CMS Issues Final Oxygen Rule
Mark Higley, vice-president of Development
John Gallagher, vice-president of Government Relations
On October 30, 2008, CMS released its final rule with comment period. The following is a summary of the provisions of the regulation that will become effective January 1, 2009, unless CMS makes revisions based on comments it receives.
1. The supplier that provides oxygen equipment to the patient in the 36th month must:
• Continue to provide the equipment to the patient at no additional charge during any period of medical need for the remainder of the useful life of the equipment, including periods that may occur after a 60-day break in service.
• Continue to provide oxygen contents to the patient for the remainder of the useful life of the equipment. Supplier can charge for the contents.
• Arrange for oxygen equipment and oxygen contents with another supplier if the patient relocates outside the supplier’s service area. The new supplier cannot charge for the equipment, but can charge for the contents.
2. The supplier is responsible for, and will not be paid for, maintenance, servicing, and repair of oxygen equipment, with the exception that for calendar year 2009 only, Medicare will pay for 30 minutes of labor once every 6 months (beginning 6 months after the 36-month cap) for routine maintenance and service actually performed on oxygen concentrators or transfilling equipment in the patient’s home. No payment is available for repair or servicing of gaseous or liquid oxygen equipment.
3. The provisions regarding 60-day notice to the patient concerning whether the supplier can continue to service the patient and/or provide oxygen contents after transfer of title have been deleted.
A participating supplier should consider becoming non-participating in order to charge the patient for oxygen contents at its “usual and customary charge” rather than having to take the Medicare allowable.