Home Health & Hospice Week

Conclusions clash with earlier independent analysis, providers say.

A new federal report fuels claims that Medicare overpays providers of home oxygen equipment.

The report from the HHS Office of Inspector General, released Sept. 13, sent the stocks of companies including Lincare Holdings down and garnered quick reaction from industry representatives.

The Council for Quality Respiratory Care (CQRC), a coalition of the nation's 11 leading home oxygen therapy provider and manufacturing companies, was among the first to challenge the OIG cost study findings, citing the study's limited scope, small sample selection, and failure to consider critical patient services in the provision of quality home oxygen care.

A 2006 study by Morrison Informatics analyzed data from 74 companies that provide home oxygen therapy to more than 600,000 Medicare beneficiaries (see Eli's Home Care Week, Vol. 15, No. 24).

That study showed that nearly three-quarters (72 percent) of the cost of providing home oxygen therapy falls under the scope of patient care and services, not equipment, says the CQRC.

"Many of these types of services were not accounted for in the OIG's survey document," the group said in a news release.

"We were stunned at the narrow sample size of the [OIG] report, which covered only 150 Medicare beneficiaries and simply failed to recognize a multitude of critical patient services provided with home oxygen therapy," said Peter Kelly, chairman of CQRC and CEO of Pacific Pulmonary, in a news release.

Medicare's policy for the provision of home oxygen has gone through numerous changes, including cuts that are scheduled to take effect over the next three years.

The policy changes that are in the works are competitive bidding, which will mandate a specified set of services, and implementation of the 36-month cap with equipment ownership requirements, as outlined in the Deficit Reduction Act of 2005. • Concerns about the local coverage determination affecting power mobility devices prompted the Rehab and Assistive Technology Council (RATC) of the American Association for Home Care to send a letter earlier this month to Department of Health and Human Services Secretary Mike Leavitt and CMS Administrator Mark McClellan. The letter outlines the council's concerns about the LCD and the October 2006 implementation timeframe.

"We believe the policy as currently written contains significant health and safety concerns and we strongly recommend that CMS postpone implementation until these concerns are addressed and a revised LCD is issued that ensures access to medically appropriate equipment," the letter states.

U.S. Senators Rick Santorum and Arlen Specter and Congressman Don Sherwood have also sent letters to CMS and the U.S. Department of Health and Human Services expressing their support for a postponing the October 1implementation of the LCD, reports AAHomecare.

The goal: provide time to address the health and safety concerns and [...]