CMS Cautions Providers on Oxygen Equipment Rules

BALTIMORE–In an Open Door Forum Wednesday, CMS included a
caution on repeal of the oxygen equipment transfer called for under
the Medicare Improvements for Patients and Providers Act–although
the agency didn’t answer any of the myriad questions providers have
raised about the impending 36-month rental cap.

“Obviously, we are still very much aware of recent changes
in the statutes required by MIPPA, mainly the transfer of ownership
of oxygen equipment and the delay of the competitive bidding
program,” said Joel Kaiser, CMS deputy director of DMEPOS
policy. “We are still analyzing these provisions, still
planning for implementation of these provisions. We are still in
the planning stages.”

Under the new law, providers will maintain ownership of oxygen
equipment, but the 36-month rental cap, imposed by the Deficit
Reduction Act, remains, and is set to take effect Jan. 1. CMS has
yet to address how service and maintenance will be paid after the
equipment has capped. (See HomeCare Monday, Aug. 25.)

Further information on CMS’ plans will be announced
“soon,” Kaiser said.

He emphasized, however, that while the transfer of ownership had
been repealed under MIPPA, “there are other requirements that
have not been repealed.” Under federal regulation 42 CFR
414.226 (g) (2), for example, providers are still prohibited from
replacing oxygen equipment during the 36-month rental period, he
said. There are some exceptions, he added:

–If a physician orders different equipment;

–If the patient elects to upgrade to newer technology;

–Or if equipment is lost, stolen, being repaired, no longer
works or suffers irreparable damage.

Kaiser indicated some problems with HME providers not abiding by
the regulation.

“We will follow up on individual cases and remedy the
situation in some way if the problems continue,” he
warned.

In an update on accreditation, CMS’ Sandra Bastinelli offered
clarification on a question posed during a previous teleconference:
Does a federally-qualified health center that provides DMEPOS need
to be accredited by the Sept. 30, 2009, deadline established for
all DME providers?

“The quick answer is yes, you would need to be accredited
by Sept. 30, 2009,” Bastinelli said, adding that because the
center provides home medical equipment, it would need to adhere to
the same requirements as HME providers.

She said CMS will host a conference Oct. 14 for DMEPOS providers
who are not accredited. The conference, “Compliance with the
DMEPOS Quality Standards: What You Need to Know,” will be
held at CMS’ Baltimore headquarters at 7500 Security Blvd. For more
information, go to www.cms.hhs.gov/apps/events/event.asp and click
on “Upcoming Events.”

Agency officials also reminded listeners that beginning March 1,
2009, DME MACs will accept only properly completed revised Advance
Beneficiary Notices as valid notification. Currently, the MACS
accept either ABN-G and ABN-L or the revised ABN.