Dear COPD Coach,
I am a “snowbird” in that I live in Florida during the winter and in New England the remainder of the year. I was informed by my oxygen supplier in New England that they will no longer supply me with liquid oxygen, and want to arrange for me to return my tanks when I return (I am still getting liquid in Florida from the same company). Since I live in New England most of the year, the thought of losing my liquid really upsets me. What can I do?
-Liquid User
Dear Liquid User,
You are facing a problem many others across the country share. Presently the COPD Foundation is looking into this issue along with several related problems such as cutbacks on the delivery of compressed tanks and problems involving traveling with oxygen. Liquid oxygen is often a preferred delivery system and can often provide these people far more mobility than they could obtain with compressed oxygen.
The first thing that should be done is to file a Medicare complaint. The easiest way to do this is by calling our C.O.P.D. Information Line at 1-866-316-2673 to reach a trained associate. It is VERY IMPORTANT that anyone who receives a notice of a change in their delivery system file this complaint. The only way the situation will change is to make our voices heard! We will use this information to access what actions we need and can take to make sure that our community is properly served.
When you begin oxygen therapy, your doctor writes a prescription.The oxygen supplier you select then works with your doctor to develop a service plan that addresses the type of delivery system you require, your liter flow both during activity, as well as what you will need for mobility and emergencies. This service plan is required by law and is effectively a contract between you and your supplier, and cannot be changed or altered without your and your doctor’s approval.The provider must also notify you in writing of any “proposed changes” to your service plan.If they are no longer able to provide you your prescribed therapy, they are obligated to work with you to find another supplier who can continue the services specified for you.What they cannot do is to simply show up and announce that the service plan has been changed. This is very important: if you simply allow them to change your equipment you will in essence be allowing them to change the service plan.
If you are a liquid oxygen user you should immediately contact your prescribing physician to make sure that your prescription is written in such a way that it specifies that you require liquid oxygen therapy. Also advise your doctor if you have been approached about a change in your service and tell him/her that you do not wish any changes to be made.This is also important for users of compressed oxygen who require regular delivery of a specified number of tanks. Make sure your prescription address not only the equipment you need at home, but also what you require to maintain your level of mobility outside the home. Any changes in your service plan cannot be made without his and your express approval!
If approached by either the delivery person or a phone call from the provider about any changes in your oxygen delivery you should do the following:
Insist on a written notice (which should be issued 60 days in advance)
Ask if they have contacted the prescribing physician about the changes and intend to, with your and your doctor’s assistance, write a new service plan
Do not allow them to remove any equipment or make any changes in your services until they comply with a written notice to you, have contacted your doctor and with your input developed a new service plan!
If they attempt to remove any equipment or refuse to refresh your oxygen supply inform them that you intend to exercise any and all legal options at your disposal which should include filing a Medicare complaint. You might also consider contacting a lawyer.
Notify local media and get them involved.
Consider filing a complaint an Americans with Disabilities Act Complaint
You can file an Americans with Disabilities Act complaint alleging disability discrimination against a State or local government or a public accommodation (including, for example, a restaurant, doctor’s office, retail store, hotel, etc.) by mail, fax, or email.
To file an ADA complaint by mail:
US Department of Justice
950 Pennsylvania Avenue, NW
Civil Rights Division
Disability Rights Section – 1425 NYAV
Washington, D.C. 20530
To file a complaint by email: ADA.complaint@usdoj.gov
Every Medicare oxygen user has a 5 year contract with their supplier. The first 3 years of the contract, the supplier receives reimbursement for rental of the equipment (called a cap). The remaining two years they are only paid for servicing the equipment. If you are at the end of your 5 year contract the provider is required to provide you with written notice in advance regarding renewal. If they can no longer provide the level of service you are prescribed for, they must then assist you in finding another provider who can provide the services you need. If no other supplier can be located, they are required to work with you and your doctor to develop a new service plan with equipment that addresses your needs. If you decide to change providers, your old supplier is required to assist you during the transition.
In short: Your oxygen supplier cannot make any changes to your level or type of service without going through the required steps! They certainly cannot simply show up to your door and announce that they will no longer provide the services they have in in past and attempt to change out your equipment! If they do change out the equipment, they might request from Medicare a new contract under the “lost or damaged” provision set forth in the rules for Medicare reimbursement. If a new contract is begun, you will be limited on any changes you might like to make for another 5 years! Your oxygen provider should not and does not determine what type of delivery and service you should receive. Only your doctor is able to do that!
It bears repeating that if you experience any “non-requested” changes in your oxygen delivery call the C.O.P.D. Information Line at 1-866-316-2673 and file a Medicare complaint!
Hope this helps you and the many others that are or will be impacted by changes in the oxygen field.
-The COPD Coach
Ask the Expert is aimed at providing information for individuals with COPD to take to your doctor, and is not in any way intended to be medical advice. If you would like to submit a question to the Coaches Corner email us at coachescorner@copdfoundation.org. We would love to hear your questions and comments. You can address your emails to any of the following: COPD Coach, Caregiver Coach, COPD Doctor or COPD RT.