Granite state providers battle double whammy

Monday, November 21, 2011

CONCORD, N.H. - HME providers here got no resolution when they met with Medicaid officials in September to discuss potential reimbursement cuts.

"We are still going back and forth and waiting to see how it's going to shake out," said Tamme Dustin, director and CFO of Herron & Smith in Hooksett.

In June, providers learned that the state was seeking to implement a fee schedule for durable medical equipment that is 60% of the current Medicare allowable. The current fee schedule is all over the board, said Dustin.

At the meeting, providers highlighted certain products, like rehab, that, if the cuts were implemented, could lead to access issues.

"They are running more analysis," said Dustin. "And we asked for better utilization numbers so we could offer more suggestions on what we could do to save money."

It may all be for naught, though. State lawmakers recently passed a law requiring that the state have a managed care/Medicaid program in place by July 2012.

"Why try to implement (a new fee schedule) that's going to create an access issue in the interim?" said Dustin. "Just leave it alone and then we'll work with you on managed care."