Region A director cautions: Not so fast

Sunday, March 31, 2002

COLUMBIA, S.C. - Region A Medical Director Dr. Paul Hughes cautioned home respiratory providers not to participate in providing oximetry tests to Medicare beneficiaries.

In an interview with HME News last month, Hughes said he's aware that Region D Medical Director Robert Hoover feels differently.

"I encourage providers to not get involved in this kind of testing because there are lots of folks out there in various law enforcement agencies who would view that as an easy kind of a case because the regulation is fairly black and white," Hughes said.

In response to a query from an independent testing facility, Hoover said recently that it's okay for an HME to deliver an oximeter and pick it up from a Medicare patient and return it to the IDTF, provided the dealer doesn't use his own oximeter or tamper with the test.

Standard industry interpretation is that providers should play no role in recertifying their own Medicare oxygen patients because it presents a conflict of interest.

In his opinion, Hughes said, oximeters still aren't foolproof and allowing a beneficiary to perform his own test increases the potential for error and that is "not acceptable"

Hoover did not return phone calls, but Hughes said that his Region D counterpart "may be more aggressive about being willing to accept some of this stuff than I am."

"The potential quality problems that can result from the untrained person doing the test will cause enough problems with the results that I question if it would represent the patient's true condition and therefore be valid for Medicare reimbursement purposes," Hughes said. HME