Cops and robbers

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07/09/2009
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UPDATE: Here's AAHomecare's response to the Cleveland Plain Dealer article.

Why does it seem like members of Congress and officials at CMS make things unnecessarily complicated? If they wanted to reduce reimbursement for oxygen in 2006, they should have reduced reimbursement. Why did they have to come up with a pricing scheme like a 36-month cap?

That's what I was thinking, anyway, when I read this story published in the Cleveland Plain Dealer on July 7. It details how patients that have been on oxygen for 36 months and move or want to switch providers have a hard time finding new providers. That's because their original provider has collected 36 months of reimbursement, leaving only a small monthly service fee for the new provider.

It's almost besides the point that the original provider should continue care for the patient or pay the new provider (for two years or however long he services the patient, up to five years). If Congress and CMS wanted to pay a total of X for oxygen equipment and services, wouldn't it have made more sense for them to pay providers a corresponding amount each month spread over five years?

That way it wouldn't matter who was the original provider and who was the new provider. Providers would get paid, patients would get service and CMS woudln't have to play cops and robbers.

Liz Beaulieu