The New Oxygen Coalition, a body consisting of various oxygen services stakeholders in the HME/homecare industry, has released an outline of a draft oxygen reform proposal. The draft was circulated to state associations as well as during the American Association for Homecare’s Washington Update conference session this week at Medtrade Spring 2009.

“I think that it’s fair to say that the oxygen benefit is under siege, and now is the time for the industry to take a reform proposal to Capitol Hill,” said AAHomecare President and CEO Tyler Wilson during the session’s opening remarks.

The NOC includes various state and national association representatives, providers and equipment manufacturers, and was formed in February to improve the oxygen benefit under Medicare.

The 13-point proposal was developed over the past 45 days to focus on a fee-for-service model that incorporates three patient classifications and that will paid on a monthly basis with a bundled allowable that would include payment for related services and supplies.

The 13 points include:

    * Eliminating the oxygen cap and taking oxygen services out of competitive bidding.

    * Recognizing the service costs related to providing oxygen.

    * Stipulating the specific activities and services related to home oxygen therapy, and then requiring them to be linked specific patient needs.

    * Creating three tiers of patient categories based on how ambulatory they are and their portability needs.

    * Payments for services and supplies.

    * Patient retesting every 60 to 120 days.

    * New coding for the patient categories, with an estimated patient mix for each category.

    * Establishment of allowable charges for the first two years, and related budget-neutral assumptions.

    * Annual updates to allowable charges based on the consumer price index for urban consumers.

    * Establishment of an advisory committee from the home oxygen therapy community that will discuss and formulate advice to the HHS Secretary regarding Medicare coverage of home oxygen therapy.

    * An industry cost study every three years to provide cost transparency.

    * Recommendations for anti-fraud measures.

    * Recommendations on beneficiary protections. 

The draft was distributed to the various station associations, as well as to attendees of the Medtrade Washington Update for review and feedback to the NOC. Once industry endorsement is achieved, the NOC will translate the plan into legislative language. The ultimate goal is to formalize a final, budget neutral reform policy proposal that the industry can circulate in Congress as the Obama administration gears up to reshape the nation’s healthcare landscape.

“We look at the next 30 days as very critical,” said Walt Gorski, AAHomecare’s vice president of government affairs.

“The healthcare reform train is moving forward, and if we’re not on it, we’ll miss our opportunity,” Wilson added.