Missouri

JEFFERSON CITY, Mo. - Home medical equipment providers in Missouri expect a steep Medicaid reimbursement cut in 2010--they're just not sure how steep.

In late December, Medicaid officials still hadn't divulged how much they plan to cut from the state's $50 million DME budget.

"We were lucky--when the 9.5% cut went through for Medicare in 2009, we didn't get that for Medicaid," said Roni Burns, a state chairman for the Midwest Association for Medical Equipment Services (MAMES) and director of the rehab department at Home Support Systems in Springfield. "But the state's revenue is down, so now they're looking to make cuts."

Because state revenue is down about 5% to 10%, providers suspect Medicaid officials will look to cut the DME budget by the same amount, anywhere from $2.25 million to $5 million.

Fortunately, providers say, Medicaid officials are asking for their help in deciding where to make those cuts.

"As doom and gloom as it is, at least the powers that be are working with us," said Patrick Naeger, a member of the association's board of directors and executive vice president of Healthcare Equipment & Supply in Perryville. "They're asking for our opinions and they're considering them. They're not just forcing things down our throat."

Providers are trying to come up with where to make cuts by thinking outside the box. One possibility: move to a single-source manufacturer for adult and pediatric nutritionals, which comprise $3 million to $4 million of the DME budget.

"Let the manufacturers compete," Naeger said. "I hate to pass the buck, but they're the ones who know what their bottom lines are and where they can control their costs."

One area that providers hope to protect: complex rehab.

"On consumer chairs, maybe we can move a little," Burns said. "But on complex chairs, we can't move at all. We're struggling right now just to make ends meet." hme