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.