Home Health & Hospice Week

Reimbursement:

FEHBP Cuts Hurt Nebulizers Most - But Oxygen Yet To Come

CMS announces cuts in 2005 fee schedule. Suppliers anxiously awaiting the final word on oxygen cuts to Federal Employee Health Benefit Plan levels will have to hang on a little longer.
 
The Centers for Medicare & Medicaid Services has issued fee schedule payment rates for seven of the eight durable medical equipment items singled out for FEHBP-related cuts - nebulizers, hospital beds, air mattresses, manual wheelchairs, lancets, blood glucose test strips, and power wheelchairs. But CMS won't reveal oxygen payment rates until the middle of this month, it says.
 
CMS made the FEHBP cuts on a state-by-state basis, as expected (see Eli's HCW, Vol. XIII, No. 35, p. 278). Nebulizers saw the most significant cuts, with as high as 18 percent cuts in some areas, notes Elyria, OH-based Invacare Corp. in an analysis of the fee schedule. Manual wheelchairs got by with the lightest cut, reaching only as high as 2.5 percent in the worst cases.
 
Could have been worse: The reductions are not as bad as the industry feared, notes Invacare's Cara Bachenheimer in the analysis. "The cuts are less than the percentage reductions identified by the [HHS] Office of Inspector General" in its 2002 analysis of FEHBP payment rates, Bachenheimer says. The report sparked the legislation requiring the FEHBP-related cuts.
 
The American Association for Homecare is urging members of Congress to co-sponsor legislation (H.R. 4491) repealing the cuts. Medicare and FEHBP populations are markedly different and Medicare has more regulatory requirements, AAH notes. 
 
Editor's Note: The fee schedule is at www.cms.hhs.gov/providers/pufdownload/#dme. A memo regarding the fee schedule is at www.cms.hhs.gov/manuals/pm_trans/R369CP.pdf.
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