Medicare phased in the first of two cuts to home medical equipment, and supplies, such as oxygen, hospital beds, walkers, wheelchairs, etc. on Jan. 1, 2016. The second phase of cuts was taken July 1, 2016
Medicare phased in the first of two cuts to home medical equipment, and supplies, such as oxygen, hospital beds, walkers, wheelchairs, etc. on Jan. 1, 2016. The second phase of cuts was taken July 1, 2016. The average cut for the providers of these items will be an average of 56 percent in urban areas, and 53 percent in rural areas such as most of North and South Dakota, according to Fact Sheet from The Centers for Medicare and Medicaid Services (CMS).
Also on July 1, 2016, CMS further cut reimbursement for home medical equipment and supplies in metropolitan area’s called competitive bidding areas (CBAs). In this program, Medicare beneficiaries are limited in who they can get their equipment and diabetic testing supplies from, and often experience long delays in getting what they need, which results in them either paying for the items they need out of pocket or simply going without the home medical equipment they need.
CMS claims these massive reimbursement cuts in home medical equipment and supplies “will reduce beneficiary out-of-pocket expenses and save the Medicare program money while ensuring beneficiary access to quality items and services.”
“Unfortunately, it has had the opposite effect on Medicare beneficiaries.” says Rose Schafhauser, Executive Director for the Midwest Association for Medical Equipment Services (MAMES), a regional association of home medical equipment providers in the Midwest. “In urban and rural America, the home medical equipment providers have been forced to make radical changes in order to stay in business to survive these drastic cuts! Home medical equipment companies throughout the country have already shuttered their doors. The radical changes and the closures of businesses are having an impact on Medicare beneficiaries’ access to home medical equipment and supplies.”
According to a membership survey conducted by the MAMES, 100 percent of the providers who are non-participating providers report they are planning to not accept assignment on Medicare claims. This means that Medicare beneficiaries will have to pay for their items up front and Medicare will pay the beneficiary the miniscule reimbursement.
“Charging the Medicare beneficiaries up front is the last thing our members want to do,” says Schafhauser. “But they are left with no choice. Home medical equipment providers have already cut everything they can cut in order to survive in business and this is their only option.”
The home medical equipment industry is less than 1.25 percent of the Medicare spending budget and has proven to be the most cost effective form of healthcare by allowing Medicare beneficiaries to have the home medical equipment and supplies they need to remain in their homes and out of costly hospitals and long term care.
Unfortunately, CMS continues to push massive Medicare cuts generated by a flawed program making it impossible for providers to continue to serve beneficiaries in the fashion our most vulnerable citizens deserve. These cuts in many cases make it impossible for many providers to even stay in business, limiting access to home medical equipment, supplies and services for Medicare beneficiaries.
The only way this problem can be fixed is an Act of Congress. The providers of home medical equipment have been strongly voicing their concerns with Medicare officials and members of Congress to show them the impact this program is having on Medicare beneficiary’s access. At this time, the only way these drastic cuts can be reversed is through Congressional action.
Medicare beneficiaries and their families are urgently encouraged to contact their members of Congress and let them know that they need Congress to protect their access to home medical equipment, supplies and services in your community by stopping the drastic Medicare cuts. They should call the Congressional Switchboard at 1-866-338-1015 or go to www.contactingthecongress.org.