HCFA urged to wait on reimbursement ruling

Physicians representing the hyperbaric oxygen industry seek delay on ending reimbursement for HBOT in preparation for a skin graft or flap.

By amednews staff. Feb. 14, 2000.

Washington -- Physicians representing the hyperbaric oxygen industry have asked the Health Care Financing Administration to hold off on a draft proposal that would end reimbursement for a widely used indication for hyperbaric oxygen therapy.

Doctors are also protesting a provision in the proposed outpatient hospital prospective payment system that would cut reimbursement for HBOT to about 75% of the current rate.

A HCFA draft of a program memorandum, scheduled to go into effect April 1, would end the use of HBOT in the preparation of a wound for a skin graft or flap. However, it would continue to allow use of the therapy for patients who have had a failed graft or flap, according to Caroline Fife, MD, president of the Undersea and Hyperbaric Medicine Society. "We want them to review our data on the use of hyperbarics and wound healing," Dr. Fife said. "We think they need to do a full-scale assessment of it and, in the meantime, don't make any changes."

The therapy has received increased attention since HCFA issued a proposal last year that would require physicians to have certain credentials to supervise HBOT in order to receive Medicare reimbursement. The proposal was delayed for one year after medical groups protested.

Although HCFA has backed off, some regional carriers are implementing their own credentialing requirements, Dr. Fife said. The Dept. of Health and Human Services' Office of Inspector General also is conducting an evaluation of HBOT.