Durable Medical Equipment Competitive Bidding Demonstration. Case Studies of OBRA's Effects on Access to DME. Part 1: Three-Market Study. Part 2: Rural Study

摘要

The report examines whether or not the Omnibus Budget Reconciliation Act of 1987 (OBRA 87) changes in Medicare's reimbursement policies had any effect, especially any restrictive effect, on beneficiaries' access to needed durable medical equipment (DME). Congress in enacting OBRA 87 raised this question for the Health Care Financing Administration (HCFA) to answer. The case studies included 3 urban areas and 9 rural markets. Results were essentially the same for both urban and rural areas - that the new fee schedule methodology seemed to have little effect on DME availability. Home oxygen systems were noted as a possible exception in that liquid oxygen systems may not be as available but gaseous and oxygen concentrators are. Thus the profile of the three different oxygen delivery systems has changed. The report states that the change may have been caused by other HCFA administrative directives tightening the coverage requirements for home oxygen rather than by the new payment schedule.