Alabama: Providers roll with changes

Tuesday, November 23, 2010

MONTGOMERY, Ala. - HME providers in Alabama are taking in stride recent changes to Medicaid and Blue Cross Blue Shield.

In October, the state's Medicaid program became the second in the country to require that certain HME providers obtain surety bonds, according to Michael Hamilton, executive director of the Alabama Durable Medical Equipment Association (ADMEA). The first: Florida.

"We negotiated exemptions for most of our members, so we did good," he said.

Exemptions include HME providers who have been in business for five years or more and who have earned less than $100,000 in the past two calendar years.

Ken Glover Drug in Dora was one of the HME providers exempted from the surety bond requirement.

"We've had our Medicare number for a long time," said Jennifer Weathers, the DMEPOS coordinator at Ken Glover. "It wouldn't have been an issue, anyway. Everyone got in an uproar over the Medicare requirement for surety bonds. It was $500. Just do it and move on."

Providers have the blues

Earlier this year, Blue Cross Blue Shield of Alabama reduced its fee schedule for home medical equipment by an average of 15% to 20%.

"We're just having to look at every product to see if it's something that we can accept for Blue Cross," said Leigh Ann Matthews, a manager at Complete Care in Fort Payne.

BCBS also dropped reimbursement for TENS units completely.

BCBS did extend HME providers an olive branch: After negotiations, an initial cut to CPAP reimbursement was bumped up from $650 for 10 months to $1,000 in October.