Industry Reels from Another Shot at HME
WASHINGTON–After a scathing article in the New York
Times blasting what reporter Charles Duhigg described as
Medicare overpayments for home oxygen, the American Association for
Homecare issued a statement late Friday explaining HME companies’
services in providing the therapy and asking for “a genuine debate”
about appropriate payment for oxygen.
In the Friday newspaper article, titled “Oxygen Suppliers Fight
to Keep a Medicare Boon,” Duhigg said the government program spends
“more than double what somebody might spend at a drugstore” for
home oxygen equipment. In addition, the article said, “Medicare
spends billions of dollars each year on products and services that
are available at far lower prices from retail pharmacies and online
stores.”
But in its statement, AAHomecare said the article “paints an
extremely biased and misleading picture” of the health care sector
that provides home oxygen therapy to Medicare beneficiaries.
AAHomecare “welcomes a genuine debate about appropriate Medicare
payment policy for oxygen therapy,” the statement said. “In fact,
the association and companies providing oxygen therapy have been
working for more than a year to design alternatives to existing
Medicare policy for Congress to consider. Unfortunately, both the
New York Times article and federal policymakers have
focused only on the equipment costs associated with home oxygen
therapy rather than the complete therapy, which requires numerous
services …
“The fundamental flaw” in the article, the statement continued,
“is the dangerously simplistic assumption that oxygen therapy
delivered to Medicare patients in their homes should cost the same
as the Internet or eBay price to buy the equipment only.”
The association pointed to a 2006 study by research firm
Morrison Informatics–which analyzed data from home care providers
collectively serving more than 600,000 Medicare home oxygen
patients–that found 72 percent of the costs of providing the
therapy represents services, delivery and other operational
expenses, while the equipment itself represents only 28
percent.
For the second time in as many months, the industry has had to
beat back the notion that Medicare is overspending on its
reimbursements vs. Internet prices.
AAHomecare and other home care supporters responded in November
when an Office of Inspector General report compared Medicare fees
for power wheelchairs to Internet prices for those products. (See
HomeCare Monday, Nov. 5.)
“Internet purchasing and the Medicare provider model are
completely different,” the association wrote in a Nov. 12 letter to
Inspector General Daniel Levinson, noting that HME providers must
shoulder expenses such as evaluating the beneficiary’s specific
needs, delivering the equipment, performing on-site training and
processing insurance claims.
“Any accurate analysis of costs required to provide the expected
Medicare standard of care must take into account these services and
administrative costs, which are distinct from the costs of
acquiring the equipment,” the letter pointed out.
Friday’s newspaper article comes just as Congress returns from
its Thanksgiving recess to finish up work on key spending bills.
The Senate Finance Committee plans to mark up a Medicare bill this
week or next that stakeholders fear could include another oxygen
reimbursement cut.
In a posting on its Web site, Waterloo, Iowa-based buying group
VGM–which conducted a Washington call-in Nov. 14 to rally support
for several industry-backed bills and ask for no further cuts to
oxygen–labeled the article “hack journalism” and said it planned
to respond. The call-in generated more than 8,100 calls to federal
legislators.
AAHomecare said its response had been sent to the national
media. If the Times article is picked up in local papers,
the association said, it has prepared points that providers can use
to write their own responses in a letter to the editor.
The National Association of Independent Medical Equipment
Suppliers sent a memo to its members on Friday to “email, call or
write this reporter with your response to the story.
“As an industry, we must respond to such stories in the
strongest manner possible,” read a message from NAIMES’ Wayne
Stanfield, president and CEO, who said the recently formed provider
organization would prepare its own response to the article.
According to the Council for Quality Respiratory Care, which
also issued a response to the story on Friday afternoon, the
New York Times article “omits salient facts about home
oxygen therapy and the critical role it plays in keeping some of
Medicare’s sickest beneficiaries in their own homes as they manage
the effects of debilitating and irreversible lung disease.
“The story inappropriately treats home oxygen therapy as though
it is nothing more than the rental of inert equipment, when in fact
home oxygen is a prescribed therapy, that when properly
administered, requires both medical devices and myriad patient
services,” the CQRC said. The group is comprised of 11 of the
nation’s leading home oxygen providers and manufacturers.
Read the New York Times article.
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