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Medicare: Access to Home Oxygen Largely Unchanged; Closer HCFA Monitoring Needed

HEHS-99-56 Published: Apr 05, 1999. Publicly Released: Apr 05, 1999.
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Highlights

Pursuant to a legislative requirement, GAO provided information on Medicare beneficiaries' access to home oxygen equipment, focusing on: (1) changes in access to home oxygen for Medicare patients since the payment reduction mandated by the Balanced Budget Act (BBA) of 1997 took effect; and (2) actions taken by the Health Care Financing Administration (HCFA) to fulfill the BBA requirements and respond to GAO's November 1997 recommendations.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Health Care Financing Administration The Administrator, HCFA, should monitor complaints about and analyze trends in Medicare beneficiaries' use of and access to home oxygen equipment, paying special attention to patients who live in rural areas, are highly active, or require a high liter flow.
Closed – Implemented
CMS, through a contractor, has conducted a long range study to monitor beneficiaries' use of, and access to, stationary liquid oxygen systems and gas portables. Additionally, CMS has collected information on access to oxygen through the competitive bidding demonstrations. Neither of these sources indicated any problems related to beneficiary access. The PRO study considered beneficiary use of oxygen, including the prescribed criteria above, and found no problems in relation to these factors.
Health Care Financing Administration On the basis of this ongoing review, as well as the results of the PRO study, the Administrator, HCFA, should consider whether to modify the Medicare payment method to preserve access.
Closed – Implemented
CMS, through a contractor, has conducted a long range study to monitor beneficiaries' use of, and access to, stationary liquid oxygen systems and gas portables. Based on the PRO study, and information from the competitive bidding projects, CMS has decided that no restructuring of the payment system is needed.
Health Care Financing Administration The Administrator, HCFA, should make development of service standards for home oxygen suppliers an agency priority in accordance with the BBA's requirement to develop such standards.
Closed – Implemented
In August 2006, CMS published quality standards for suppliers of home oxygen and other durable medical equipment, prosthetics, orthotics, and supplies. These standards, among other things, require home oxygen suppliers to provide respiratory services 24 hours a day, 7 days a week as needed by the beneficiary and follow delivery and set-up practice guidelines established by the American Association for Respiratory Care.

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Health care cost controlHealth care programsMedical equipmentMedical services ratesMedical suppliesMedicareRespiratory diseasesOxygenPatient carePhysicians