Texas, HMEs massage new fee schedule

Wednesday, April 30, 2003

AUSTIN, Texas — Texas Medicaid backed off a plan to introduce a new HME fee schedule March 1 to give providers a chance to offer input.

“We are working with them in good faith but are not at liberty to talk about what changes may be in it,” said Michael Flores, president of the Medical Equipment Suppliers Association (MESA). “It was a good opportunity for us to have a little say in what the policy changes may be rather than have someone come through with an iron fist and blindly make changes without knowing the ramifications.”

In January, Texas Medicaid unveiled an 80-page blueprint to revamp the DME fee schedule effective March 3. The move galled providers who, recognizing the state’s need to save money, offered up $6.7 million in savings through increased bureaucratic efficiencies and minor changes to the fee schedule.

Changes to the fee schedule will go into effect on or after May 1, said Medicaid spokesperson Kristy Zamrazil.

“Providers indicated they needed more information, and we wanted to provide them that,” Zamrazil said.

By working with Medicaid officials last year, Flores said, the two sides have developed a “trusting relationship.” MESA’s new lobbyist has also given providers better access to decision makers. Additionally, in working to stave off Medicaid competitive bidding last year, the group mounted a torrid grassroots campaign and earned the support of a number of elected officials.

“I think they realize they have to listen to us,” Flores said.

Medicaid needs to reduce the DME fee schedule by $7.3 million. To reach that number, officials have not ruled out competitive bidding. HME