Tuesday, January 26, 2010

BOSTON - An overflow crowd packed state offices in December to testify against $2.84 million in proposed Medicaid cuts for several HME supply categories.

"We put the state on notice that if you go forward with these rates, (beneficiaries) are going to get inferior quality products," said Karyn Estrella, executive director of the New England Medical Equipment Dealers (NEMED) association.

In October, the Division of Health Care Finance and Policy, which sets the state's Medicaid rates, proposed cutting reimbursement beginning Jan. 1 for several product categories including incontinence, ostomy, urological and diabetes supplies. The rate cuts vary across codes and categories, but reimbursement for most items would be at about 80% of the current Medicare allowable.

That's an "unworkable" margin, said provider Peter Tallas.

"For some reason people think you just drop off a box, which is frankly ridiculous," said Tallas, president of Pembroke-based Charm Medical Supply.

Charm Medical serves about 6,000 patients--mainly Medicaid--statewide. If the cuts go through, Tallas worries about access for the state's most vulnerable citizens.

"Delivery services will have to be cut, and providers will move toward inferior substitute products which are going to lead to negative health outcomes," said Tallas. "They'll end up in the hospital or develop infections. Frankly, I don't think this is going to save a penny."

After the hearing, providers and patients demonstrated at the state capital, even dropping off a case of briefs at the governor's office, said Estrella.

"There are many (lawmakers) watching and aware and urging (Medicaid) not to make cuts that have a heavy impact on some of the neediest people in the state," said Estrella. hme