The multi-point plan for reforming oxygen polcy that was refined over the past two months and circulated by the New Oxygen Coalition in March hit a speed bump on its fastrack to Congress, as two central players, AAHomecare and NAIMES, disagreed on key points this week.
The NOC’s proposal outlines a fee-for-service model that moves oxygent to provider status, 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 NOC includes various industry stakeholders, such as providers, equipment makers, and state and national association representatives, including the American Association for Homecare and the National Association of Independent Medical Equipment Suppliers
AAHomecare announced Wednesday that its Board of Directors had voted to endorse the new policy, while NAIMES announced on the same day that it did not support the notion of moving oxygen to provider status, and said that the NOC had reached an impasse over the issue.
AAHomecare cited the plan’s exemption of oxygen from competitive bidding, elimination of the 36-month rental cap and the creation of a plan to recognize the services required for providing home oxygen therapy as key reasons for giving the reform package the nod.
“This is an important step forward to move oxygen policy toward better recognition of the services that we already provide to Medicare beneficiaries who require oxygen,” said Alan Landauer, chairman of AAHomecare and chairman of Landauer Metropolitan. “The plan is designed to remove oxygen from the long cycle of reimbursement cuts that we have suffered.”
“From my perspective as an oxygen provider, the reform proposal is about establishing some much-needed stability in the oxygen sector that will protect the beneficiaries we serve,” added Tom Ryan, chairman of Homecare Concepts and immediate past chairman of AAHomecare. “The idea is to get us out of a reactive position with respect to proposed cuts in Congress. It is important for us to rationalize the oxygen benefit to get paid for the patient-centric services we provide and not rely on the irrational cross-subsidies that the current benefit supports.”
NAIMES, on the other hand, said that moving to provider status represented a “fissure” within NOC and that the plans cost reporting and the use of the plan to remove oxygen from bidding were two other “sticking points” in gaining a consensus on a plan.
“NAIMES does not support a move to provider status or a move to a case-mix, cost-adjusted prospective payment system,” the association said in a public statement. “We also feel that including elimination of competitive bidding in the oxygen reform plan will result in an unacceptable cut to payments if it is to remain budget neutral.
“We do not agree that a move to provider status is the only path leading to meaningful reform, nor do we believe that such a move will protect us from further cuts to reimbursement,” the statement continued. “There is a need for much broader reform of the entire DMEPOS benefit, not a piece-meal attempt to solve the issues of the 36-month cap and competitive bidding by removing oxygen to a stand-alone benefit with no proof of its value.”
NAIMES also raised concerns that those crafting the plan must keep in mind the possible unintended outcomes once Congress were to use it as a basis to shape public policy.
“There is no assurance that the bill will end up as we propose, or that it will reach the final vote as it leaves committee,” NAIMES stated. “The concerns with this process and the regulatory issues point out clearly that the move to provider status must be left out of the proposal. History has proven that good intentions and midnight changes can result in serious consequences.”