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Reimbursement continues to be an issue, poll respondents say 

Reimbursement continues to be an issue, poll respondents say  ‘There’s no extra money’ to make investments in 2021 

YARMOUTH, Maine – The notion that reimbursement rates have stabilized due to the pause in Round 2021 for most products is a “misconception,” say numerous respondents to a recent HME Newspoll. 

CMS announced in October that it would not move forward with new single payment amounts for 13 product categories, instead continuing the current rates in bid areas. 

“(Rates) have not stabilized and will continue to be an issue going forward,” wrote one respondent. “The competitive bidding program is broken and unsustainable. There needs to be a topline strategy on the direction of reimbursement rates and the lack of access or poor access in these areas and especially in the rural/non-rural areas due to low reimbursement rates and a flawed bidding process.” 

CMS has proposed continuing to pay 50/50 blended rates in rural and non-contiguous bid areas, but it doesn’t plan to continue paying the 75/25 blended rates in non-rural, non-bid areas that are in effect through April 1, 2020, or whenever the public health emergency ends. 

Numerous respondents say they’ve been barely scraping by under the current rates for years and looked to Round 2021, with its modifications to the bid process, as an opportunity for at least a small boost in single payment amounts. 

“There’s no extra money,” wrote one of the 43% of respondents that don’t plan to make any significant investments in their businesses in 2021. “Just because the bleed has been stopped doesn’t mean that there is enough left, and there is especially not enough to get into a body building program.” 

The lack of permanent relief in non-rural areas, in particular, is an obstacle to making investments for numerous respondents. 

“Stable DME rates?” wrote one respondent. “The rates may be ‘stable,’ but the industry certainly isn’t stable. The non-rural rates will slowly kill small dealers like us.” 

Fifty-seven percent of respondents, however, say they do plan to make investments in their businesses in 2021, with the focus for the majority of them on new products and services (32%), including home access and modifications and non-invasive ventilators. 

“We will be ordering more equipment that we sell or rent every day, but we will also be adding new lines to expand our offerings,” wrote Dorothy Nowik of Pacific Medical Systems in Bellevue, Wash. “When we can reopen our lobby, we will be ready with new items to offer.” 

 Other areas of focus for new investments, according to respondents: hiring (23%) and technology (23%). 

“We plan to leverage technology to reduce costs,” wrote one respondent. 


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