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Homecare Association Says CMS Pricing For DME Equipment Will Endanger Seniors, Cost Jobs, And Force Business Closures
Date:1/30/2013

r, Joel Marx , chairman of the American Association for Homecare and chairman of Medical Service Company in Cleveland, called the new reimbursement rates disastrous for providers across the country.      

"These reimbursement rates are based on a convoluted methodology which pits providers in a life or death situation," said Marx. "The government then decides which companies survive and which are driven out of business rather than run a fair auction conducted by auction experts. The current bidding system is forcing seniors and people living with disabilities to seek medical help in emergency rooms, to be forced into nursing homes and to be hospitalized when they could be cared for at home at much lower costs."

Clearly, momentum is building to change the system. Last year, legislation in the House to establish a Market Pricing Program (MPP) for Medicare DME collected 94 co-sponsors.  MPP, which was shaped by economists and the nation's leading auction experts, features an auction system that would establish market-based prices and require fundamental changes in the current system. Similar legislation will be re-introduced in the new Congress.  

Wilson said that Medicare beneficiaries are paying a steep price for the false savings.

He cited data indicating that when Medicare patients aren't receiving some DME products they have a higher risk of death, a higher frequency of emergency room visits and hospitalization, and longer hospital stays. Moreover, since CMS is not considering the higher costs of emergency room and hospital visits in their alleged savings, it is further evidence that their projections are bogus.

"The hidden costs of the bidding program are far exceeding any savings to the government from reduced claims on home medical equipment," Wilson said. "The government's own data also portrays the extent to which the progr
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SOURCE American Association for Homecare
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