HALIFAX, Va.--A Tuesday afternoon update from the National Association of Independent Medical Equipment Suppliers said that after more than 20 hours of teleconference calls, the New Oxygen Coalition “has reached what seems to be an impasse over details of the proposal to reform oxygen.

“The plan originally sent to state DME leaders was later altered and was not supported by most of the independent provider groups on the NOC,” according to the update. “The fracture has occurred along the fissure between those who see moving to a provider status as the only path to follow and those who feel strongly that moving to provider status comes with enormous risks that have not been adequately vetted through the independent provider community.”

Two other “sticky points,” the group said, involve cost-reporting and using the reform plan to remove oxygen from competitive bidding. “Moving to provider status comes with risks and unknowns,” the update said.

An official statement from the association follows:

"NAIMES does not support a move to provider status or a move to a case-mix, cost-adjusted prospective payment system. We also feel that including elimination of competitive bidding in the oxygen reform plan will result in an unacceptable cut to payments if it is to remain budget neutral.

While reform of oxygen may be needed, there are too many unknowns and too many risks to move this quickly on a plan that could result in dangerous unintended consequences. There are too many presumptions of what will be in the regulatory process without any assurance of the end result. We have heard no convincing argument that has changed our view of these dangers over the past three months.

We do and will continue to support the original 13-point NOC proposal, but only if the majority of the state leaders and Boards, and the other representatives of independent providers formally support this plan. If there is no majority agreement, we will withdraw our support totally.

We do not agree that a move to provider status is the only path leading to meaningful reform, nor do we believe that such a move will protect us from further cuts to reimbursement.

There is a need for much broader reform of the entire DMEPOS benefit, not a piece-meal attempt to solve the issues of the 36-month cap and competitive bidding by removing oxygen to a stand-alone benefit with no proof of its value.

There is no assurance that the bill will end up as we propose, or that it will reach the final vote as it leaves committee. The concerns with this process and the regulatory issues point out clearly that the move to provider status must be left out of the proposal. History has proven that good intentions and midnight changes can result in serious consequences.

We will continue to be a part of the dialog and will do everything possible to advance the desires and needs of NAIMES members and the independent provider community."