Providers still waiting for Medicare to slash O2

Thursday, March 31, 2005

WASHINGTON — There was still no word in mid March on when Medicare will release the size of its reimbursement cut for home respiratory therapy, but when it does, AAhomecare wants to make sure the reduction is not retroactive.
“Right now we are trying to lightly apply some pressure to CMS so that when the number is implement it will be date of service driven versus any retroactive application,” said AAHomecare Chairman Tim Pontius. “Historically they have always done that, but we are going to try to clarify that for sure and wait around for them to release the number.”
The Medicare Modernization Act required CMS to reduce reimbursement effective Jan. 1, 2005, for several home medical equipment items, including home oxygen and oxygen equipment. CMS is required to base payment on the percentage difference between median 2002 Federal Employees Health Benefits Program (FEHBP) amounts and Medicare amounts, to be calculated in a report by OIG. Last fall, AAHomecare shared pricing data with CMS and the OIG and expressed concern about statistical issues in oxygen calculations made by OIG. In December, CMS announced that OIG needed to collect additional information before the FEHBP medians for oxygen and oxygen equipment are finalized. The OIG has yet to provide that data.