Calif. reimbursement change ‘is insane’

Wednesday, March 31, 2004

SACRAMENTO, Calif. - Reimbursement for California providers took a turn for the worse in late February when California Children’s Services declared it would no longer rent apnea monitors, concentrators and other respiratory devices.

Instead, CCS now will assume ownership of the equipment after a 10-month rental period or when the purchase price has been reached,” said Bob Achermann, executive director of California Association of Medical Product Suppliers.

“This is insane,” Achermann said. “I tried to explain that people who rent equipment can’t sell their inventory every 10 months and stay in business. If you go to Abbey Rents and rent a rototiller 10 times, they don’t give it to you.”

CSC, which provides medical coverage to low income children with chronic illnesses, announced its new purchase policy in late February. CAMPS is working to rescind it, Achermann said.

Adding insult to injury, if a provider places a piece of used equipment in the home initially, CSC wants a new piece when it assumes ownership. CSC also wants providers to issue a six-month warrantee on all equipment it purchases. Achermann said he tried to explain that most insurers don’t buy respiratory equipment or if the do they also purchase a service contract.

“I said this is a major policy change,” he said. They said, ‘It is not - we need the money.’ I said, ‘If you think providers are going to drop this stuff in patients’ homes and risk liability for misuse without monitoring or service responsibilities, you are nuts.’”

Last summer, as part of a plan to close a $38-billion budget deficit, California Medicaid (Medi-Cal) slashed the state’s $140 million DME budget by about $20 million.