AAHomecare Asks for Answers on Oxygen Cap

WASHINGTON–Last week, the American Association for Homecare
asked CMS to address providers’ concerns about the 36-month
oxygen rental cap, which is scheduled to take effect in less than
five months on Jan. 1.

The cap was imposed by the Deficit Reduction Act of 2005, which
also required that ownership of oxygen equipment transfer to
beneficiaries after 36 months of rental. The title transfer was
eliminated by the Medicare Improvements for Patients and Providers
Act of 2008–the same law that delays competitive bidding–but the
rental cap remains. Under the newest rule, providers will maintain
ownership of the equipment for its useful lifetime (five years),
but CMS has yet to address how service and maintenance will be paid
after the equipment has capped.

The association submitted a list of nearly two dozen questions
related to the impending cap and revisions under MIPPA,
including:

–How will CMS develop appropriate payment amounts for episodes
of maintenance of oxygen equipment?

–CMS currently pays one month’s rental payment for loaner
equipment when the beneficiary-owned equipment is repaired. Will
CMS apply this policy to oxygen equipment after payment for the
equipment has capped?

–Currently, suppliers furnish services that the Medicare
program does not recognize, such as 24/7 on-call services,
emergency services and trouble-shooting by phone. May a supplier
establish a service contract with the beneficiary to provide these
types of services after the rental payments cap?

–How does CMS plan to reimburse for parts and labor after the
rental period has ended?

–If a beneficiary moves outside the supplier’s service
area after the rental payments cap, will CMS initiate a new
36-month rental period for oxygen equipment?

The questions were collected through inquiries AAHomecare has
received from its members seeking clarification related to oxygen
therapy as the 36-month payment cap approaches. The association
said it has also requested an in-person meeting with CMS staff to
discuss the issues.

To view the complete list of questions submitted to CMS, check the
AAHomecare Web site at
www.aahomecare.org.