Pennsylvania HMEs rally in the rotunda

HARRISBURG, Pa. -- Medicaid beneficiaries and HME providers in Pennsylvania joined the legislative fray in April when they expressed their opposition to Gov. Ed Rendell's proposed budget cuts during a "Rally in the Rotunda" in the Capitol building here. The rally, sponsored by the Pennsylvania Law Project and supported by the Pennsylvania Association of Medical Equipment Suppliers (PAMS), aimed at illustrating to state legislators that the proposed cuts would fall squarely on the shoulders of children and adults with disabilities. The governor's proposal, if passed, would restrict access to medical care by placing caps on services, like hospital visits, prescription drugs and medical equipment. The proposed cap for DME is set at $5,000 per adult per year. "Any patient who needs multiple pieces of equipment, like an oxygen concentrator, a hospital beds, and a manual wheelchairs, will probably exhaust that $5,000 within eight or nine months," said Dave Fiorini," executive director of PAMS. "Anyone on a ventilator alone is probably going to exhaust it in two or three months." Fiorini said the burden of the cap on DME, as well as similar caps of only two hospital visits per year and six prescriptions per month, will unduly impact the disabled and financially distressed patients. The cuts, of course, will also weigh heavily on DME providers in the state. "We did a study of just our patients and found that at the nine-month mark most of our patients will reach the cap," said John Kaiser, president of PAMS and director of Walnut Medical in Johnstown, Pa. "Does that mean months 10, 11 and 12 are free for the customer?" Kaiser said he is also concerned that there is no provision in the proposal requiring disclosure to providers about how much of the cap patients have left. "We don't know what other companies are providing, and they don't know what we are providing, so we could be putting out equipment when the patient has already met the cap with another company," he said. To address these concerns, PAMS is encouraging members to meet with and write letters to their legislators. PAMS also hired a full-time lobbying firm to represent the industry's interests at the Capitol. The governor said cuts are necessary to help bridge an estimated $1.2 billion gap in the state's budget, according to the Philadelphia Inquirer. The welfare department, which covers 1.7 million Medicaid recipients, needs to trim its costs by $600 million this year.