new medicare replacement schedule?

seaweedgee · Post by **seaweedgee** » Tue Aug 21, 2007 7:51 pm

My DME told me that Medicare has a new list- changing the intervals between cpap item replacement. She could only tell me that schedule changed 1 july 07 and that the hoses were authorized every 3 months instead of 1 month now. DME is changing their policy to comply with medicare rules for ALL their clients whether medicare eligible or other insurance.
Have any of you more experienced folks seen the "new" list?

Jeri

6PtStar · Post by **6PtStar** » Tue Aug 21, 2007 8:29 pm

Looks like it did change on hoses. Just looked at the web site. Did not see much else that changed.

http://www.cpapforseniors.com/how-it-works.php#3

muld00n · Post by **muld00n** » Wed Aug 22, 2007 10:41 am

6PtStar wrote:Looks like it did change on hoses. Just looked at the web site. Did not see much else that changed.

I heard at my last sleep support group meeting that CPAP machines would not be replaced unless they are broken. No more 5 year replacement schedule.

Is this just a rumor or is this the new ploicy ?

Steve

seaweedgee · Post by **seaweedgee** » Wed Aug 22, 2007 1:48 pm

I finally found this:

http://tinyurl.com/2vfqcx

Jeri

needingu · Post by **needingu** » Wed Aug 22, 2007 3:31 pm

Bravo..A hose a month was too much any way..I've had mine for a year and half and going strojng..I'm glad someone woke up...

Slinky · Post by **Slinky** » Wed Aug 22, 2007 5:07 pm

6PtStar, I don't think that cpapforseniors URL you gave is current. It states

Deductible
All Medicare beneficiaries have a $124.00 deductible per year. Payment of the $124.00 deductible amount is the responsibility of the patient or their secondary insurance carrier. By Medicare guidelines, the deductible can not be waived, nor negotiated.

My Medicare deductable went up to $131 this year from the $124 in 2006.

Slinky · Post by **Slinky** » Wed Aug 22, 2007 8:11 pm

Has ANYONE found the CURRENT, effective 01 Jul 07, Medicare DME rules/regulations/guidelines for CPAP equipment maintenance and replacement?

darthlucy · Post by **darthlucy** » Wed Aug 22, 2007 8:18 pm

That's what I was looking for when I found the other info I posted. I'll keep looking, though. The CMS web site is definitely not user friendly!

darthlucy · Post by **darthlucy** » Wed Aug 22, 2007 8:36 pm

Jackpot...finally found it. Yes, the new hose replacement is every three months. This document does indicate that it was revised effective 7/1/07. You'll note that this document lists specific states. It appears that there are two other documents posted that cover the remainder of the states, but all three appear to contain the same information.

http://www.cms.hhs.gov/mcd/viewlcd.asp? ... 4&show=all

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CPAPopedia Keywords Contained In This Post (Click For Definition): hose

Slinky · Post by **Slinky** » Wed Aug 22, 2007 8:46 pm

Thank you yet again, DarthLucy. What I'm especially interested in is that no further replacement in 5 years clause Muld00n heard about at the support group meeting.

Once I switched getting my mask and equipment (other than the CPAP) supplies to my 02 DME supplier a month later I got a hose in the mail and I told them that it wasn't necessary to send me a hose or anything else unless I called and told them I would be needing something. So the hose change makes plenty of sense to me.

darthlucy · Post by **darthlucy** » Wed Aug 22, 2007 8:55 pm

Grrrrr. Now I can't get the link to work! Try this.....

Go to http://www.cms.hhs.gov/mcd/
Click on "search" (left side)
In Step 1, check Local Coverage
In Step 2, select your state
Check "keyword", type in "continuous positive", and check "title"
Click "search now"
The complete policy is L11528.

darthlucy · Post by **darthlucy** » Wed Aug 22, 2007 9:11 pm

Slinky wrote:What I'm especially interested in is that no further replacement in 5 years clause Muld00n heard about at the support group meeting.

I didn't see anything that mentioned this in any of the coverage policy documents I found.

Mask

Mask

Mask

Mask