Perhaps the most important issue facing oxygen users is the impending implementation by Medicare of its Congressionally mandated competitive bidding program. This program requires oxygen providers wishing to serve oxygen patients in 10 selected regions to submit bids, with winning bidders in each geographic area serving those regions January 1, 2011.
This program was originally slated to begin in July, 2009, but Congressional action delayed the implementation until 2011.
Oxygen users in those regions will be faced with important decisions:
- Their current oxygen provider may not be a winning bidder, and therefore will be required to choose a new provider from among winning bidders.
- The “grandfather” provision would permit not winning bidders to continue to serve their current customers as long as they accept the price set through the bidding process.
The link to the Medicare competitive bidding website is http://www.dmecompetitivebid.com/Palmetto/Cbic.nsf/DocsCat/Home
There is a move in the House of Representatives to repeal the competitive bidding law, and there are more than 240 co-sponsors to the legislation. There is no similar provision in the Senate, so the future of such a repeal is unclear. The House legislation is HR 3790 and can be reviewed at http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3790:
36 Month Cap
Congress has mandated that, for all practical purposes, payment for oxygen continues for 36 continuous months, after which the provider is still obligated to provide the oxygen service but receives no ongoing monthly payment from Medicare.
If a beneficiary moves to a new residence after 26 months of continuous use, the original provider is obligated to continue to provide the oxygen to the customer at the new location, even if it is across the country. In most cases, the provider will identify a new local provider and the two companies and the customer will work together to meet the oxygen user’s needs.
A new oxygen system, and a new “36 month payment cycle” can begin after the 60th month of continuous use, as this is the average lifetime of oxygen equipment.