In order to address the complaints that have arisen as a result of changes in Medicare home oxygen equipment reimbursement, the COPD Foundation’s resource hotline—the C.O.P.D. Information Line (1-866-316-2673)—will be receiving calls from those with COPD who have complaints about their home oxygen service.
Beginning Jan. 1, 2009, reimbursement for home oxygen changed, when the law establishing a 36-month rental cap on payment for oxygen equipment impacted the first round of Medicare beneficiaries. The law states that Medicare will be responsible for paying 80 percent of the equipment rental for the beneficiary for 36 months, beginning at the time when the Medicare beneficiary receives the new oxygen unit. After the 36 months, Medicare will cease to make payments, but the Durable Medical Equipment (DME) providers must continue to provide service, free of charge, to the beneficiary for the remaining life of the oxygen equipment, which is deemed to be five years after the oxygen equipment was first delivered to the patient.
The beneficiary is never responsible to continue making payments or co?payments after the first 36 months have passed. Once the life of the oxygen equipment is completed, DME providers must pick up the old equipment and supply the oxygen patient with a new one if it is determined that the beneficiary must continue to receive oxygen. If the unit is replaced, Medicare will begin a new 36 month rental schedule.
In addition to the 36 month rental cap, home oxygen reimbursement has been cut by 9.5% in a deal that the DME companies negotiated with Congress in order to delay the implementation of a Competitive Bidding Program. The 9.5% implemented Jan. 1, 2009 is intended to represent a portion of the savings that would have been realized had Medicare implemented the Competitive Bidding Program. Competitive Bidding is still planned but has been delayed for 18 months until Medicare and the DME industry work out issues associated with the program, such as accreditation.
The COPD Foundation’s goal is to assure that individual beneficiaries continue to have access to the care they need. These reimbursement policy changes prompted some people to contact the COPD Foundation about their concerns with their DME supplier and home oxygen service.
The COPD Foundation has established a relationship with the appropriate liaisons within the Centers for Medicare and Medicaid Services (CMS) to register and respond to patients’ concerns, and developed a consistent tool to collect patient complaint data that will allow CMS to take action with their DME contractors if it is warranted.
Reports from individuals who call the COPD Foundation through the C.O.P.D. Information Line to file a complaint will be sent directly to the appropriate individuals at CMS.
Please contact the C.O.P.D. Information Line at 1-866-316-2673 to report a complaint you may have regarding your oxygen service.