Mass., has also thought about the hazardous implications of the proposed oxygen cap and the likely drop in services. Beneficiaries can't be relied on to maintain their concentrators safely, he said. "Right now, we have a preventative maintenance program where we see patients every three months--every week, if they're on portable," Fessler said. "Part of these visits is re-educating patients about safety. If they're not reminded, they get lax." Fessler took part in a state task force last year that aimed to distribute educational pamphlets outlining the potential dangers of using oxygen concentrators in the home, especially when patients smoke. (The task force's efforts have been on hold due to lack of funding.) In its coverage of the fire, KLTV-7 cited experts who urge patients to service their concentrators every eight to nine weeks.