WASHINGTON--With Congress scheduled to vote on the 2006 federal budget reconciliation bill Wednesday, the American Association for Homecare is rushing to correct misinformation that it says is being spread in support of the bill.

The Deficit Reduction Act, or S. 1932--which contains $39.7 billion in spending reductions, with $6.4 billion in savings from Medicare and $4.8 billion from Medicaid over five years--would cap oxygen rentals at 36 months (see HomeCare Monday, Jan. 17) and rentals of most other DME, except for power wheelchairs, at 13 months.

AAHomecare, which has spearheaded HME efforts against the measure, said a document circulating in some Congressional offices last week claims that concern about the bill is unfounded.

According to the document, which is called "Reforming the Medicare Oxygen Payment System is Good Government," the Medicare program will pay for service and repairs to beneficiaries' oxygen equipment as well as continue to pay for deliveries of oxygen.

But AAHomecare argues that the bill does not contain specific assurance or directive for payment--just ambiguous language concerning "payments for oxygen" and "maintenance and service" after the purchase and transfer of title for the equipment to the beneficiary. While the bill suggests such payments "may" be available and will be determined by HHS, AAHomecare said, there are no codes or policies governing the maintenance and services of oxygen technologies in today's Medicare system.

Moreover, the association said, the bill provides no guidance for many service components--such as disposable accessories, 24-hour emergency service and equipment replacement--that are currently required and incorporated into Medicare oxygen rules and payment.

"Once the patient owns items such as oxygen cylinders, the delivery and filling of such will become the beneficiary's responsibility," AAHomecare said. "There are numerous state and federal regulations governing the safe handling, filling and transport of medical oxygen that will be complicated with this change in ownership."

According to its proponents, however, the Deficit Reduction Act changes oxygen payment from perpetual rental to a rent-to-own program because Medicare currently pays significantly more than the retail price to buy oxygen equipment--and that payment system needs reform.

For example, according to the document, under current law, "Medicare pays indefintely for the rental of oxygen equipment at a rate of approximately $200 per month (CMS). So after five months, Medicare has paid for the piece of equipment. Yet the program continues to make payments for the equipment--and beneficiaries continue to pay coinsurance. Medicare beneficiaries who need oxygen rent the equipment and use it for an average of 30 months, according to CMS. This means that Medicare and beneficiaries will pay several times the cost of the equipment over the course of the rental period."

The document points out that provisions of the budget bill change this system by transferring ownership of the equipment to the beneficiary after 36 months of rental, so that neither Medicare nor beneficiaries "continue to pay for equipment that has been more than paid for."

To access the full text of "Reforming the Medicare Oxygen Payment System is Good Government," click here.

To access the full text of AAHomecare's "Response to Arguments in Favor of Changes to O2 Policy," click here.

To view the text of the budget bill, also known as S. 1932, visit http://thomas.loc.gov.

For further information about provisions that would affect DME in the budget bill, visit www.aahomecare.org or www.vgm.com.

To find your members of Congress, click here.