September 12, 2016. On July 1, Medicare cut funding for home medical equipment by upwards of 50-80 percent. The consequences have severely impacted people with disabilities and chronic conditions who rely on medical equipment. Caseworkers and homecare providers are also feeling the effects of the cuts. The stories below have been collected by People for Quality Care and showcase the wide range of stakeholders whose daily living and ability to service patients has been limited as consequence of these drastic reductions in funding for vital home medical equipment and services.
“I don’t have the money for my equipment”
For Rita Thomas of Eclectic, Alabama, Medicare cuts mean cutting back on her CPAP supplies needed to treat sleep apnea. Rita first called People for Quality Care in early July with concerns about her inability to get her CPAP supplies now that her home medical equipment supplier is having to bill patient claims non-assigned; patients must front the difference in what Medicare pays and the cost of the equipment. As of late August, Rita reports that she still has not received her supplies because she is on a limited income and cannot afford them. She tried contacting Medicare, but she said they were not helpful and simply offered to make note of the problem.
“I am very concerned about paying up front for my equipment. My husband and I live on a limited budget and having the money to do so is not an option”
“No one is taking Medicare anymore”
Beneficiaries are not the only people burdened after Medicare’s funding cuts. Case managers and discharge planners like Kristie L. are having a hard time finding suppliers who still take Medicare patients. Kristie is a physical therapist and case manager from Leominster, Massachusetts, who has called numerous HME providers to find equipment for her patient but has found no one in her area is taking Medicare.
“With Medicare rate cuts and competitive bidding, I am really struggling to find equipment for my patients. I have gone through all my regular channels, and no one is servicing Medicare patients anymore.”
“We don’t want to turn patients away”
“The cuts to HME are not just impacting Medicare patients, but Medicaid patients as well,” explains Cindy Coy, business office manager, at Avera Health in Sioux Falls, South Dakota. The hospital-based home medical equipment provider has already limited its service area because the reimbursement doesn’t cover the extended travel and personnel expenses. They recently had to turn away a pediatric patient in search of oxygen because the child was not in their coverage area. Coy says many hospital-based providers are following suit and shrinking their coverage areas.
As a faith-based business, turning away patients is not easy for Coy.
“We do not want to turn patients away, but if we aren’t fiscally accountable, we won’t be able to take any patients at all. We are doing everything we can to cut costs. We are reviewing vendor contracts, looking at our delivery models, how we service patients – we are looking at everything.”
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If immediate action is not taken, the hardships experienced by Rita, Cindy and Kristie will continue. Congress has reconvened and will only be in session until the end of September. To advocate for preserved access to medical equipment, call and send a letter to your legislators asking for immediate legislative relief. Visit People for Quality Care to learn more and to send a letter to Congress about this important issue.