Letter to the editor

After reading "CMS proposes aggressive stance on oxygen" (HME News, August 2010), what stuck me was the unintended consequence of this flawed policy of making providers who service oxygen patients on or after month 18 of their 36-month rental payment period responsible to service them through month 60.

I live in Florida. There are millions of "snowbirds" who flock to our Sunshine State between Thanksgiving and Easter each year, and some of those who are long-term oxygen therapy (LTOT) patients discovered last winter that their longtime Florida provider could no longer care for them because of the 36-month cap. CMS says these patients are experiencing "great difficulties."

I do find it somewhat encouraging to know that CMS does at least listen to some beneficiaries. But CMS defines just how many beneficiaries this impacts in these words: "Relocation is not a common occurrence--less than 0.05% of beneficiaries using oxygen equipment." Thus, potentially 50,000 individuals are impacted and experiencing "great difficulties."

Don't get me wrong: That's a lot of people, but in the scope of the 307 million Americans and the estimated 1 million LTOT patients, it's pretty insignificant. Maybe not to the individuals or their families or their providers, but from a public policy standpoint, that doesn't even constitute a "minority."

It most certainly cannot justify a policy change when, theoretically, 99.5% of patients are not experiencing "great difficulty."

Since "great difficulties" occur at 36 months, how many patients and their families will be impacted at 18 months? Won't this happen with any arbitrary month they choose? That's why this is quite simply a flawed policy written by people who seemingly have no understanding of DMEPOS--and, really why should they when it represents only about 1.7% of overall Medicare expenditures.

In yet another misguided policy, CMS will cut reimbursement, on average, by 32% as part of a competitive bidding in nine cities.  Has anyone at CMS estimated how many beneficiaries in these areas will have "great difficulty" finding a provider promptly?

- John Durkee, vice president of sales, MedSage Technologies