California lifts moratorium on respiratory services

Tuesday, July 31, 2007

SACRAMENTO, Calif. - California's Medicaid program exempted respiratory services from its moratorium on provider numbers earlier this year, but providers like Bernie Zimmer still can't supply oxygen concentrators and other products to Medicaid beneficiaries.
Zimmer, who owns California Home Medical Equipment in Foster City, submitted his application for a provider number to supply respiratory services in March. The Medicaid program, known as Medi-Cal, returned his application months later, because Zimmer's pharmacy license had expired in the time it took the agency to review his application.
"We're in the process of refilling," Zimmer said. "(The exemption) is good news--there's a real need for oxygen providers, especially for pediatrics--but it has been difficult."
Medi-Cal has extended its moratorium on provider numbers like clockwork every six months since 1999. As a result, the number of providers supplying HME in the state has dwindled from about 1,300 to 900, according to the California Association of Medical Product Suppliers (CAMPS).
So far, Medi-Cal has exempted custom rehab and respiratory services from the moratorium due to a lack of providers.
Bob Achermann, executive director of CAMPS, agreed that the exemptions represent progress, but they don't solve the state's ultimate problem.
"This piece-meal approach isn't productive," he said. "When you have a referral for a patient, you say, 'I'll do this part,' and then you have to get someone else to do the other part, because it's unusual that a respiratory patient wouldn't need some other HME. So now you have two companies making deliveries? It doesn't make any sense."