The U.S. Medicare Competitive Bidding Program, intended to cut costs and curb fraud and abuse, is causing fears of loss of liquid oxygen availability among Alphas and other COPD patients who need liquid oxygen for their home health care.
Medicare beneficiaries in 100 areas will be affected by the 45% cuts in durable medical equipment reimbursement beginning July 1, 2013. Oxygen equipment is among the list of durable medical equipment that will experience reimbursement cuts. The competitive bidding program is intended to reduce spending as the country faces ballooning medical costs, unmanageable deficits, and an aging population.
Some patients who need liquid oxygen are being told that their suppliers are discontinuing providing liquid oxygen and instead are replacing equipment with a stationary home concentrator and E-Tanks. Patients also say they are being given fewer E-Tanks, which results in restricting their mobility. While this is not illegal, for many patients it is totally unacceptable, as it reduces their mobility and ultimately their health status.
Suppliers claim that with the existing price structures, they lose money on liquid oxygen due to more frequent delivery, longer service periods, and more frequent customer complaints. Many suppliers are offering patients “transfill” systems that allow people to refill their own tanks of varying sizes in the home. Suppliers are actively encouraging people to move from liquid oxygen to the transfill systems.
Liquid oxygen delivery is very expensive compared to providing a stationary concentrator and E-Tanks. Since most suppliers have their own tank filling facilities, once the cost of the filling unit is taken care of, their cost to furnish tanks is reduced considerably.
However, an oxygen supplier cannot refuse to provide liquid oxygen when the patient’s physician specifically prescribes it, and if the oxygen provider can’t identify another supplier to whom the patient’s liquid-oxygen prescription can be transferred.
Patient advocacy groups are asking whether these cost savings on liquid oxygen delivery will translate into cost increases, because patients are being hospitalized for longer periods and may require more frequent physician visits.
The Centers for Medicare & Medicaid Services (CMS) has created an ombudsman to respond to problems and complaints about the Competitive Bidding Program.
It is vital that anyone encountering problems with liquid oxygen delivery due to competitive bidding should register a formal complaint with specific information. Individuals, including beneficiaries and caregivers, should call Medicare about complaints and problems at 1-800-633-4227. TTY users should call 1-877-486-2048.
The COPD Foundation is taking the lead on addressing patient concerns about limiting liquid oxygen availability. The Foundation is also contacting each of the major home oxygen suppliers to survey changes in policy and make patients aware of changes.
Anyone who is experiencing problems with access to liquid oxygen because of the new competitive bidding process is also encouraged to call the C.O.P.D. Information Line at 1-866-316-2673. This is a toll-free number for peer-to-peer information about COPD by patients and caregivers. Information Line staff will collect information about problems with the Competitive Bidding Program and forward it to advocates for better patient access to care.