OIG: Access to oxygen, enteral supplies not impeded

Thursday, May 24, 2018

WASHINGTON – Round 2 of Medicare’s competitive bidding program does not appear to have impacted access to oxygen or enteral supplies for most beneficiaries, according to two new reports from the Office of Inspector General.

The OIG analyzed claims data from three months before and six months after the July 1, 2013, kick-off of the program in both CBAs and non-CBAs.

For oxygen, the OIG found that Medicare payments continued for 86% of beneficiaries in CBAs and 89% of beneficiaries in non-CBAs. Those rates were consistent with payments being made for 88% of beneficiaries in 2012.

For enteral nutrition supplies, the OIG found that Medicare payments continued for 91% of beneficiaries in CBAs and 94% in non-CBAs, slightly lower than the 95% in 2012.

In both cases, the OIG said that the slightly higher percentages of beneficiaries in the CBAs “may or may not indicate disruptions,” and that the difference could also be attributed to the program reducing unnecessary equipment and supplies, as CMS has claimed in the past.

The OIG reports follow an interim final rule recently released by CMS that validates concerns raised by industry stakeholders about the significant reimbursement challenges and the decline of suppliers in certain areas.

A 2017 survey of beneficiaries, suppliers and discharge planners commissioned by AAHomecare found that 59% of oxygen patients reported access issues.