My name is Cindy Coy and I work for Avera Home Medical Equipment and I am a Board Member of the Midwest Association of Medical Equipment Suppliers (MAMES). Avera Home Medical Equipment has 15 locations throughout South Dakota, Iowa, and Minnesota. Most of our locations are in rural areas and I am concerned about the impact that Competitive Bidding has on rural America. Not only the DME suppliers but the patient’s we serve as well. We as suppliers are having to find ways to serve the Medicare population in rural America and still keep our operations fiscally viable. For some suppliers this means cutting back on staffing or closing branches doors altogether. Some suppliers I have talked with are having to look at implementing routes in rural areas, which means that a patient needing equipment might have to wait a few days to a week before the supplier will be in their area to deliver equipment.
Suppliers are having to buy cheaper, less trustworthy products from vendors to lower their acquisition costs.
One case that was shared with me is a patient who was using cheap diabetic strips to do their testing and ended up going into a diabetic coma due to the strips were not producing the correct blood glucose levels. This is a direct result of suppliers having to look at alternative vendors/products.
Patient injury could also occur with other cheaply made products, especially mobility equipment and respiratory equipment. Another thing that is not in the favor of the beneficiary is that more suppliers will be taking claims non-assigned. What this means for the beneficiary is they will have to pay more out of pocket for items. These are elderly or disabled people on a fixed income that do not have the means to pay out of pocket for equipment.
The cuts are being made, however, the administrative overhead that suppliers have is not being diminished in any way. As a matter of fact administrative requirements are increasing due to additional audits and now the roll out of prior authorization. DME audits have increased substantially over the past few years and money has been taken back from suppliers. Many times the recoupment of money has little or nothing to do with the patient qualifying for the equipment but rather some minor technical reason such as an “i” not dotted or a “t” not crossed.
DME has always been at the mercy of physicians documentation practices and this has not made an easy road for us to get patients that truly need equipment to meet the qualification guidelines due to physicians not documenting what Medicare wants to see. For many years it has been the suppliers burden to educate physicians on what needs to be in the medical record in order for patient’s to qualify. I understand that there are some suppliers in our business that have been fraudulent, however, those suppliers should be dealt with. I believe that the majority of suppliers are truly trying to do the right thing and truly care about the patient’s they serve and we are all paying for the sins of the fraudulent suppliers.
I have been in this business for 25 years and have seen many changes in that period of time, none of them as devastating as Competitive Bidding to the rural areas. The roll out of Competitive Bidding is going to reduce our reimbursement substantially and we as suppliers do not have the means to stay in business and serve the Medicare population the way they should be.
My mother lived to be 95 years old and passed last July. She worked hard all of her life paying into Medicare, luckily she did not have the amount of medical issues that some elderly or disabled folks do. If she would have, I would like to think that she would have been taken care of in the manner that she deserved to be. Our elderly are a generation to revere, not to close off from the care that they need. I am hopeful that CMS will take another look at what their policies are doing to the elderly and disabled who have no other recourse than to rely on Medicare to pay for their heath care needs.
Cindy Hoy shared her testimony at a regulatory and fairness hearing held by the Small Business Administration on Thursday, March 24th in South Dakota. Another round of reimbursement cuts is slated for competitively bid items in July. This will add more devastation to an already suffering local health care system.