O2 Advocates Urge Support of Price-Ross Letter–Today

WASHINGTON — With a deadline looming at close of business
today, home oxygen providers and other stakeholders pressed
legislators last week to sign on to a bipartisan “Dear Colleague”
letter calling for appropriate payments for home oxygen therapy
(see Price Asks
House Colleagues to Act on Oxygen Payments, Feb. 10).

“We are pressing every button we can press to get everyone to
call their congressman,” said Wayne Stanfield, president and CEO of
the National
Association of Independent Medical Equipment Suppliers. “The
drop-dead deadline is Monday.”

As of Friday, 59 legislators had signed on to the letter,
authored by Reps. Tom Price, R-Ga.; Mike Ross, D-Ark.; Jo Ann
Emerson, R-Mo.; and Heath Shuler, D-N.C. Crafted with the aid of
the American
Association for Homecare, the letter asks members of the
powerful Ways and Means and Energy and Commerce committees, as well
the top leaders in the House of Representatives, to urge CMS to
provide appropriate payments for home oxygen throughout the period
of the patient’s medical need. A Senate letter is also being
drafted.

“There’s still time to call those offices,” said Cara
Bachenheimer, senior vice president of government relations for
Invacare,
Elyria, Ohio. While there is no “magic number” of signatures,
Bachenheimer said, “the more the better.”

Providers are looking for relief from the 36-month cap that went
into effect Jan. 1, saying it is unworkable. Post-cap payment rules
require providers to continue service to beneficiaries for an
additional 24 months, including patients who move outside the
provider’s service area.

The cap and payment rules have worked a major hardship on Neal
Hansen, owner of Hansen Homecare Specialty Services in Ketchikan,
Alaska.

“We are in a situation where we have to travel so far,” said
Hansen, whose business is 600 miles away from Seattle and 600 miles
from Anchorage. “We have to go to the outer islands. You can take a
ferry over, but you have to wait a day to come back. It costs close
to $900 a [round] trip. We try to do everything by mail and float
plane.”

But not everything can be handled that way. Hansen often travels
to Prince of Wales Island or Annette Island to service oxygen
patients there. With reimbursement being what it is, however, he’s
not sure how much longer he can continue to do that.

Reimbursement must go up, he said, “or we are out of business on
the outer islands. To take that service away would be pathetic. It
would be catastrophic for some people.” No other oxygen provider
serves the islands, Hansen said. “They all refer [patients] to me
because I am the only one crazy enough to do it.”

He and other oxygen providers are hopeful that Congress will
provide some relief.

“My opinion is that Congress is looking for reform,” said Joan
Cross, co-owner of C&C Homecare in Bradenton, Fla. “They don’t
like what they are hearing. They are looking to reform oxygen.”

Cross said she is encouraging her legislators to sign on to the
letter, and she believes they will.

John Reed, COO of Pro2 Respiratory Services in Cincinnati, spoke to his
representatives during an AAHomecare fly-in Feb. 11. He said he was
encouraged by the reception the Ohio delegation got.

“We were there on the Hill the day of the stimulus package,” he
said, “so we saw that the timing was not going to benefit us. But
we were amazed how much time they sat with us. I think we do have a
group of people who are trying to balance the cost of care and do
it in a way that is responsible.”

Reed said his group spent a lot of time educating legislators.
“They could all recite the prices of an Internet oxygen
concentrator,” he noted. “We tried to communicate very clearly [the
realities of the business]” and detailed the current reimbursement
model that doesn’t pay for services.

“I think the message is working,” he said. Two Ohio legislators
signed on right away, and he is hopeful others will also support
the Price-Ross letter.

In addition, stakeholders are working to reach consensus on
long-term oxygen reform. Toward that end, earlier this month
AAHomecare formed the
New Oxygen Coalition, or NOC, after many state HME associations
said they could not support an overhaul plan backed by AAHomecare
and the Council for
Quality Respiratory Care. After a meeting Feb. 11, the
coalition is attempting to reach a clear consensus on a plan to
present to Congress, but as of Friday, stakeholders remained
divided.

“There is still a considerable movement of providers that feel
some immediate relief must be obtained from whatever source we can
[get it],” said NAIMES’ Stanfield. “The vast majority feel that a
repeal of the cap is the only solution to get things back to a
level point where you can talk long-term reform.”

Stanfield is among nine members of a NOC workgoup charged with
ironing out the reform plan. Other members include AAHomecare
Chairman Alan Landauer; Lisa Getson, executive vice president of
Apria
Healthcare; Chris Kane of Pacific Pulmonary; Joe Lewarski, vice president
of Invacare’s respiratory group; John Gallagher of VGM; Don Clayback of
The MED
Group; Montana provider Mike Calcaterra of the Big Sky Association of
Medical Equipment Services; and provider Jason Rogers,
president of the Georgia Association for Medical Equipment
Services.

The AAHomecare/CQRC plan calls for the cap to be repealed and
for oxygen to be removed from any competitive bidding project, but
it also includes a case-mix adjusted payment system some
independent providers don’t like. Both Calcaterra and Rogers have
presented alternative plans (see Oxygen
Stakeholders Work toward Common Ground, HomeCare
Monday, Feb. 9).

Bachenheimer noted the AAHomecare/CQRC plan and the other plans
that have been floated have an “extraordinarily similar”
framework.

“The devil’s in the details,” she said. “We just need to get
everybody on the same page.”

Read the Price-Ross
sign-on letter in full.

To e-mail U.S. representatives, visit www.house.gov and click
“Write Your Representative” on the top toolbar. To contact
representatives by phone, call the U.S. Capitol switchboard at
202/224-3121.