Oxygen Stakeholders Step Up Work on Benefit Overhaul

ARLINGTON, Va.—After working for weeks to find common
ground on reform of Medicare’s oxygen benefit and repeal of
the 36-month cap, the American Association for Homecare said Friday
that a proposal is nearly complete.

AAHomecare’s New Oxygen Coalition, a group representing a
range of home oxygen stakeholders, has been meeting over the past
45 days to come to agreement over the reform plan, originally
proposed by the association and the Council for Quality Respiratory Care. But some state
associations balked at the plan because it did not immediately
address the 36-month cap and the post-cap payment rules (see

”Oxygen Stakeholders Work toward Common Ground,”
Feb. 9).

There was also unease among some providers over how the CQRC
plan would pay for oxygen under a case-mix adjusted system. Both
Jason Rogers, president of the Georgia Association for Medical Equipment
Services, and the Big Sky Association for Medical Equipment Services
proposed alternate plans.

But as the nation’s health reform debate speeds up,
members of the NOC–which includes some state associations,
VGM, The MED Group, the
CQRC, the National Association of Independent Medical Equipment
Suppliers and AAHomecare–have worked quickly to settle their
differences. “The big push is to get a unified voice,” Mike
Calcaterra, Montana state chairman and legislative/DAC chair for
the Big Sky association, told HomeCare Monday last month.
“We need to make sure we are on message [in Washington] with
something that is giving us immediate relief. We are already seeing
providers closing their doors.”

According to AAHomecare, a NOC workgroup has been meeting in
person and by phone to develop a reform plan that addresses the
problems with the current Medicare oxygen payment system. The goal
is to put the final reform plan into legislation that would be
considered by Congress this year, the association said.

“All of our political intelligence tells us that oxygen
providers may face a further reduction in the reimbursement period
from 36 to 18 or fewer months. Alternatively, or even in
conjunction with a reduced reimbursement period, current payment
rates could be severely cut,” said AAHomecare President and
CEO Tyler Wilson.

“Add to this state of affairs the prospect of competitive
bidding. It is within that context that a reform plan is being
proposed,” Wilson continued. “In essence, the NOC has
developed a reform plan out of necessity (including admonitions
from our allies on the Hill) because the home oxygen benefit is
under siege.”

Looking for consensus on the draft plan, the association has
sent it out to state associations for vetting this week and is
hoping for feedback–and endorsement–before the plan is put into
final form. Wilson and Walt Gorski, AAHomecare vice president of
government affairs, will detail the plan for attendees at the
association’s “Washington Update” at Medtrade
Spring on Wednesday, March 25.

The session will take place at 2 pm in Room N261 at the Las
Vegas Convention Center.