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New Medicare oxygen rules pinching patients

Wall Street Journal, November 25, 2009

New Medicare rules designed to reduce waste and fraud in medical-equipment reimbursements are driving some home-oxygen suppliers out of business and leaving patients scrambling to find new providers. The new payment rules, effective Jan. 1, affect the more than one million people who rely on Medicare to pay for oxygen services, which relieve the symptoms of conditions, such as emphysema and chronic obstructive pulmonary disease. Under the new rules, Medicare pays suppliers at the prevailing rate—an average of $200 a month, paid 80% by Medicare, 20% by patients—for the first three years after a patient begins coverage. Suppliers are then required to continue providing oxygen services to patients for an additional two years, but at a sharply reduced payment rate. After that, patients are entitled to receive new equipment, and Medicare will resume paying suppliers at the higher rate.