Medicare Home Oxygen: Refining Payment Methodology Has Potential to Lower Program and Beneficiary Spending
DIANE Publishing, Apr 1, 2011 - 58 pages
Studies have found that Medicare payment rates for home oxygen exceeded other payers' rates. Congress has reduced home oxygen payment rates, capped rental payments after 36 months, and directed the Centers for Medicare & Medicaid Services (CMS), which administers Medicare, to use competitive bidding. This report examined Medicare home oxygen payment policy. It describes how Medicare pays for home oxygen; the effect on Medicare's payments of using other methodologies and rates; and changes in beneficiary access. The report reviewed industry-reported costs, Medicare claims data and payment data from selected private insurers, the VA, and CMS's competitive bidding program. Illustrations. This is a print on demand report.
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36 months 36-month rental cap AAHomecare access to home adjusted cost Analysis of Medicare Appendix approximately beneficiaries used stationary beneficiaries using portable beneficiary relocates CHEST Journal competitive bidding program cost estimates cost of providing Data in Industry delivery of oxygen durable medical equipment equipment types estimate suppliers gaseous systems HCPCS home oxygen beneficiaries home oxygen equipment home oxygen payment home oxygen suppliers liquid oxygen Medicare beneficiaries Medicare claims data Medicare expenditures Medicare home oxygen Medicare’s payment rates methodologies and rates monthly cost months of continuous Morrison report National Coverage Determinations number of suppliers OGPE overall overhead costs oxygen payment rates Oxygen Therapy patient payers payment for oxygen payment for stationary payments for home percent of home provide home oxygen rates for home rates for stationary rental payments Representatives respiratory therapists scheduled maintenance stationary concentrators stationary equipment stationary oxygen concentrators supplier’s service area surety bond traditional portable equipment VA’s