Congress Decides Life is Worth $7,214.76?

Many of you read about Congress passing the Deficit Reduction Act of 2006 and will surely hear more about it in the upcoming election. The incumbents who voted for the legislation will try to use their affirmative vote to political advantage. However, these incumbents will avoid discussing the amendments known as Section B and Section C that were attached to the Deficit Reduction Act that negatively and drastically impacted Medicare. These amendments changed oxygen services and equipment from a "frequently serviced" item to a "capped rental" item, as of Jan. 1, 2006. In the past, Medicare has covered oxygen services for beneficiaries who met Medicare qualifying guidelines, for as long as the beneficiary needed the oxygen. Effective Jan. 1, Medicare will only pay for oxygen for 36 consecutive months (capped). After 36 months, the beneficiary owns the oxygen equipment and is responsible for all maintenance and service associated with the equipment. The total amount reimbursable over the 36 month period is $7,214.76 for the oxygen equipment, of which Medicare will pay approximately $5,474.20, with the beneficiary responsible for the balance. You say, "Sounds okay to me. What's the catch?" The catch is why oxygen equipment has always been classified as a "frequently serviced" item. Oxygen equipment needs periodic testing and maintenance. Oxygen concentrators require testing every 30 to 90 days, depending on the manufacturer, and require a preventative maintenance (PM) overhaul every 8,000 to 12,000 hours. The beneficiary who uses oxygen 24 hours a day will put 8,760 hours on the equipment in 12 months. The approximate cost associated with the periodic testing is from $100 to $150 per test and a major PM is from $200 to $500. This can translate into an approximate annual cost of $600 to $1,700, which after 36 months, will be the responsibility of the beneficiary. Under the original "frequently serviced" Medicare program, the Durable Medical Equipment (DME) provider was responsible for these costs, not Medicare nor the beneficiary. Testing and preventative maintenance require specialized equipment and training, which DME oxygen providers have obtained. In addition, DME providers keep maintenance records. It is questionable as to whether or not an 80 year old beneficiary will be capable of not only keeping the appropriate maintenance records and performing the tests and PMs, as outlined by the manufacturer, but to even be able to identify if the oxygen equipment is operating properly. After all, oxygen concentrators can continue to run even if it is not providing oxygen, thus the need for periodic testing. Oxygen deprivation leads to mental confusion and can result in death. DMEs supply their oxygen clientele with a backup system in case of a power failure or an equipment malfunction. This backup system has been furnished at no charge. During periods of natural disaster or threatening weather, DMEs supply their clientele with additional backup equipment, free of charge. Under the "capped" system, once the 36 month period is complete, the backup system will be returned to the DME. The beneficiary will now be responsible for all costs associated with maintaining a backup in their home and for any additional backup systems needed during natural disasters. If the oxygen equipment fails after 36 months, it will be the responsibility of the beneficiary to make arrangements for repair or replacement. Furthermore, if the failure occurs after normal business hours, the beneficiary should have a system in place that will provide oxygen until the equipment can be repaired or replaced. How these amendments were attached to the Deficit Reduction Act is a disgrace in itself. Representative Bill Thomas (R-CA), Chairman of the House Ways and Means Committee, introduced the amendments to the House of Representatives at approximately 3:00 a.m. on the morning of the scheduled vote. Once the amendments were presented, the House leadership, under the direction of Rep Thomas, suspended parliamentary rule, preventing any debate. Rep Thomas had no prior discussion on the legislation with any industry sources or experts before adding the amendments. These types of shenanigans may be acceptable in some third world nations without a rich history of democracy, but they are not appropriate or acceptable in this country. These amendments require repealing and our elected representatives should be put on notice during the upcoming election that our vote hinges on their commitment to repeal. Joe Bryant is the owner of Happy Home Health, a medical equipment company specializing in respiratory, sleep disorders, and rehab.