Providers, beneficiaries, referral sources: No one’s happy

Friday, July 12, 2013

YARMOUTH, Maine – It doesn’t matter if you’re a contract supplier or a non-contract supplier: In the first few days of Round 2 of competitive bidding, you’re spending the bulk of your time educating shell-shocked Medicare beneficiaries, according to a recent HME NewsPoll.

“Many beneficiaries can’t deal with complex issues and have little family support,” said Janet Tersoff, the billing manager for New Hampshire Pharmacy & Medical Equipment in Washington, D.C. “They are finding these changes very difficult to understand and manage.”

Of the 114 respondents to the NewsPoll, 70 submitted comments detailing their experiences in the first few days of Round 2, which kicked off in 91 cities on July 1. Words often used to describe the program: mess, chaos, ridiculous, frustrated, stupid and disaster.

Respondents reported beneficiaries who are upset they have to switch suppliers; who are waiting days or weeks to receive necessary equipment, sometimes delaying their discharge from hospitals; who are being asked to switch brands of diabetes supplies; who can’t find a contract supplier willing to take them; and who are giving up and paying cash to save themselves the trouble.

“Patients in my area are seeing access problems,” said Jerry Hall, owner of Hall-Moore Medical Supplies in Jacksonville, Fla. “They are being told it will be days to weeks before they receive much needed equipment. Some are choosing to private pay, even though they qualify through Medicare.”

None of this is making the jobs of referral sources—who, in many cases, have enjoyed working with the same provider for decades—any easier, respondents say.

“It has been hard letting referral sources know that after 35-plus years that we can no longer provide their patients with equipment through Medicare since we were not awarded a contract,” said Stephen Stanley, assistant manager at Suncoast Medical Supply in St. Petersburg, Fla.

And it’s not just the relationships between providers and their beneficiaries/referral sources that are strained under Round 2. Contract suppliers and sub-contractors are trying to iron out multiple wrinkles, respondents say.

“We are a subcontractor and our contract supplier wants a credit card or copy of patient personal check to bill if not paid,” said Brad Lipham, CEO of Durable Medical Equipment, Inc. in Carrollton, Ga. “The credit card or check is not encrypted so our patients will not honor the request.”

For some contract suppliers, all of this extra work isn’t even paying off, respondents say.

“We won a contract but you’d never know it,” said Dave Anderson, owner of Anderson’s Medical Products in Bloomington and Terre Haute, Ind. “We have two locations and each of our locations serves a nearby contract county we do some business in. But neither location has had any calls to provide the contracted services. So far, it is as if nothing happened.”

The results

If you’re a non-contract supplier in a Round 2 area, what has been your experience in the first few days of the program?

39%: Spending a lot of time educating beneficiaries and referral sources

27%: Hearing of delays in service

25%: Having trouble finding contract suppliers to take our patients

10%: Business as usual

If you’re a contract supplier in a Round 2 area, what has been your experience in the first few days of the program?

50%: Spending a lot of time educating beneficiaries and referral sources

25%: Business as usual

18.8%: Making a lot of calls to referral sources to get their business

6.2%: Handling an increased volume of business