A Medical Device Daily

The Department of Health and Human Services reported that states can access an additional $268 million authorized by the American Recovery and Reinvestment Act to help pay hospitals to treat their most vulnerable patients.

Eligible hospitals are those that serve a disproportionate share of low-income or uninsured individuals and are known as Disproportionate Share Hospitals (DSH). States receive an annual allotment to make payments to DSH hospitals to account for higher costs associated with treating uninsured and low-income patients. This allotment is calculated by law and includes requirements to ensure that DSH payments to hospitals are not higher than the actual costs incurred by the hospital to provide the uncompensated care. The Recovery Act increases the amount of allotments available to states from roughly $11.06 billion to $11.33 billion for 2009.

"Millions of people rely on the care provided by their community hospitals," said Acting HHS Secretary Charles Johnson. "Through the help provided by the Recovery Act, we can make sure they continue to get the care they need in those hospitals."

The Centers for Medicare & Medicaid Services (CMS) will notify states about the availability of the increased portion of allotments for hospitals. Not all states spend their full DSH allotments; so, before this new funding can be accessed, states must demonstrate they have used all of their existing fiscal year 2009 DSH allotments. States must request the additional funds from CMS as part of their quarterly Medicaid budget request and the funds will be distributed as separate Recovery Act DSH grants.

"Thousands of hospitals around the country are the first place many families take their sick children for care or the only place where some of the more than 45 million uninsured Americans can receive some form of health care," Johnson said. "The funding from the Recovery Act will help ensure hospitals can keep their doors open to the people who need care most."

Boehner urges CMS to reconsider oxygen policy

In a letter to the CMS, House Republican Leader John Boehner (R-Ohio) urged the agency to reconsider policies governing Medicare's payment of emergency services, supplies, and other obligations after 36 months of service. The Boehner letter comes on the heels of a letter signed by 123 members of the House expressing concern over the same policies.

Citing lack of payments for maintenance and services post-36 months, Boehner said, "Not only does this policy potentially harm the current care that many Medicare beneficiaries are receiving, but oxygen providers may be forced to make difficult decisions and reduce services that these beneficiaries and their physicians traditionally rely upon."

In the March 18 letter, Boehner calls attention to CMS policies that require home oxygen providers to provide, without any payment, unscheduled service and maintenance visits, 24-hour emergency care, equipment repairs and oxygen supplies for two years following the 36-month rental cap. The CMS policies also require the original oxygen provider to ensure the provision of these services even when a beneficiary moves to a part of the country where the provider does not operate.

Applauding Boehner's attention to this issue, Peter Kelly, chairman of the Council for Quality Respiratory Care (CQRC) said, "We praise Congressman Boehner for standing up for home oxygen patients and providers across the country." CQRC is a coalition of leading home oxygen therapy providers and manufacturers who care for nearly one half of the 1.5 million Medicare home oxygen beneficiaries. "We, too, have urged CMS to use its authority to make payments for services and supplies required by beneficiaries for the entire length of their medical need."

On Jan. 1, massive cuts to the Medicare home oxygen benefit, in the form of a 36-month cap enacted by Congress in the Deficit Reduction Act of 2005, took effect, sending a slow but growing tidal wave of change throughout the provider community. In addressing the implementation of the 36-month cap policy, CMS issued a regulation that home oxygen providers will no longer receive Medicare payment for patient-generated, non-routine emergency visits or needed oxygen supplies, such as oxygen tubing and masks, once a beneficiary reaches the three year mark. These CMS-developed policies came at a time when the home oxygen benefit was also subject to a payment cap and an additional 9.5% across the board cut. The collective impact of these policies equals a 27% cut, totaling $845 million this year alone.