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Calling Policies 'Unreasonable,' 123 Members of Congress Press for Changes in Medicare Home Oxygen Policies for Emergency Care, Supplies and Other Obligations After 36 Months of Service
Date:3/3/2009

in the form of a 36-month cap enacted by Congress in the Deficit Reduction Act of 2005 (DRA), took effect, sending a slow but growing tidal wave of change throughout the provider community. In addressing the implementation of the 36-month cap policy, CMS issued a regulation that home oxygen providers will no longer receive Medicare payment for patient-generated, non-routine emergency visits or needed oxygen supplies, such as oxygen tubing and masks, once a beneficiary reaches the three year mark. These CMS-developed policies came at a time when the home oxygen benefit was also subject to a payment cap and an additional 9.5 percent across the board cut. The collective impact of these policies equals a 27 percent cut, totaling $845 million this year alone.

Excerpts from the letter to Speaker Pelosi, Majority Democratic Leader Hoyer and House Republican Leader Boehner, urging House leaders to ask CMS to revise post 36-month payment for home oxygen include:

"CMS' final rule, published on October 30, 2008, addressing the treatment of oxygen therapy post 36 months established very limited payment levels and unreasonable obligations that are impeding the provision of quality care to Medicare beneficiaries on home oxygen therapy."

"We seek your assistance in urging CMS to revise post-36 month oxygen payment policies to address serious shortcomings that are creating hardships for both oxygen patients and providers of these services. Without immediate changes to the Medicare policies patient care will be compromised and Medicare costs will increase."

The Council for Quality Respiratory Care, a coalition of the nation's leading home oxygen therapy providers and manufacturers representing nearly one half of the more than 1.5 million Medicare beneficiaries who depend on the home oxygen benefit for independence and quality of life.


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SOURCE Council for Quality Respiratory Care
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