Medicaid sharpens ax in Northwest

Friday, October 31, 2003

SALEM, Ore. - After beating back attempts by Oregon Medicaid to slash DME reimbursement by 20% across the board earlier this year, providers in the Pacific Northwest are now waging another campaign to keep the state’s Office of Medical Assistance Programs from cutting two rehab miscellaneous codes, E1399 and K018, by 20%.

In Washington, the state’s Medicaid program wants to cut reimbursement by 25% across the board on all DME products.

Since the states wanted to enact the new reimbursement rates on Oct. 1, the Pacific Association of Medical Equipment Services (PAMES) is appealing the decisions before emergency boards in each state.

Tom Coogan, a PAMES officer and vice president of Care Medical, which has seven locations in Oregon and Washington, is surprised by the renewed attempts to slash DME reimbursement because PAMES meets with Medicaid quarterly.

“They must forget our conversation from meeting to meeting,” Coogan said, “because they keep writing these policies into the administrative rules for public hearing.”

Coogan believes the states are looking for 20 to 25% price reductions because they are basing their rates on MSRPs for products manufactured offshore.

The West Coast has been particularly hard hit by state budget deficits. Gov. Gray Davis of California recently cut that state’s $140 million budget for DME by $20 million.