The numerous changes in Medicare billing rules for oxygen equipment over the
past several months have left patients uneasy and confused. As providers,
manufacturers and the medical community make their concerns known to our legislators,
we ask that you also contact your Senators and Representatives and help
make patients concerns known as well.
One option for writing your Senator or Representative is to go the
Congress.org Web site
and use their tools to search for your elected representative and send an email. You will have to
register on the site first and then you can enter your zip code to locate the address(es) of
your Senators and Representative. You will then be able to either email your letter or print
it our for postal delivery. EFFORTS does not, of course, endorse any Web site.
Alternatively, you can
the Write Your Representative page
from the White House's Website. Select your state,
enter your Zip Code and follow the prompts to generate an email to your elected Representative.
Enter your concerns in the text area of the email or use the following as a model:
As a COPD patient and member of EFFORTS, an internet advocacy and support group for people
with COPD (Chronic Obstructive Pulmonary Disease), I am writing to ask that you consider
the ultimate effects of the Oxygen therapy provisions upon the patients as you enact the
necessary legislative changes in the CMS final rule as mandated by the Medicare Improvements
for Patients and Providers Act of 2008 (MIPPA).
A single visit to the Emergency Room by a COPD patient costs $3500 - $8,000. An uncomplicated
stay in acute care for three days of treatment for an uncomplicated exacerbation of COPD is
around $12,000. Severe complications can raise the costs up to over $20,000. An ICU stay of
four days or more hospital time, acute care for a week or more and inpatient
rehab for an additional week COPD with complications can cost up to $120,000
for a single episode.
All of these high cost courses of treatment can be avoided by providing adequate and proper
Long Term Oxygen Therapy (LTOT) equipment and professional respiratory services at
a cost of approximately $250 per month per patient. Patients on LTOT rely on durable
medical equipment (DME) for the oxygen that sustains each breath and affords us a productive and
active quality of life.<
Because LTOT greatly reduces emergency room trips and hospitalizations and because
it increases our ability to fully participate in work and social activities,
it is very cost effective, and results in a healthier, more active and more
productive life style
I am concerned about how these billing changes will further restrict the life
of a person on oxygen. As it is now, there are many inequities in what is
available from one patient to the next. Some have no emergency back-up, some
have little or no portable equipment, and some do not have enough oxygen for
exercise or even realize that they should.
We ask you to consider these optimum provisions for LTOT.
Supplemental Oxygen is a prescription medication and must be ordered by
and administered under the direction of Medical Doctor.
Each patient must be evaluated and the individually suitable stationery and
portable equipment shall be provided under the supervision of a Respiratory Therapist.
The Provider must supply all durable medical equipment and accessory
items such as tubing and cannulas. They must also coordinate delivery and
patient instruction about the proper use of equipment with a Respiratory
Technologist in accordance with the physician's orders.<
A Respiratory Therapist should perform a periodic check of patient
welfare to insure that the equipment is in good working order and is the
optimum for the individual patient.
Back up equipment must be provided for all oxygen systems; gas, liquid, compressed
O2 and home units.
Oxygen equipment should be made available to the patient, in such a manner
as to allow the patient to have as active and healthy a lifestyle as they
are capable of; including the ability to participate in family events or
activities outside the home.
Many oxygen patients live in fear of having their equipment removed. Many are
totally dependant on their equipment suppliers, for whatever knowledge or
advice they need to use the equipment properly. Some do not have an adequate
supply of hoses, which harden and crack and need to be changed routinely to
avoid infection, some have no portable equipment. If you have the
opportunity to make changes in the way this equipment is currently billed
and handled, I hope you will keep the consequences to the patient in mind.
That's it. You've just written to you Senators and Representative. We thank
you for your participation. Please drop Linda a note
so we can add your
letters to our count.