CONCORD, N.H. - HME providers in New Hampshire are reeling from a change in the way the state's Medicaid program pays for products that require prior approvals and are manually priced.
Medicaid now pays cost plus 10% instead of cost plus 30% for these products–everything from hospital beds to CPAP devices.
"We're going to have to make some decisions as to whether or not we can continue to support their patient base," said Darryl Coplan, general manager of Keene Medical Products in Lebanon, N.H. "We're scrambling to see what we can do, but there's just no margin left."
Medicaid implemented the change April 1, largely unbeknownst to providers, they say.
For some affected products, like gait trainers, providers are now in the red, they say.
"You'd have to be a mail order provider to be able to do these products at cost plus 10%," said Jan Soderquist, president of Rehab Equipment Associates in Manchester, N.H.
Providers, with help from the New England Medical Equipment Dealers association (NEMED), are lobbying state lawmakers to "instruct" Medicaid officials to meet with them to discuss alternatives.
"We understand there's a budget problem, so we're not opposed to the cuts," Soderquist said. "But there are other ways it can be done that wouldn't hurt beneficiaries in such a significant way."
Providers realize they have their work cut out for them.
"The truth is that the budget problems are so big and, relatively speaking, ours seem so small," Soderquist said. "It's like asking the people dealing with the Gulf oil leak crisis to fix the leak in our carburetor. It may be small, but it's devastating to so many consumers."