Counting every breath – How Alicia’s oxygen was limited by Medicare’s competitive bidding program

Posted on in HME Government Issues

Imagine only having 34 hours per month when you were able to leave your home.  If you went past 34 hours, you would run out of supplemental oxygen. This scenario is a reality for Alicia Boyd, whose oxygen has been severely limited by Medicare’s competitive bidding program.

Alicia lives with her husband in Tonto Basin, Ariz. She enjoys spending time with family and giving back to her local community by volunteering at the Senior Center in Payson, Gila County Council for Senior Citizens and Kiwanis Club.

She has COPD and pulmonary hypertension which requires her to be connected to a high flow of supplemental oxygen. She uses eight liters of oxygen per minute (lpm); most supplemental oxygen patients use 2-4 lpm. At home, she uses a concentrator that provides her with a steady stream of oxygen, but when she leaves her house or travels beyond her 50-foot extension cord, she is required to use external oxygen tanks.

Since her health diagnoses, nearly 15 years ago, Alicia has been able to live a vibrant life because Medicare has properly supplied external oxygen tanks. Unfortunately, things have changed. In October, Alicia was notified by her oxygen supplier that she would go from a continual supply of E-Tanks and C-Tanks oxygen cylinder tanks to a maximum 34 E-Tanks per month.

E Tanks are large, 8-pound oxygen tanks that must be rolled and provide Alicia with one hour of oxygen.  C Tanks are smaller, more portable oxygen tanks that can be carried on the shoulder and typically provide Alicia with 20‑30 minutes of oxygen. C Tanks allow users much more flexibility for short trips, such going into a store.

Shocked, angry and confused by this limited supply of tanks, Alicia called her oxygen provider. The provider explained the change was due to Medicare’s competitive bidding program. The bidding program, already implemented in metropolitan regions throughout the United States, will expand to rural areas on January 1, 2016. The expansion, often referred to as rural rollout, will slash reimbursement rates up to 45 percent for oxygen tanks and other types of medical equipment in rural areas, pushing providers to reduce equipment offerings and services to stay afloat.

The impact of this policy has been devastating to Alicia, who lives in a rural area where the nearest grocery store is in Payson, 31 miles away.

“I went to Payson twice this week and used 16 E-Tanks and 9 C-Tanks. Next week will be bad because I have a heart doctor appointment and my husband has one, too.  I am in a position where I have to constantly monitor my oxygen usage,” Alicia said.

Alicia worries about her ability to remain independent, care for her 76 year-old husband and complete daily tasks. And getting in her car with large oxygen tanks isn’t just inconvenient, it’s dangerous. Simple tasks like picking up packages from her post office will be challenging, she said, because she will only have one free arm; the other will be rolling her oxygen tank. Fun outings and visits to see her family and friends will inevitably decrease, because she won’t have enough tanks to last her throughout the month.

“I’m very angry over this.  Why should I have to constantly fight to breathe?  It’s very frustrating to know that you’re tied to something that somebody else controls,” she said.

Help Alicia and others who rely on medical equipment by urging Congress to stop cuts to medical equipment in rural America. Take action here!