Medicare assures patients about access to oxygen

Medicare officials tried on Monday to quell growing worry by the elderly that they could lose access to lifesaving oxygen supplies with the start of the new year.

The concerns are unfounded and stem in many cases from misleading representations from medical equipment companies, which are unhappy with a change in federal law that kicks in Jan. 1, said Laurence Wilson of the Centers for Medicare and Medicaid Services.

Out of concern that Medicare overpaid for oxygen, lawmakers capped at three years the length of time the government will pay a rental fee for oxygen concentrators.

However, the supplier is required to continue to maintain the equipment for up to five years. With the start of the new year, the three-year cap will kick in for some patients.

The agency has heard from consumers and insurance counselors in Nebraska, Ohio, South Carolina and other states, Wilson said. He described the information given to consumers as having an "organized flavor."

"Our hope would be this problem is isolated, but we are concerned this could be growing," Wilson said.

Medicare officials provided The Associated Press with an example of correspondence given to the elderly in recent weeks. It came from a Centerville, Ohio, company: "This letter is to inform you that over the next six weeks, Halsom Home Care will have to pick up the oxygen equipment you have been using," the letter said. "Unfortunately, due to the decision by Medicare, you will probably not be able to obtain this type of equipment from any other company. This would leave you without any home oxygen services."

The company's owner, Mike Zelinskas, said Monday that he had "no intention of picking up equipment at this point. Nor are we allowed to."

"The purpose of letter to was to get people actively calling their congressman," Zelinskas said.

Zelinskas added that he had a draft letter he was planning to send out soon as a "clarification."

Medicare spends about $3 billion annually to provide oxygen to an estimated 1 million participants who need assistance breathing. About a third of those customers will use oxygen for more than three years.

Medicare officials said that a provider's obligation to continue furnishing oxygen equipment ends after five years. At that point, Medicare will begin making rental payments for up to another 36-month period.

Zelinskas said he was skeptical the government would follow through on that commitment.

"They seem to think that this is just a two-year period where the supplier eats the costs and then gets to bill again, but I can almost guarantee you that's not going to happen," he said.

Although the rental payment stops, Medicare officials say the program will pay for a routine maintenance and servicing visit six months after the end of the three-year rental period.

Wilson said that the agency will take enforcement action against companies it believes mislead consumers. Those sanctions will range from a warning letter to revocation of a supplier's billing number.

He said that Medicare will spend about $7,200 over a three-year period for an oxygen concentrator, while the machine itself costs about $600. Suppliers counter that much of the rental fee reimburses them for servicing and repairing the equipment, and would lead to a reduced level of care for patients with chronic obstructive pulmonary disease and other chronic illnesses.

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On the Net:

Centers for Medicare and Medicaid Services: http://www.cms.gov