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.