The National Association of Independent Medical Equipment Suppliers reports that it has again written to Acting CMS Administrator Kerry Weems to urge him to release a revised oxygen policy.

  “The industry simply cannot wait any longer to get the needed policy revisions, HCPCS codes, and fees along with clarification of supplier responsibility after the cap begins on January 1st,” noted Wayne Stanfield, NAIMES President. 

The NAIMES Board, at the October meeting, directed that NAIMES write to Weems, as well as to key members of the House and Senate as a follow up to an Aug. 21 letter to Weems that NAIMES says received no response.

That letter called for a policy release by Oct. 1, which would have let providers prepare for any changes. NAIMES notes that providers must notify patients no later than Nov. 1 regarding their intent and ability to serve their needs after the cap begins.

NAIMES reports that its counsel has advised it that if providers fail to notify patients 60 days prior to the cap start date that they could be obligated to serve those patients for the remaining 24 months, regardless of the payment policy. NAIMES says the suppliers it has contacted regarding the matter indicated that between 25 percent and 40 percent of their patients will cap on Jan. 1, 2009, with a much smaller percent capping each month after.

Moreover, the issue of moving and traveling patients still presents a problem for providers, especially “snowbird” patients who make lengthy, seasonal treks to warmer climates, NAIMES reports.

“Many who have been served in the past may not find a provider willing to take them with only two months left on the 36-month cap without assurance that there will be payments for the service,” a public statement from the association says.

The association notes that providers can make opt out decisions on a
patient-by-patient basis, along with making a different opt out
decision each month as new patients cap. Regardless, three years have gone by with no policy release. Even with changes related to MIPPA, NAIMES says CMS has had plenty of time to prepare.

“CMS has been aware of the cap since November 2005, and yet we are about 75 days away and they are still dodging the issue,” the NAIMES statement adds.  “… It is uncertain at this point whether a comment period will be required when the oxygen policy is finally released or what the effective date will be.”