Home Health & Hospice Week

CMS relaxes limits on self-testing.

Durable medical equipment suppliers will soon be able to deliver home oximetry tests to Medicare beneficiaries - a regulatory change that will make it easier for patients to qualify for home oxygen therapy.

The Centers for Medicare & Medicaid Services on July 22 issued a program transmittal allowing DME suppliers to deliver overnight pulse oximetry testing units to patients' homes under certain conditions. The new policy takes effect Aug. 22.

"It's a tremendously good thing for the industry," Wayne Stanfield of the Halifax, VA-based Home Care Alliance of Virginia tells Eli. "It represents a loosening of some of the more rigid rules on self-testing CMS has put in place since the late '80's"

An oximeter is a small monitor with a clop placed on the index finger.  It records a patient's blood pulse oxygen levels during sleep in order to record the severity and length of apneas.

CMS last year began allowing home oximetry testing with some devices such as the Power Ox distriguted by The Letco Companies of Decatur, AL.  The new policy expands that permission to other companies' devices under the following conditions:

The beneficiary's treating physician has ordered the test;
  The test is performed under the direction and/or instruction of a Medicare-approved independent diagnostic testing facility; and
  The test unit is sealed and tamper-proof so results can't be accessed by anyone other than the IDTF. A few caveats: Because federal law prohibits DME suppliers from performing tests, they are not allowed to create the testing instructions or participate in the testing. And while suppliers may use technology to download testing results and submit them to the IDTF, they may not access or manipulate the results in any way.

Furthermore, suppliers may not charge beneficiaries for shipping or handling, as those costs are included in the Medicare fee schedule payment for the tests.

Suppliers have expressed frustration over long waits for IDTFs to qualify patients. The delays led to lost revenues since suppliers can't bill Medicare until patients are qualified.

"This changes gives us the ability to provide qualifying tests without jumping through hoops," Stanfield says.

Note: The transmittal is online at www.cms.hss.gov/manuals/pm_trans/R166OTN.