AAHomecare Finds Mississippi Senior Unable To Access Oxygen Therapy Because Of Flawed Medicare DME Bidding Program

May 01, 2014, 16:08 ET from American Association for Homecare

JACKSON, Miss., May 1, 2014 /PRNewswire-USNewswire/ -- Due to the controversial bidding program operated by the Centers for Medicare & Medicaid Services (CMS), a Mississippi senior citizen cannot access critical oxygen therapy and CPAP supplies, even though she works part-time for a local medical supply company, according to the American Association for Homecare (AAHomecare).

Danyelle Carroll, owner of Mobility Medical, told AAHomecare about the ordeal involving Medicare's bidding program for home medical equipment and Sandra Tedford, a 70-year-old Jackson woman.  For years, Tedford has worked at Mobility Medical and the company filled her oxygen therapy and other breathing-related prescriptions.

But when Medicare's bidding program came to Jackson last summer, Mobility Medical didn't win the bid to provide oxygen and CPAP supplies in the area, so Tedford was given a list of bid winners to contact about becoming her new Medicare provider.

However, Carroll said that despite repeated calling, Tedford can't find a provider willing to supply the equipment. Several are suggesting that she begin the long and laborious process of re-qualifying for the benefit.  "It has been very frustrating for her," said Carroll. "She needs the oxygen therapy and other breathing equipment that was prescribed by her doctor and approved for Medicare coverage, now suppliers won't provide it to her."

At times, Carroll said that her company has still provided the equipment to Tedford knowing that Medicare will not reimburse them.

Tedford appears to be one of many Medicare beneficiaries who have been unable to obtain adequate oxygen therapy and CPAP supplies because of the bidding program.

Last week, the COPD Foundation, which works to prevent and cure Chronic Obstructive Pulmonary Disease and improve the lives of people affected by it, sharply criticized the Medicare bidding program. The Foundation said the bidding program has brought "hardship" to Medicare patients requiring critical oxygen therapy. The Foundation was responding to a GAO report stating that advocacy groups did not report widespread beneficiary access concerns related to the much scrutinized bidding program.

"The COPD Foundation takes great umbrage with the GAO report that states that beneficiary advocacy groups they interviewed did not report widespread CBP beneficiary access concerns," the Foundation said in a press release. "The COPD Foundation has had direct contact with the CMS Ombudsman on this issue and is surprised that the GAO would make a statement like this regarding the CBP. Had the GAO interviewed the COPD Foundation, we would have had the opportunity to express our displeasure and growing concern with this flawed program."

Specifically, the Foundation said it has contended for some time that CMS should exempt oxygen from the bidding program. "From the beginning, the Competitive Bidding program has caused market place changes that have brought hardship to the patient community," the Foundation wrote. "Many oxygen providers have discontinued the practice of providing liquid oxygen to patients. This practice may significantly restrict a patients' mobility by requiring them to transport multiple tanks while attempting regular day-to-day activities such as grocery shopping or seeing their physicians for routine care."

Furthermore, the Foundation said that in many cases, elderly patients are now being forced to pull large tanks of compressed oxygen.  "… Many oxygen providers are now restricting or ceasing delivery of compressed oxygen tanks citing reimbursement issues. The result of this is many oxygen patients are being forced to drive long distances to pick up the very tanks they rely on for their mobility. High flow oxygen patients are experiencing the greatest difficulty when losing their liquid oxygen, as no compressed system allows them the same degree of mobility they are able to attain using liquid."

Tom Ryan, president of AAHomecare, said the Foundation's comments, as well as Tedford's problems, exemplify the problems with the Medicare bidding program.

"What good is a bidding process, if some of the most vulnerable people in our society can't access the equipment and services that are prescribed by their physicians?" Ryan asked.  "Patient access to critical medical equipment must be the priority for any Medicare bidding program. And this program repeatedly gets failing grades. It's time for Congress to step up its efforts to fix this program so that our seniors and people living with disabilities can get the equipment and services that they deserve."

Meanwhile, Tedford is a victim of the bidding program because there has not been a smooth transition to a new provider, a problem that many others are surely experiencing.

"This has been very frustrating," Tedford said. "I need my oxygen and night time breathing equipment. This is really affecting me. I'm not sleeping well, so I don't have the energy that I once had. It would be much worse if Mobility Medical wasn't helping me. I don't know what I would do without them. But it is not fair to them. This process is broken and Medicare needs to fix it."

Furthermore, Tedford added, "What is most disturbing is that I have to choose between the company in which I work for and having to use a competitor. A competitor could use me as ammunition against the company I work for to referral sources. It's just grossly wrong. Or I could also be singled out or put on the bottom of their priority list. It is a complete conflict of interest in which I am the pawn, and this is NOT okay with me at all."

The American Association for Homecare represents providers of home medical or durable medical equipment and services who serve the needs of millions of Americans who require prescribed oxygen therapy, wheelchairs, enteral feeding, and other medical equipment, services, and supplies at home. Visit www.aahomecare.org.

SOURCE American Association for Homecare