COLUMBUS, Ohio - The state has proposed new coverage criteria for home oxygen therapy that contain both good and bad news for providers. The good news: The state no longer seeks to make oxygen a capped rental item. The bad news: It still seeks to cut reimbursement almost in half.
"We're still very much apart on reimbursement," said Kamela Yuricich, executive director of the Ohio Association of Medical Equipment Services, who met with state officials in late November to discuss the new coverage criteria. "There's a disconnect between what it means to provide the benefit as a whole vs. just the equipment. It's the classic problem we face."
If the new coverage criteria passes muster with a legislative committee, the state will drop reimbursement for oxygen to $100 per month from $175 per month. At the earliest, the change would take effect April 1, 2007, Yuricich said.
OAMES plans to gather data to show the state that the $175 per month it now reimburses for oxygen goes to good use, paying for not only equipment but also services like 24/7 hotlines.
Previously, the state proposed dropping reimbursement for oxygen to about $75 per month, with a maximum payout of $750 for 10 months. The change was due to take effect Sept. 1, 2005, but it was delayed numerous times. Eventually, the state agreed to go back to the drawing board. OAMES is hoping that will happen again, Yuricich said.
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