New Oxygen Guidelines
The Medicare Improvements for Patients
and Providers Act of 2008, which went into effect on January 1, 2009,
caused a number of changes in the services provided. These changes were
made to comply with the Act's requirements. The patient's needs for
life-sustaining oxygen are also considered.
The Deficit Reduction Act of 2005 limited monthly payments for oxygen and
oxygen equipment to 36 months of continuous use after which the equipment
title was to transfer to the patient. This has changed.
The Medicare Improvements for Patients and Providers Act of 2008 repeals
the transfer of ownership to the patient provision and permits the
supplier to retain ownership of the oxygen equipment following the
36-month rental period.
As before, Medicare's rental payments cover contents, maintenance, and
supplies such as hoses, cannulas, face masks plus any other services
needed. These payments to the supplier are based on a fee schedule. The
patient is still responsible for any coinsurance or deductibles.
The important parts of the Medicare Improvements for Patients and Providers
Act of 2008 as they apply to the patient are:
The supplier who furnished the oxygen equipment in the first month must
continue furnishing the oxygen equipment for the entire 36 month period,
with the following exceptions:
If the Patient relocates outside the
supplier's service area.
If the patient elects to obtain oxygen equipment from another supplier.
Certain other special cases such as emergency situations (must be
The supplier is prevented from arbitrarily switching oxygen equipment
systems during the 36 month period. (example: switching from liquid oxygen
or compressed to a concentrator)
Exceptions to this rule:
If you choose newer technology, you will have to sign an Advance
Beneficiary Notice (ABN) acknowledging that you may possibly have a financial liability for
the newer technology.
After the 36 month period the following requirements apply:
The supplier is required to continue furnishing the equipment, supplies
and accessories for the remainder of the reasonable useful lifetime of the
equipment as needed by the patient.
The supplier is required to provide all of the same items and services
after the 36-month rental period as they furnished during the 36-month
rental period. The supplier must furnish these items and services without
charging Medicare or the beneficiary.
Continuing the use of equipment following temporary breaks of in-home
oxygen services for such reasons as hospitalizations, nursing home stays,
etc. There is no limit to the time for non-use from hospitalization or
other valid reason.
The oxygen contents used with the supplier-owned oxygen equipment for any
period of that medical need.
One general maintenance-and-servicing visit for concentrators or
transfilling equipment in 2009, but it must be 6 months or more after the
end of the 36-month rental period.
NOTE: Other than that one general maintenance and servicing payment,
payment is not allowed by Medicare for any other repair or maintenance and
servicing of supplier-owned oxygen equipment.
If you move before the end of the 36 month rental period, your present
supplier should work with you to help you find a new supplier in the new area.
If you move after the 36 month rental period, but still within the useful
life of the equipment period, your present supplier is still responsible
for your needs and must make arrangements for you to continue receiving
oxygen services at the new place of residence.
Patients are entitled to change suppliers at any time during their period
of medical need.
NOTE: Finding new suppliers after your 36 month rental period may be
difficult because the new supplier would receive no monthly rental
payments for the equipment. Their only income from the equipment might
possibly be for that one time maintenance and servicing visit.
If the you choose to purchase your own
oxygen equipment instead of renting, Medicare will not reimburse you for
the lump sum purchase. For oxygen equipment, Medicare only pays on a
rental basis up to that 36-month rental period.