Many Medicare beneficiaries face obstacles that either delay or prevent them from obtaining critical durable medical equipment (DME) and services in nine regions of the country where a controversial procurement system was implemented a year ago, according to data collected by the American Association for Homecare (AAHomecare), an association representing DME providers nationwide.
Despite assurances from the Centers for Medicare and Medicaid Services (CMS) that the well-being of Medicare patients wasn’t compromised by the competitive bidding system, Medicare beneficiaries taking part in AAHomecare’s survey sharply contradicted those assurances.
CMS says access to DME and services such as oxygen therapy, respiratory devices, walkers, hospital beds, and power wheelchairs hasn’t been restricted. But in a recent statement, CMS acknowledged "a significant decrease" in DME utilization by Medicare patients in the nine bidding areas. CMS contends there was "a lack of evidence of adverse beneficiary impacts."
Patients, according to AAHomecare, in the nine affected metropolitan areas—Charlotte, NC; Cincinnati; Cleveland; Dallas; Kansas City, Mo; Miami; Orlando, Fla; Pittsburgh; and Riverside, Calif—tell a different story. In addition, government data from the areas demonstrate a steep reduction in the number of providers allowed to supply products and services to Medicare patients.
The complaints from beneficiaries are widespread. Some patients now need to travel long distances for prescribed equipment and repairs. Many are unable to find providers in their area who have the equipment they need. Others have found that local providers have gone out of business.
AAHomecare points out that the lack of access to critical DME can drive Medicare costs up in other categories because low-cost DME will be replaced with much more expensive emergency room visits and hospital stays. CMS is planning to expand this program to 91 more metropolitan areas nationwide.
Source: American Association for Homecare