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MAMES - Mississippi Association of Medical Equipment Suppliers
 

Mississippi Association of Medical Equipment Suppliers

 

Title: Med Learn Matters Oxygen Article
Posted on: 11/21/2008
Description:

CMS released a Med learn Matters Oxygen Article late Wednesday.

Below are some key points:

Section 414.226(g)(2) of the regulations prevent suppliers from switching
oxygen equipment modalities during the 36 month period (e.g., from liquid oxygen to a concentrator).  There are special exceptions to this rule in the event the physician orders different equipment based on medical necessity or where the beneficiary chooses newer technology and signs an Advance Beneficiary Notice (ABN) acknowledging potential financial liability for the newer technology.
 
Section 414.226(g)(1) also requires the supplier to disclose its intentions for accepting assignment of claims during the 36 month rental period.
Be aware that after the 36 month cap the following requirements apply:
The supplier is required to continue furnishing the equipment, supplies
and accessories for any period of medical need for the remainder of the
reasonable useful lifetime of the equipment.  This requirement includes
use of equipment following temporary breaks of in-home oxygen services
(e.g., due to a hospital or other facility stay) of any duration after the 36-
month rental cap.


Beneficiary Relocation Issues
If the beneficiary relocates before the end of the 36-month rental period,
he/she should work with his or her supplier to make arrangements to continue receiving oxygen and oxygen equipment from a new supplier at his or her new place of residence.
 
If the beneficiary relocates after the 36-month rental period, the supplier is required to continue furnishing oxygen and oxygen equipment, and therefore, must make arrangements for the beneficiary to continue receiving oxygen services at his or her new place of residence.
Take Note: Suppliers that are found to be out of compliance with existing
regulations and these new requirements are subject to significant administrative remedies, including removal of billing privileges.
 
Beneficiary Issues of Importance to Providers

Beneficiaries are entitled to change suppliers at any time during their period of medical need.  A word of caution, finding new suppliers after the 36 month cap may be difficult because the new supplier would receive no monthly payments except for maybe the maintenance and servicing
visit.

If beneficiaries choose to purchase their own oxygen equipment instead of
renting, they need to understand that Medicare does not pay a lump-sum
purchase for oxygen equipment. Medicare pays on a rental basis up to a
36-month rental period
   
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