Tropical storm offers lessons to be learned

MIAMI--Some Florida providers used August's Tropical Storm Fay to tell Medicare beneficiaries they could be left high and dry when a 36-month oxygen cap kicks in early next year. “We started getting calls for (back-up equipment) on Saturday and realized this was a good opportunity to let oxygen patients know about changes to their benefit,” said Rob Brant, CEO of City Medical Services in North Miami Beach, Fla. “They are not going to be able to ask for extra oxygen tanks and portable systems. A lot of patients were shocked and wanted to know who they should call (to complain).” The storm didn't develop into a full-blown hurricane, but the slow-moving Fay drenched parts of the state-in some places dropping 26 inches of rain-and caused flooding. Florida and most other states-and accreditors-require that providers have disaster plans to ensure that life-sustaining oxygen is available to patients. That includes dropping off extra back-up equipment in case of power outages or other problems. While CMS doesn't pay for back-up cylinders, providers consider it part of the bundle of services they offer. And, in the event that a patient is relocated or a provider loses operational ability, other providers step in to help. But, if CMS no longer pays for oxygen after 36 months, or providers worry that a patient may have reached their cap, providers worry there will be little to no help for patients. “We cannot work for free,” said Jack Marquez, owner of Doral-based Cobra Medical. “If a hurricane hits and we are without power, we might leave 8 or 9 tanks with each patient and that costs money.” After Hurricane Katrina wreaked havoc in 2005, CMS created policy to ensure that in the event of a natural disaster, the agency would pay for back-up cylinders, said Walt Gorski, vice president of government affairs for AAHomecare. “We want to make sure that policy is still in place,” he said. “(With the 36-month cap), we would like to get that formalized again.”