Providers start dropping Medicare assignment

‘The prices offered are completely non-sustainable’
Friday, July 22, 2016

YARMOUTH, Maine – HME providers are taking a hard look at what products they can continue to accept Medicare assignment on, from oxygen down the line to canes and crutches.

In a recent HME NewsPoll, the overwhelming majority of respondents (89%) said they have stopped taking assignment on certain products in the past year.

“In this last year, we have stopped accepting Medicare assignment on all DME except oxygen, vents and enteral nutrients,” said Heather Dominguez, executive director of reimbursement for Monterey, Calif.-based AdvantaCare Medical. “With the new cuts hitting, we are considering discontinuing Medicare services altogether.”

CMS on Jan. 1 reduced reimbursement, on average, by 25% in non-bid areas. It delivered a similar cut on July 1, for a total reduction in reimbursement of more than 50%.

Others aren’t just considering dropping Medicare altogether.

“As of April 1, 2016, we have stopped taking all new Medicare jobs which have competitive bid pricing,” said Paul Gammie, president of Gammie Homecare in Hawaii. “The prices offered are completely non-sustainable. The January cuts alone were enough to cause this action.”

The decision to stop accepting assignment reflects a new mindset for many providers, who have long felt doing so would alienate beneficiaries.

“It was our decision that it was time for our company to stop covering up, to our patients, Washington’s mistakes,” said Clark Robichaux, president of Wilmington, N.C.-based Oxy-Care, who stopped taking assignment on liquid oxygen Jan. 1, and nebulizers and some CPAP supplies July 1.

As for beneficiaries: What do they do when a provider stops taking Medicare assignment? Forty-seven percent choose to pay upfront, while 53% forgo equipment, respondents say.

“We are no longer able to bill for lift chairs and nebulizers,” said Nancy Dela Motte, manger at Miller’s Pharmacy in Wyckoff, N.J. “The customers who are able to pay upfront do but are not pleased.”

Those who can’t pay upfront go without—at risk to themselves and at great expense to the Medicare program.

“Many people will suffer injury and repeated hospitalization due to lack of inexpensive care at home offered by DME providers,” said Cindi Lamprecht, owner of Fremont, Neb.-based ProMedCare. “This is only going to create a greater financial burden on Medicare.”



Should be offering a list of Medicare providers vs taking self payments