Friday, February 28, 2003

Q. What’s the outlook on Medicaid reimbursement for HME?

A. According to the U.S. General Accounting Office, Medicaid is a “high-risk” program that is in need of sweeping Medicaid reform. Many state governments are facing the worst budget shortfalls in over 50 years. A solution being proposed by the Bush Administration is a cash infusion for states that choose a new, more-flexible Medicaid option. This option would provide for two annual federal allotments: one for acute-care health insurance and one for long-term care and community services. In exchange for choosing this flexible option, states would receive approximately $3.25 billion in extra federal funding during fiscal year 2004, and an additional $12.7 billion in extra funding during the next seven years.

The increased funding for community services, according to the Bush Administration, would encourage people with disabilities and the elderly to make the transition from institutional to home and community-based care settings. This is a great opportunity to expand reimbursement for equipment used in the home care setting and home health services to keep individuals out of a premature institutional admission. Maintaining the quality of care at home is being realized as a way to save money and integrate individuals into the community as planned in the President’s New Freedom Initiative.

Martin Szmall is dir. of gov’t affairs for Pride Mobility Products. Reach him at (800) 800-8586.