HMEs frown over IR bed cuts
WASHINGTON - If CMS pays way too much for semi-electric hospital beds, as the OIG stated in December, that’s news to Daryl Bowman.
“It’s not that wonderful a deal,” said Bowman, owner of Bowman Medical in San Carlos, Calif. “They’re awkward to deliver. They are one of the most expensive items you buy. They take up a lot of warehouse space because of their size. And they’re the one item that increases my workers compensation insurance - from lifting foot sections, the sections with the motors that weigh the most.”
That aside, the OIG still says CMS pays “substantially higher” rates for semi-electric hospital beds than do other payers and could save $34 million a year ($171 million over five years) by using other, less-costly billing codes. As another alternative, the OIG suggested in its December report that CMS use IR to adjust downward the fee schedule for semi-electric hospital beds.
On Feb. 11, CMS will be free to use IR, and it’s not “unreasonable” to think semi-electric hospital beds might be an IR target,” said Asela Cuervo, sr. vp of government relations at AAHomecare.
“Scully has said there is not a short list for IR, but at the same time, we know there are a couple of items out there they keep harping on,” Cuervo said.
Among those items: manual wheelchairs, hospital beds, certain kinds of walkers.
As far as Bowman’s concerned, beds should be scratched from that list.
“For them to cut back on $167.10 a month for the first three months, and then reduce the $125.33 for the remaining 10 months, to me seems inappropriate,” he said.
Over the life of its 13-month capped rental, beds pay $1,754 (minus 20%), Bowman said.
But in addition to being labor intensive and a chore to store, at $650 a pop (bed, mattress and rails), beds are among the more expensive pieces of DME, Bowman said. At the current reimbursement rate, it takes about four months to earn back the cost of the equipment. Add another month to pay for the $100 delivery cost, and another month to cover the $100 spent on billing. Then there are some beds returned before the six-month break even point, Bowman said.
It’s also more than just delivering a bed. Some times it requires moving an existing bed to install a hospital bed.
“Try to get Sears to do that,” Bowman said. “We do that because we’re dealing with elderly people who often live by themselves. I think reimbursement should be increased.” HME