Biting the hands that help you breathe


I saw two items online this morning that really bent me out of shape.

The first was an article in The Hill:

America’s Health Insurance Plans (AHIP) has reported that more than 40,000 seniors have called, written or met with their congressional offices to oppose the Obama administration’s proposed 2.2% cut to Medicare Advantage.

Good for the AHIP, but if I’m an HME industry stakeholder I see so many things wrong with this paragraph.

First of all, this cut was proposed, oh I don’t know, in the past few months, and already, 40,000 seniors have spoken out about it? Where have these seniors been in the, I don’t know, 10 years or more that the HME industry has been fighting competitive bidding?

Second of all, these 40,000 seniors are up in arms over a 2.2% cut? I guess this is only the latest in a series of reductions to Medicare Advantage, but a 2.2 cut%? A “crushing blow”? Really? Do they know that on July 1, their friendly HME providers will have to absorb, on average, a 45% cut for certain HME and a 72% cut for diabetes supplies?

So this was the frame of mind I was in when I saw this second item, a letter to the editor from a user of home oxygen therapy in North Carolina:

At night, I am prescribed to use an Invacare Perfecto2 oxygen generator. I can buy a new one over the Internet for $707. I did not buy one though; instead, I rented one from a company in Greenville. The company in Greenville billed Medicare $17,100 for my $707 unit. Medicare said, “You are nuts! You overbilled us! That machine is only worth $6,338. Consequently, Medicare will only pay 80 percent of its worth, or $5,070, and you can get the other 20 percent from the user.” That left me paying the $1,268 balance. So, in summary, the company in Greenville received $5,070 from Medicare and $1,268 from me for a machine whose retail price is $707.

I wonder how many services come with that $707 unit? Set-up? Training? Maintenance? Emergency assistance?

So, not only are seniors not supporting the HME industry’s efforts on a grand scale, but also they’re biting the hands that help them breathe.

Suffice it to say, the lack of awareness among this growing and galvanizing group, when it comes to the HME benefit, hit me really hard today.