Power Ox gets thumbs up, yet skeptics linger

BIRMINGHAM, Mich. - Like ducks in a shooting gallery, questions about the viability of the Power Ox oximetry testing system keep coming, and Power Ox keeps knocking them down, usually with a letter from John Warren, a health insurance specialist at CMS. The most recent query, voiced by Region A Medical Director Dr. Paul Hughes at a New England Medical Equipment Dealers meeting in June, was this: “When I realize that the [Power Ox] lab only receives the information, I have to wonder if they are doing all the steps necessary to bill. Is it an official test?” Under existing Medicare guidelines, the lab that performs the test must also bill for the test. But with Power Ox, the HME supplier delivers the oximeter to the patient, and it is Oximetry Company, an IDTF based here, that bills for the test. “CMS had made the decision that our system will be billable under the existing codes as an exception,” said Bob Rudowski, Power Ox's designer and owner of Oximetry Company. (For more detail on how Power Ox works, see the May and June issues of HME News.) CMS said it was still reviewing this latest question about Power Ox. But if history serves as a precedent, Power Ox clears this one, too. In three letters, dated Jan. 22, March 23 and April 23, John Warren has given the thumbs-up to this singular oximetry testing solution. On Jan. 22, Warren wrote: “If the pulse oximeter is a sealed unit, owned by the testing facility, and the test results cannot be accessed or modified by the operator or handler of the unit, the DMERCs will allow suppliers to deliver overnight testing units.” On March 23, Warren wrote that suppliers could participate in the Power Ox program: “The DMERCs will allow suppliers to deliver and pick up the units and to download the encrypted information to the IDTF.” But how does the Power Ox system stand up against the LMRP? “The Program Integrity Group has determined that the Power Ox system does not violate any portion of the Local Medical Review Policy or National Coverage Determination for home oxygen therapy,” Warren wrote on April 23. The Oximetry Company processed its first test on Feb. 17. As of July 7, Letco Companies, which distributes the technology, has dispatched 358 palm pilot units to approximately 300 companies. Also in July, Letco won a major contract to do Rotech's business. “We're going to start training 12 regional Rotech people this month,” said Mickey Letson, president of Letco. “Those people will then get it out to the branches.” Not everyone is yet persuaded. Stewart Pace, an executive vice president at Med-South, said there's no question that Power Ox fills a “big need” in the industry. But he's still more comfortable watching from the wings, despite the CMS letters. Regardless of what CMS says, the OIG can come in and say you can't do that,” said Pace. “Once the OIG signs off on it, it's done.” But the OIG is not likely to sign off on it, not the way CMS has. That doesn't trouble Letson. “Nothing is 100% perfect,” he said. “If someone spent hours and hours, they could probaby find a way to cheat the system. But if used as ordered, there is no fraud, no inducement. This is a way to analyze and control data.” To work with Power Ox, Letco charges $515 for a set-up fee and a $50 per month subscription, which covers access to Web sites and subscriptions. The Oximetry Company bills Medicare for the labwork.