Home Health Care Professionals, Inc.

Home Health Care Professionals' Newsletter

Impact of the Deficit Reduction Act of 2005 on Patients with DME & Receiving Oxygen Therapy

The Deficit Reduction Act of 2005 was passed on February 2, 2006 and signed into law (Public Law 109-171) by President Bush on February 8, 2006. Among other changes to Medicare, a "rent-to-own" rule has been chosen for durable medical equipment (DME) and oxygen therapy equipment.

Durable Medical Equipment

Section 5101(a) of the law describes how certain equipment is to be rented for 13 continuous months before its title is transferred to the patient using the equipment. The rule is not changed for inexpensive (under $150), routinely purchased (i.e. accessories for a nebulizer or ventilator) equipment, items requiring frequent and substantial servicing (example: IPPB machines and some ventilators), or customized items.

Maintenance and servicing after the title has been passed on to the patient will be subjected to the "reasonable and necessary" clause well known to providers who deal with Medicare. Patients may be caught in the same web that a lot of providers have been fighting for years and end up paying for more than they used to. This must be where Medicare is supposed to save money!

In the case of a power-driven wheelchair, it can be purchased by patient before the 13 months renting period.

Oxygen Therapy Equipment

Oxygen equipment title will be transferred to the patient after 36 months of continuous use. Maintenance and servicing will abide by the same rule as DME. The patient will be responsible for emergency visits, supplies (i.e. cannulas, tubing, converters...) and maintenance. Even if Medicare agrees that maintenance and services rendered and reasonable and necessary, the patient will still have to pay 20% of the bill. That bill is sure to go up as the providers of DME will try to make up for the loss of revenue on rentals. Medicare had based its payments for oxygen therapy on equipment rather than service, but service is more important to seniors and that is what is taken from then with the new regulations.

The burden is not only on the patients, but also on their family. What are they going to do with the equipment when treatment is no longer needed, or the patient dies? The new law may encourage manufacturers to build cheaper, less durable equipment like hospital beds. Maintenance and servicing fees will rise.

As more cuts are foreseen, good health is the first thing we must be working on now!