KHN Morning Briefing

Summaries of health policy coverage from major news organizations.

Providers And Medicare Battle: Who Owns Home Oxygen Equipment?

A Medicare rule limiting payments for oxygen providers is prompting an aggressive lobbying campaign by the industry, and unintended consequences for patients, the Cleveland Plain Dealer reports: 

"In an attempt to cut Medicare costs that government auditors said were outrageously generous, Congress set a 36-month limit on paying for oxygen in patients' homes, starting in 2006. Most patients use oxygen concentrators -- machines that take in ambient air and purify it for people who need oxygen. The concentrators were to become the property of patients after 36 months.
But battered by a related lobbying campaign, Medicare changed the rules in 2008 so that the rental companies still owned the equipment after 36 months. The companies had to continue to provide it to the same patients for another two years if medically necessary -- without additional payment except for a six-month service fee.
To the companies, that seemed unfair. They would have to leave the equipment in patients' homes and service it, but not be paid for the final 24 months."

The Plain Dealer adds: "...now that it's 2009, the 36-month payment cap is kicking in for patients who have used oxygen since 2006. And the industry has a fresh complaint: Patients who want to change providers, or who have moved, cannot find companies willing to take them. That's because Medicare has already paid one provider for 36 months, so a new provider would not get paid for the remaining two years."

"If nothing changes, oxygen providers say they expect to see pronounced problems next winter, when so-called snow birds flock to Florida. By then, just about everyone who was on oxygen in 2006 will have hit the payment cap," the Plain Dealer reports (Koff, 7/8).

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