Tobacco Deal Chokes Off Access To Oxygen Therapy For Half Million Medicare Beneficiaries Who Receive Cost-Effective Care At Home, USA

Main Category: COPD
Also Included In: Caregivers / Homecare;  Medicare / Medicaid / SCHIP
Article Date: 27 Jul 2007 - 1:00 PST

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Unwilling to increase tobacco taxes enough for pay for changes to Medicare and children's health insurance, committees in the House of Representatives are proposing a reimbursement cut that jeopardizes the benefits of a half million seniors who depend on medical oxygen therapy to treat severe respiratory conditions such as COPD. The changes were proposed in H.R. 3162, titled "The Children's Health and Medicare Protection Act of 2007."

This bill will be marked up in the days ahead in two House committees with jurisdiction over Medicare, the Ways and Means Committee and the Energy and Commerce Committee.

The bill would also eliminate the first-month purchase option for power wheelchairs in Medicare. Eliminating the first-month purchase option for power wheelchairs will reduce access for beneficiaries who suffer from long-term conditions such multiple sclerosis, Lou Gehrig's disease, spinal cord injuries or paralysis. Analysis by the American Association for Homecare, which represents providers of home medical equipment and therapies, has shown that eliminating the first-month purchase option would result in the Medicare program paying five percent more for power wheelchairs than Medicare currently pays.

The House bill cuts provider reimbursement for some oxygen systems by about two-thirds and forces patients in Medicare to assume ownership of oxygen equipment after 13 months of use rather than the 36 months of use under current law. "Medical oxygen is a highly regulated prescription drug, and providing home oxygen therapy requires numerous services and costs above and beyond the cost of the equipment," stated Tyler J. Wilson, President and CEO of the American Association for Homecare.

"Both oxygen therapy and power wheel chair reimbursement have suffered numerous reimbursement reductions, which already threaten to erode patient access and quality of care," Wilson said. More than one million Medicare patients depend on home oxygen, and the proposed ownership transfer would affect more than 45 percent of those patients.

The typical Medicare home oxygen beneficiary is a woman in her seventies who suffers from late-stage COPD with associated severe low levels of oxygen in her blood (hypoxemia). COPD is the leading cause of morbidity and mortality worldwide and is the only leading cause of death for which both prevalence and mortality are rising. COPD is a chronic, debilitating disease characterized by severe airflow limitation resulting from chronic inflammation of the airways, decrease in functional lung tissue, and the dysfunction of pulmonary blood vessels. Approximately 15 million Americans have been diagnosed with COPD, and an estimated 12 to 15 million more remain undiagnosed.

Congress has reduced Medicare reimbursement for oxygen therapy by nearly 50 percent over the past 10 years.

The American Association for Homecare represents providers and manufacturers of durable medical equipment. Association members serve the medical needs of millions of Americans who require oxygen equipment and therapy, mobility assistive technologies, medical supplies, inhalation drug therapy, home infusion, and other home medical equipment, therapies, services, and supplies. Membership includes providers of all sizes that operate approximately 3,000 locations in all 50 states.

http://www.aahomecare.org