AAHomecare Urges United Fight as Oxygen Cap Nears

ALEXANDRIA, Va. — With just weeks to go before the
36-month oxygen cap — and CMS’ new policy and payment
regulations surrounding it — take effect Jan. 1, the cries of
those in the home oxygen sector have grown increasingly vocal as
HME organizations pursue several different strategies to fight
it.

The National
Association of Independent Medical Equipment Suppliers and
member services organization VGM Group are urging repeal of the cap. The Accredited Medical Equipment
Providers of America is calling on providers to file complaints
with the Small Business Administration about CMS’ lack of
compliance with the Regulatory Flexibility Act because the new
oxygen rules place an undue burden on providers. (See “AMEPA
Rallies Providers to File O2 Complaints with SBA” in this
issue.)

But late Friday, American Association for Homecare Chairman Alan
Landauer sent an open letter to the industry’s home oxygen
providers noting that while “the imminent cap should make it
evident to everyone that the Medicare home oxygen benefit needs to
undergo significant change … To achieve meaningful reform on
Capitol Hill, the home care community will have to speak in a
coordinated voice with one message that advocates one consensus
plan for reform.”

The association is working to introduce legislation early in
2009 that would “fundamentaly reform” the Medicare home oxygen
benefit by removing the 36-month cap, Landauer said. “Broad reforms
are needed to stop the endless cycle of payment cuts and the
disregard for the services required in providing oxygen therapy …
The reform we are fighting for would remove oxygen from competitive
bidding. It would also require that oxygen therapy be provided and
reimbursed during the entire period of medical need–not just for
36 months. We urge you to support this reform effort.”

Following are additional excerpts from the AAHomecare
message:

“Be aware that an immediate simple repeal of the 36-month
cap that was enacted as part of the Deficit Reduction Act of 2005
would come with a significant price tag. Unless accompanied by
broader reform, repeal would trigger reimbursement cuts to offset
the increase in Medicare spending that would result from removing
the cap. That cut would come on top of the 9.5 percent cut that
will take effect on Jan. 1, 2009, and it would make it virtually
impossible to enact more far-reaching and significant reform to
home oxygen policy.

“Right now, providers should be urging Congress to tell CMS
to adopt fair and reasonable post-cap payment rules. At the same
time, home care providers can submit their own comments to the
recent CMS oxygen rule. A challenge to CMS for overstepping its
authority with respect to the Regulatory Flexibility Act, the
Paperwork Reduction Act or any other statutory mandate requires a
court challenge. Complaints to the Small Business Administration
alone will not suffice. As this association knows from our efforts
to overturn the competitive bidding rule, a court challenge to a
federal agency is very expensive and hard to win.

“Only fundamental reform of the oxygen benefit in Medicare
will give home care providers real relief and preserve the level of
services that oxygen patients require.

“Register your concerns with your senators and
representatives about the oxygen rules and the consequences of
those rules. Submit comments to CMS on the payment rules. Also,
support fundamental oxygen reform. These three actions, in
combination, offer the best course for change that will help
providers and patients move toward a healthier, more stable
future.”

View talking points on the oxygen rules from the
AAHomecare Web site.

CMS is accepting comments on the oxygen
regulations until 5 p.m. EST Dec. 29. In commenting, refer to
file code CMS-1403-FC.