Oregon restores reimbursement

Friday, January 31, 2003

SALEM, Ore. - The Pacific Association of Medical Equipment Services (PAMES) is declaring victory after the Office of Medical Assistance Programs (OMAP), which oversees the Oregon Medicaid program, restored fee-for-service reimbursement rates for DMEPOS to 100% of the 2002 Medicare allowable.

In October, OMAP slashed fee-for-service reimbursement rates for DMEPOS to 80% of the 2002 Medicare allowable in an effort to save $300,000 and ease a budget shortfall. PAMES hollered, saying the cost to providers would far exceed a few hundred thousand dollars, and fought back.

The association hired a lobbyist, Richard Kosesan. It waged a letter writing campaign. It briefed state legislators. It conferenced with members of key state agencies. It enlisted beneficiaries in the fight.

PAMES’s efforts paid off on Nov. 8, when OMAP restored reimbursement rates.

“When I asked our lobbyist in October whether we should spend the money and time to fight this thing, he said we’d never know until we tried,” said Andy Boesl, chairman of PAMES’s Oregon Medicaid Committee and regional marketing director of Home Medical in Medford, Ore. “So we gave it our best shot, and our efforts paid off.”

Throughout the process, Boesl said, PAMES learned how few legislators knew what DME was. But once the association demonstrated the impact the cut would have on the industry, they were sympathetic and helped change OMAP’s mind.

“We realized what a huge stake the Legislature has in determining the allocation of funding,” Boesl said.

With that information in tow, Boesl said, PAMES is looking to hire a lobbyist on a long-term basis. The association can then keep the Legislature up-to-date on the DME industry and its concerns.

Boesl said that will be key, because PAMES realizes its victory is short lived: The stage has been set for the budget challenges in 2003. HME