COPD & Emphysema Support Group

CMS Issues Policy on Replacing Oxygen Equipment Lost Due to HME Bankruptcy

The Centers for Medicare and Medicaid Services (CMS) issued instructions to contractors regarding processing of claims for replacement oxygen equipment in situations in which the equipment is considered lost because an HME oxygen provider files for Chapter 7 or 11 bankruptcy and is unable to continue furnishing oxygen and oxygen equipment. CMS guidance on the issue follows:
The regulation at 42 CFR §414.210(f) provides that a patient may elect to obtain a new piece of equipment if the equipment has been in continuous use by the patient for the equipment's reasonable useful lifetime or has been lost, stolen or irreparably damaged.

Oxygen equipment is considered lost if:

the supplier of the equipment has declared bankruptcy by filing a
petition under Chapter 7 in a United States Bankruptcy Court; or
the supplier of the equipment has declared bankruptcy by filing a
petition for Chapter 11 bankruptcy in a United States Bankruptcy Court and the oxygen equipment was sold or scheduled to be sold.

2010 Physician Fee Schedule Final Rule Addresses Bidding, Oxygen

The Centers for Medicare and Medicaid Services released the final rule for the 2010 Physician Fee Schedule which includes sections related to competitive bidding for HME, payment for damages from termination of contracts awarded in 2008 related to the bid program, and maintenance and servicing of oxygen equipment. The rule is now on display at the Federal Register under Medicare Program; Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2010.

See http://federalregis ter.gov/page2. aspx. Some of the details are described below.

Maintenance and Serving of Oxygen Equipment

The new maintenance and servicing rules, effective for items furnished on or after July 1, 2010, permit payment every six months, beginning six months after the end of the 36-month rental payment cap, for maintenance and servicing of oxygen concentrators and transfilling equipment to ensure that the equipment is kept in good working order for the safety of the beneficiary. Beginning July 1, 2010, a single maintenance and servicing payment of $66 may be made once every six months for maintenance and servicing of an oxygen concentrator (stationary or portable) and, if applicable, oxygen transfilling equipment. The maintenance and servicing
fee covers all maintenance and servicing needed during the six-month period.

[Still no reimbursement for 24/7 emergency service, disposables, and patient education]
Posted on 11/05/09, 09:11 am