Medicare Rate Reduction Negatively Impacting Providers and Medicare Beneficiaries
There was another round of Medicare rate cuts effective July 1st that are negatively impacting DME/CRT providers. This drastic and irresponsible cut applies to all areas of the country not included in Medicare’s competitive bid program. These rate cuts averaged 50-60% compared to 2015 rates and affects all products that are part of the bid program. Products affected include standard power wheelchairs, scooters, standard manual wheelchairs, oxygen, CPap, hospital beds, walkers, nebulizers, patient lifts, bedside commodes, and many others.
It is unrealistic for providers to simply absorb these cuts and continue business as usual. Some providers around the country have closed their doors while others have stopped doing business with Medicare. Read more about the provider impact here. The article here shares the story of an Illinois provider that once served President Abraham Lincoln and is now closing their doors after 170 years- very sad to see.
Miller’s is doing everything we can to continue providing service for our clients and referrals. It is important we do so in a way that makes sense with the new rates. Effective August 1, 2016 Miller’s no longer accepts Medicare assignment for ambulatory aids including walkers and quad canes. The new rates do not even come close to covering our costs to provide.
Medicare beneficiaries can still obtain a walker from Miller's, and they can do so on a non-assigned basis. Non-assigned means the client pays Miller’s in full our retail charge for the walker. We can then submit a non-assigned claim to Medicare if the client requests it. If a non-assigned claim is submitted and Medicare determines the walker is medically necessary, Medicare would pay the client directly the Medicare fee schedule amount. Note this payment amount is approximately 40% of the amount the client paid to Miller’s to originally purchase the walker. There is no guarantee the client will receive any reimbursement from Medicare.
The client does have the choice to seek a different DME provider that may still accept Medicare assignment for walkers. Miller’s will continue to provide ambulatory aids assigned to other payers. This is subject to change depending on their ambulatory aid rates.
It is unfortunate it has come to this. Miller’s and the DME industry has worked tirelessly to educate CMS and elected officials that at some point we could not provide after so many rate cuts. If you would like to voice your concern about these rate cuts, please visit the American Association for Homecare's Action Center here and let your legislators know.