A new spin on bidding


I talked to a wheelchair provider in Texas last week who told me they have to participate in some kind of bidding system to provide wheelchairs to Medicaid recipients in a certain part of the state. The system works like this: When Evercare, the HMO that administers the Medicaid program for the Houston area, receives a bid from a provider, it turns around and solicits a second bid from another provider. Nine times out of 10, whichever provider has the lowest bid wins the patient.

Here's an example of how the system plays out, according to the provider:

Say a patient goes to a hospital or a clinic and the therapist there selects a chin drive and some other high-end stuff. We submit it to Evercare and they send it to another provider who sends their own therapist out and they downgrade the equipment. In one case, the tech asked a patient to get out of bed—she was a para—to try a Captain's seat when she needed a head array. So then the case manager at Evercare asks us why we speced out such a fancy chair and we say, "We didn't; the hospital did with their PT and our ATP; this is what the patient needs." But they're making decisions solely on cost.

You can probably see where this is going. Providers complain that other providers are undercutting their bids and, to do so, putting patients in inappropriate wheelchairs.

The provider also gave me an audio clip of one of his employees discussing the system with one of Evercare's employees. Getting a straight answer out of Evercare seems as difficult as getting a straight answer out of CMS.

Evercare conversation

Liz Beaulieu


This is absolutley ridiculous! HOW can any govern official not listen to this and see the wrong doing of these insurance companies? This lady sounded like she should have worked at a corner gas station..not in a well renouned goverment insurance office! This makes me sick. I believe all private insurance,HMO, Medicaid, Medicare ect .should be governed to the same standards and abide by guidelines that providers are requried to jump thru? It's disgusting how they make up their own rules as they go to their convience! How the hell can you not give a paitient what they medically need? A para getting a basic unit rather than chin drive...uh HELLO??? IDIOTS!! Any one see what's wrong with that? Do officials have to walk in the consumers shoes before the GET IT? If this was turned around and let's say a govermment official was in this situation...beyond the stress of not having mobility, now they are going to try to get you in a unit you can't use because it's cheaper?? TOTAL BS! Get the consumers what they medically need and stop jerking the health care providers around!