State aims at manuals
SACRAMENTO, Calif.--The California Department of Health Services, which runs the state’s Medicaid program, has a pilot project in the works to contract for DME. Its first target: adult manual wheelchairs.
The department announced recently that it seeks to contract with manufacturers to determine a fair acquisition price for adult manual wheelchairs. It then plans to offer that price to providers, plus a to-be-determined markup.
“It’s their version of competitive bidding,” said Bob Achermann, executive director of the California Association of Medical Product Suppliers (CAMPS).
The department accepted comments on the project in June. It has targeted adult manual wheelchairs, industry stakeholders believe, because wheelchairs represent 52% of total DME expenditures.
Provider Mark Hawkins says he’s OK with the department contracting for low-end but not high-end manual wheelchairs.
“I can’t see how we could use just one manufacturer for custom manual wheelchairs,” said Hawkins, president of Western Rehab in Santa Rosa, Calif. “We often use different manufacturers based on different diagnoses, because some features and accessories are available on some chairs but not on others.”
Providers also fear getting reimbursed on a cost-plus vs. a fee schedule basis.
“What are they going to pay?” Achermann asked. “Will it be enough to cover all aspects of providing the products that are now included in the fee schedule?”
While it’s common for states to contract for supplies, it’s less common for other DME. Achermann has been in touch with rehab organizations like NCART.
“Everyone is concerned,” he said.