States continue to fight cuts

Monday, December 31, 2007

SALEM, Ore. – The Pacific Association for Medical Equipment Services (PAMES) failed to convince a state emergency board to repeal a 17% reimbursement cut to HME and supplies. On Nov. 1, Medicaid began paying only 83% of Medicare’s allowables.
“Our cry has fallen on deaf ears,” said Tom Coogan, president of PAMES and director of government affairs and managed care relations for Care Medical & Rehabilitation in Portland, Ore.
The state stuck to its plan largely due to a study that showed that HME consumes too big a piece of the Medicaid pie compared to other medical specialties, Coogan said.
“It’s an apples-to-peanuts comparison, because the cost of doing business for HME is substantially greater,” he said.
PAMES hasn’t given up, Coogan said.
“We want the state to provide projected savings from this cut and the savings it has already incurred through the Deficit Reduction Act and other Medicare initiatives,” he said. “We believe patient services will be impacted by all of this.”
HARRISBURG, Pa. – The Pennsylvania Association of Medical Suppliers (PAMS) continues to “put a case together” to fight the state’s recent decision to pay only 80% of the Medicare allowable for power mobility devices (PMDs).
“We’re still trying to crosswalk old and new Medicaid allowables for hundreds of codes (to determine the severity of the cut),” said John Shirvinsky, executive director of PAMS. “It has been time consuming to unravel everything.”
PAMS encourages providers who can no longer afford to provide PMDs at the new rate to file for program exceptions, but the association has little faith that will do any good.
COLUMBUS, Ohio – The state will move forward with its plan to implement competitive bidding for HME “in its original form,” according to a recent bulletin from the Ohio Association for Medical Equipment Services (OAMES).
The association had argued that the state’s plan was too vague. The state’s response: “The specific details for bidding on any items proposed for inclusion in the volume purchasing program will be contained in the request for proposals released by the state.”