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Office of Workers' Compensation Programs

Division of Coal Mine Workers' Compensation (DCMWC)

Announcement for Physicians and DME Providers of Medical Care to Federal Black Lung Miner Beneficiaries

Oxygen Reimbursement Revision

Background: On May 15, 2000, The Federal Black Lung Program (FBLP) modified its rate of reimbursement for oxygen concentrators. This modification was intended to bring more uniformity in the payment practices between the FBLP and the Health Care Finance Administration (HCFA), now known as Centers for Medicare and Medicaid Services (CMS). HCFA had adopted a "modality neutral" method of oxygen reimbursement. This provides an all-inclusive (supplies included) fixed reimbursement rate to the provider regardless of the mode of oxygen delivery (tank, concentrator, or liquid system). Medically, it allows physicians to prescribe the most appropriate home oxygen system, while administratively providing suppliers with the latitude to adopt the most efficient methods of oxygen delivery (e.g., accurate assessment of patients' actual oxygen needs, keeping delivery truck stocked with supplies to avoid extra trips).

Implementation: The Division of Coal Mine Workers' Compensation (DCMWC) Program will now adopt the CMS "modality neutral" payment methodology at this time. Effective April 1, 2002, it will implement an all-inclusive reimbursement rate policy of CMS as it relates to the monthly fee for tank, concentrators, and liquid system. The revised, monthly rental rate, including supplies, will be $230.17, which is equal to current CMS's reimbursement rate for flow rates of four (4) liters or below per minute.

If you are currently approved for oxygen reimbursement, you will continue to be reimbursed at the current price for both tank and liquid system and supplies until the April 1, 2002, implementation date.

Thank you for your continued service to our miner community. You may contact our toll-free information line 1-800-638-7072, Monday through Friday, 8:15 A.M.to 4:45 P.M., Eastern Time, if you have questions on any of the issues discussed in this announcement.