New Medicare payment rules are starting to strangle local small oxygen suppliers by forcing them to turn away business.

In the process, patients who live here part-time, travel, move or want to switch suppliers locally are left struggling to find new options for oxygen.

“This is going to dramatically affect patients’ lifestyles, how they move and their freedom,” said Mark Hassett, general manager of Stuart-based OxyPros Inc., which also has a Port St. Lucie office “Patients need to speak up.”

In the new rules for 2009, Medicare pays suppliers about $164 monthly for three years for patients renting respiratory equipment. In the following two years, suppliers continue providing oxygen and services, but only receive negligible reimbursement. After the fifth year, the payment cycle begins again and patients are entitled to new equipment.

Now, it’s become a losing proposition, suppliers said, to take a patient who has been on oxygen even for a year or two, because two years of providing essentially free oxygen and services follow.

And close to three full years is necessary to cover the costs of the impending two-year period with little reimbursement, said Kathie Rovella of Oxygen Plus in Vero Beach.

So suppliers are often forced to reject patients who are a few years into their oxygen use. Oxygen Plus has turned away 12-15 patients this year because of the new billing cycle, including two in the last week, Rovella said.

Because much of Florida’s population doesn’t live in the state year-round that can make it difficult because patients have to find a supplier in two locations. And patients a few years into the cycle who move are often left confused and without coverage.

Travel cane be even more difficult.

Patients either have to lug their equipment around with them, or search diligently for willing suppliers wherever they are going, Rovella said.

The rule is part of a large-scale effort to cut Medicare costs and eliminate fraud in the oxygen industry, which long lacked sufficient regulation, said Zane Morgan, a manufacturers representative for several Florida oxygen suppliers.

Dorothy McGrath is approaching four years using oxygen. She decided that carrying her 30-pound concentrator to Kentucky to see her daughter last month was unreasonable.

So McGrath, of Hobe Sound, rented from a local supplier, and was handed a $150 bill, which OxyPros luckily paid for her.

Because McGrath was in the middle of her third year, the Kentucky supplier wouldn’t accept her Medicare.

“You’re really bound to your house, and that’s not fair,” said McGrath, 63.

Patients like McGrath, who travel, move across the state, live seasonally up North, or look to move closer to family simply are getting turned away, Hassett said.

Meanwhile, the loss in customers and reimbursement could be debilitating for small suppliers in the long run.

Medicare reimbursement hardly accounts for labor costs, like providing 24/7 on-call services, and equipment set-up, maintenance and refills, which in reality are the prime expenses for suppliers, Hassett said.

OxyPros and Oxygen Plus have both added smaller health-care items to their inventories to help make up for profit losses. And OxyPros is in a hiring freeze, while Oxygen Plus staff members have taken pay cuts.

But neither company is confident small suppliers will be able to continue the same services without a large-scale change.

“Oxygen Plus is a mom-and-pop store,” Rovella said. “And trust me, we won’t be able to sustain this much longer.”

In the end, however, it’s the patients like those who come in for portable oxygen so they can move and be active who suffer — and who become confined to one area in an effort to be mobile.

“They’re not thinking about the person’s life,” McGrath said. “It’s important when you’re disabled to be near your friends and family.

“Everybody has to breathe.”

OXYGEN BREAKDOWN

In years one to three, suppliers receive an average of $200 per month – 80 percent from Medicare, and a 20 percent copay from the patient or secondary insurer – for renting, installing and maintaining rented oxygen equipment

In years four and five, Medicare offers minimal reimbursement to oxygen suppliers, who are required to continue offering the same equipment and services

After five years, the payment cycle restarts, and patients are entitled to new equipment

By Jonathan Mattise, TCPalm.com

INDIANTOWN — For years, the owners of J&R Outfitters ran a hunting lodge featuring exotic game such as Asian water buffalo, Nilgai antelope and Pere David deer thinking they had all the required Martin County permits.

But several code violations were discovered at J&R Outfitters last fall after the opening of a shooting range that outraged nearby homeowners with incessant gunfire.

Now Bill Richey and Joe O’Bannon are aiming to keep their hunting lodge open by jumping through all the regulatory hoops that apply to their business at 7600 S.W. Fox Brown Road.

“We never dreamed that what we were doing was illegal and we never tried to get away with anything,” said Richey, a former state prosecutor. “We have been no secret in Martin County. We have been here for 20 years.” (more…)

INDIANTOWN — Wildfires had consumed more than 2,000 acres in Martin County by Tuesday morning, and firefighters were working to contain the fires that were burning for a third day, officials said.

There were as many as 10 fires that firefighters had to contend with late Monday and overnight, according to Melissa Yunas, spokeswoman for the state Division of Forestry.

Three single-engine air tankers were called in late Monday to battle the main fire that threatened the Indianwood mobile home community, according to Melissa Yunas, spokeswoman for the state Division of Forestry.
(more…)

By JASON SCHULTZ

INDIANTOWN— Fires that broke out near Indiantown in western Martin County over the weekend continued to burn last night and have charred more than 1,400 acres while crews tackled another large fire near Palm City, according to fire officials.

Residents from the Indianwood Mobile Home Park were evacuated and the American Red Cross has opened its shelter on Kanner Highway in Stuart for fire evacuees, according to a Martin County press release last night.

Three of the four brush fires that burned hundreds of acres near Indiantown, closed roads and prompted authorities to cut power in the Treasure Coast Sunday continued to burn overnight.

Two flare-ups occurred this afternoon.

The one between the Booker Park fire and the Lincoln Park fire was about 3 acres, said Melissa Yunas, a wildfire specialist with the state Division of Forestry.

The second flare-up, near the Indian Trail fire, jumped over a canal and headed toward three homes in the Little Ranch Estates neighborhood.

Firefighters took up positions around the homes.

(more…)

It’s common to see Treasure Coast teens and preteens using cell phones for sending text messages and photos.

But it’s also becoming common for teens nationwide to send other things via their phones or computer Web cameras, including explicit and sexual photographs that have given the phenomenon a new name — sexting.

“It’s been going on for several years here. We just didn’t call it this,” said Detective Brian Broughton of the Martin County Sheriff’s Office. “Now it has a little buzz word, but basically we’re referring to the same thing — when children would take nude pictures of themselves and send it to other children.”
(more…)

ANDREW MARRA

Palm Beach Post Staff Writer

A fire destroyed a mobile home Friday night in the Sunshine Mobile Manor in the Stuart area, a fire official said.
The blaze started about 10 p.m. and gutted a trailer at 5000 S.E. U.S. 1, displacing one person, according to Martin County Fire-Rescue Chief Brian McGlothin.
The Red Cross is helping the person find temporary lodging. The cause of the fire is being investigated.