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Congressmen Mike Ross and Kendrick Meek Introduce Bill to Protect Medicare Patients Who Require Medical Oxygen Therapy at Home
Date:7/16/2009

American Association for Homecare Applauds 'Medicare Home Oxygen Therapy Act of 2009' Which Would Repeal Harmful Rules that Cause Confusion, Service Disruption, and Reduced Access to Care for More than One Million Seniors

ARLINGTON, Va., July 16 /PRNewswire-USNewswire/ -- The American Association for Homecare applauds Representatives Mike Ross (D-Ark.) and Kendrick Meek (D-Fla.) for introducing the Medicare Home Oxygen Therapy Act of 2009, which would protect more than one million Medicare beneficiaries by focusing the oxygen benefit on patient needs.

The Ross-Meek bill, H.R. 3220, introduced yesterday, follows Tuesday's introduction of the House healthcare reform bill, which addressed Medicare oxygen policy but fell far short of repairing fundamental flaws in the oxygen benefit. In contrast, the Ross-Meek bill makes critical and necessary changes to the oxygen benefit.

"The Ross-Meek bill provides an opportunity to help protect seniors who receive medical oxygen at home, bring stability to the oxygen benefit in Medicare in a budget-neutral fashion, and provide cost transparency," said Tyler Wilson, president of the American Association for Homecare. "We thank Representatives Ross and Meek for championing this important reform legislation." Congressman Ross is a leader among the fiscally conservative Blue Dog Democrats, who are one of the guiding forces shaping healthcare reform legislation in Congress.

The Deficit Reduction Act of 2005 arbitrarily capped reimbursement for Medicare home oxygen at 36 months. The resulting regulations for home oxygen therapy from the Centers for Medicare and Medicaid Services (CMS) have caused confusion, service disruption, and reduced access to care for many of the more than one million seniors in Medicare with COPD and other lung diseases who require home oxygen therapy. This antiquated policy will limit patient access to life-sustaining oxygen equipment and services. Without meaningful changes through the Medicare Home Oxygen Therapy Act of 2009, patient care will be compromised and Medicare costs will increase as the frequency of emergency room visits increase.

Moreover, the net effect of the Deficit Reduction Act and the Medicare Improvements for Patients and Providers Act of 2008 has been a 27 percent cut in reimbursements for home oxygen therapy in 2009. In Medicare, home oxygen therapy costs less than $7 per day.

The Medicare Home Oxygen Therapy Act of 2009 specifically:

  • Requires, in the law, recognition of the essential services that are part of home oxygen therapy. This recognition would end the singular focus on equipment costs and help to dispel the myth of equating Medicare home oxygen therapy costs to the cost of purchase of oxygen equipment alone.
  • Is budget-neutral, so total Medicare spending for oxygen therapy does not change.
  • Strengthens beneficiary protections as well as existing efforts to curb fraud, abuse and waste in Medicare.
  • Repeals the 36-month cap on oxygen, so oxygen can be provided to patients as long as medical need continues.
  • Creates cost transparency by requiring providers to submit annual cost reports to CMS with a streamlined system for small providers.
  • Removes oxygen therapy from competitive bidding, which the Association is trying to end for all HME categories.

Currently home oxygen policies end reimbursements for oxygen services and equipment after 36 months. The new oxygen rules do not account for the required range of services and the realities of providing oxygen therapy to patients. These policies also do not recognize costs associated with unscheduled emergency visits.

Under the CMS rule, the original home oxygen provider must continue to provide, without any payment, for a two-year period following the reimbursement cap: unscheduled service and maintenance visits; 24 hour, 7 day a week emergency care; equipment repairs; and oxygen supplies and accessories. This issue would be resolved by the budget-neutral elimination of the 36-month cap on oxygen.

Home oxygen providers offer far more than just equipment. They are also front-line caregivers. They educate patients on the proper use of their equipment, answer patients' questions, make repairs and adjustments, and ensure that patients are receiving the prescribed amount of oxygen. These providers are one of the primary points of contact for many Medicare patients.

The American Association for Homecare represents durable medical equipment providers, manufacturers, and other organizations in the homecare community. Members serve the medical needs of millions of Americans who require oxygen equipment and therapy, mobility assistive technologies, medical supplies, inhalation drug therapy, home infusion, and other medical equipment and services in their homes. The Association's members operate more than 3,000 homecare locations in all 50 states. Visit www.aahomecare.org/oxygen.


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SOURCE American Association for Homecare
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