Readers to Mike Moran: Not so fast

Thursday, August 26, 2010

Here’s something I’ve been thinking about for a long time: Would it be totally off the wall to suggest that Medicare remove a bunch of HME products from the fee schedule?

I’m not talking about oxygen and power wheelchairs and some of the bigger more expensive items that some seniors (but certainly not all) might have trouble paying for. I’m talking about stuff that could be considered a commodity. Things like walkers, commodes, cane handgrips, bedside rails, trays. That kind of stuff.

I suggest this because recently I went to two large family gatherings. One was a good old-fashioned family reunion and the other a memorial service. There were plenty of Medicare age folks at both, including my mother, 72, and my father, 75. I didn’t see one person who could not afford some of this less-expensive HME. In fact, many, if not all, could probably afford a power wheelchair if they really needed one. I know my parents could and they are not wealthy. They recently bought a big, fancy flat-screen TV. If they can afford that, they can certainly afford a scooter, and a commode would not even make them blink. They may even think it’s funny that Medicare pays for a cane grip. I know I do. A cane grip? Come on.

Like I said, I could be way off base here. But removing some of these inexpensive/commodity items from the fee schedule seems to make sense for two key reasons (and I’m sure there are more): 1. HME providers would see an immediate increase in cash sales and reduce their dependence on Medicare; and 2. Medicare would see a corresponding decrease in utilization.

Isn’t that what they call a win-win?

HME News readers respond

In a perfect world, your suggestion makes sense. Most of my clients are sitting in un-air-conditioned, 100-degree heat because they can’t afford electricity. Purchasing a walker with extra cash seems out of the question, particularly with an urban-poor population. What you are getting to is identifying income strata that can afford equipment outside of CMS and who probably should buy it and those who can’t. This is really important with state Medicaid programs also cutting back. Segregating benefits by income is not new, and some aspect should be investigated. But is it a concept to offer during an election year? I doubt it.

– spider

A large percentage of our rural patient base can barely afford their LIS “extra help” co-pays on their medications. I have no doubt many would choose to forego the “inexpensive/commodity” items prescribed by their physicians, were they to be removed from the fee schedule, so that they can continue to pay for items such as groceries and their electric bills.

– becky