AMARILLO, Texas — With all the confusion surrounding CMS' new post-cap oxygen payment rules, it's time for some answers. Beginning a special series today for HomeCare Monday, Lisa K. Smith, Esq., an attorney with the Health Care Group at Brown & Fortunato, P.C., a law firm based in Amarillo, Texas, responds to several of home medical equipment providers' most common questions about the new rules.
HomeCare: What are the ramifications from CMS, based on current information, if the current supplier cannot find a supplier willing to accept patients moving from its service area?
Lisa K. Smith, Esq.: If it is during the 36-month cap period, the current supplier should do its best to assist the patient in locating a supplier to service the patient in the area where the patient is moving, but the current supplier has no liability if it is unable to find one. If it is after the 36-month cap period, the supplier will have to make arrangements for servicing the patient by either allowing the patient to take the supplier's equipment to the new location and contracting with a local supplier to service the equipment as needed, or paying whatever it takes to get a supplier to provide equipment and services to the patient. In the case of oxygen contents, I believe it should be sufficient to find a supplier willing to provide contents to the patient, whether on an assigned or unassigned basis.
HomeCare: If a home filling unit is provided, can the supplier automatically bill monthly charges for oxygen contents?
Smith: If it is a system where the patient fills portable tanks from an oxygen generating device (i.e. concentrator), the answer is no. If it is a liquid or gas system requiring contents delivery that the patient uses to fill its portable, then the supplier can bill for portable contents. If the patient uses the stationary unit with its contents as his or her stationary oxygen supply, then the supplier can also bill for stationary contents.
HomeCare: Can a supplier limit the number of portable tanks it provides to the patient to the amount used by the patient in the home? Can the supplier ask that the patient pick up the tanks from its facility or does it have to deliver?
Smith: CMS has stated that the supplier cannot limit the portable oxygen contents to only the amount used in the home, as it is understood that portable contents will be used both inside and outside the home. The Supplier Standards require the supplier to deliver equipment and supplies, so the supplier cannot ask the patient to pick up tanks from its facility.
Lisa K. Smith, who is Board Certified in Health Law by the Texas Board of Legal Specialization, represents HME companies, pharmacies, hospitals and other health care providers throughout the United States. She can be contacted at lsmith@bf-law.com.
