Oxygen Company Too Big to Ban?

We expanded our independent pharmacy into providing Home Medical Equipment (HME) in the early 1980’s. Providing home Oxygen and other respiratory services turned out to be a large part of our HME business. After a decade in the business, with annual inflation being in the 3%-4% range, Medicare never gave HME vendors a increase in what we were paid. As we approached the middle of the 90’s decade, there were rumors stirring that Medicare was going to CUT REIMBURSEMENTS. I knew that we could not take care patient properly after not getting any increase in payments for a decade and then having to deal with a cut in payments. I sold the pharmacy and HME business in late 1996 and 2 yr later Medicare cut reimbursement by about 40% of what we had been paid for abt 15 yrs.  Abt another 15 yrs, Medicare cut reimbursement again and was only paying abt 22% of what we were being paid in the early 1980s. Adjusting for inflation, Medicare was paying about 10% of what they were paying in early 1980 and they add many mandatory services without any reimbursements.  As is stated in this article: Lincare customers aren’t pleased with the services they receive; it only has a 1.3 out of 5 on the Better Business Bureau site.

It would seem that Medicare & Lincare are at a standoff. Taking care of home oxygen/respiratory pts is both labor and equipment intensive and Medicare has ran so many small vendors out of the market place that no small/independent vendor would enter into providing HME services/products to respiratory pts with what Medicare is offering as payment. Medicare apparently found it acceptable for pts to deal with POOR SERVICE, than to pay what the service is worth.

Oxygen Company Too Big to Ban?

https://www.medpagetoday.com/special-reports/features/113015

Despite decades of misbehavior — from overbilling to violating kickback laws — Medicare has never banned Lincare, the largest distributor of home oxygen equipment in the U.S., ProPublica revealed

In 2023, HHS placed Lincare on probation — a “corporate integrity agreement” with a “death penalty” provision. Yet Lincare was already under that form of probation and had been on and off it for years. The company regularly violated the terms of probation with little punishment, according to ProPublica.

Part of the reason Lincare has gotten away with this for so long is because Medicare fraud is so rampant that a lot of bad behavior gets through. Plus, the company has a near-monopoly, begging the question whether it’s too big to ban, the article stated.

In addition, paying multimillion-dollar legal settlements has been affordable to the company. “As long as that [settlement] check is less than the amount you stole, it’s a good business proposition,” Lewis Morris, former chief counsel to HHS’ Office of Inspector General, told ProPublica.

Lincare customers aren’t pleased with the services they receive; it only has a 1.3 out of 5 on the Better Business Bureau site, with one reviewer writing that Lincare is “running a scam where they have guaranteed income” and that “the customer can’t do a thing.”

ProPublica’s reporting found “a dismal picture of a company with a sales culture that depends on squeezing infirm and elderly patients and the government for every penny.”

Filed under: General Problems