2005 Home Oxygen Fee Amounts Are Significant Improvement, American Association for Homecare

Main Category: Caregivers / Homecare
Article Date: 04 Apr 2005 - 0:00 PDT

email to a friend   printer friendly   opinions  

The American Association for Homecare (AAHomecare) called the 2005 home oxygen rates a significant improvement for providers of home oxygen. On March 30, the Department of Health and Human Services Office of Inspector General (OIG) posted its revised report on Medicare fees for home oxygen and equipment and immediately afterward, the Centers for Medicare and Medicaid Services (CMS) posted the state by state 2005 fee schedule.

The 2005 Medicare oxygen reimbursement amounts were reduced, as required by the Medicare Modernization Act of 2003 (MMA), but were reduced by a smaller percentage than the OIG had originally proposed last fall. CMS has continued to pay the 2004 Medicare fee schedule amounts for home oxygen and equipment pending the CMS announcement of the new 2005 fee.

"These reimbursement cuts for oxygen are several percentage points lower than they would have been if AAHomecare had not pressed OIG and CMS on this issue," said Kay Cox, President and CEO of AAHomecare. "AAHomecare made a successful case for CMS to ask OIG to take the unusual step of re-examining the data in the initial OIG report on home oxygen. We still have questions about some of the methodology used by OIG, but we are very grateful for the level of openness and cooperation at the OIG and CMS. AAHomecare and its members will continue a dialogue with CMS and OIG to protect the oxygen benefit in Medicare."

The MMA mandated that CMS reduce reimbursement, effective January 1, 2005, for several home medical equipment items, including home oxygen and equipment. CMS is required to base payment on the percentage difference between median 2002 Federal Employees Health Benefits Program (FEHBP) amounts and Medicare amounts, to be calculated by OIG. Last year, AAHomecare collected data about the costs of providing home oxygen to Medicare beneficiaries and shared with CMS and OIG this home oxygen information and concern about statistical issues in calculations made by OIG. In December, CMS announced that OIG needed to collect additional data before the FEHBP medians for oxygen and oxygen equipment could be finalized. For the March 30 report, the OIG gathered additional data regarding the pricing of oxygen contents for the figures used to compute the median FEHBP price.

The CMS announcement on March 30 said the new fee schedule amounts "will be implemented by Medicare contractors as soon as possible and by no later than April 8, 2005. All claims for oxygen and oxygen equipment and portable oxygen equipment furnished on or after January 1, 2005, that are received after the fees are implemented will be paid using the 2005 fee schedule amounts. Claims with dates of service on or after January 1, 2005, that were previously paid using the 2004 fee schedule amounts will not be retroactively adjusted."

Homecare is a tremendous value for Americans' healthcare dollar. AAHomecare is the only national association that represents every line of service in the homecare community, including home health and home medical equipment providers, respiratory and infusion therapy, telehealth and telemedicine, rehab and assistive technology, and hospice. Visit http://www.aahomecare.org.

American Association for Homecare
625 Slaters Lane, Suite 200
Alexandria, VA 22314-1171
703-535-1881 Cell: 703-966-9574
http://www.aahomecare.org

• Additional
• References
• Citations