New Choices

If you are in the oxygen business, it is time to take a deep breath. Just when it seemed business could not become more complicated for home medical equipment providers — after all, competitive bidding is imminent — a last-minute provision added to the Deficit Reduction Act poses serious concerns for those in the home oxygen therapy sector. The law includes a mandate that caps rental of oxygen devices after 36 months and transfers title of the equipment to Medicare beneficiaries at the same time.

Now more than ever, HME providers must evaluate their business practices and seek new methods to increase operational efficiency while providing clinically effective service for their patients.

“There is ambiguity about the future,” says Joe Priest, president and COO of AirSep Corp. “One of our hopes is that shortly — hopefully, within this year — we can come to a mechanism of reimbursement through CMS that is stable. Then, providers and manufacturers can approach the market based upon that and provide the best equipment that meets patients' needs and is also reimbursed appropriately.”

At press time in fact, an “oxygen summit” attended by physicians, manufacturers, providers, patient advocacy groups and others had convened to take a look at Medicare's entire oxygen benefit. And a bill called the Home Oxygen Patient Protection Act, which would repeal the 36-month oxygen cap, had been introduced in the House of Representatives.

But for now, the 36-month cap is a disconcerting and significant policy change, says Jim Clement, global director, DeVilbiss Systems, for Sunrise Medical. “Thus far, there are many more questions than answers since the legislation has not been translated into policy.”

It is possible that technology could provide some answers and, according to these experts, it is also clear that HME providers are best suited for the job of serving patients both during and after the 36-month rental period.

Priest notes the clinical requirement of home oxygen therapy that is necessary and cannot be ignored: “The doctors can't do it, and there is no one else who can do it; the best people to provide oxygen therapies in the home are the current providers,” he says. “Somehow, that clinical component needs to get addressed in the reimbursement scheme.”

The expertise providers utilize involves determining the right system for each patient, and that is not a simple decision.