Positive News

Last week I got a phone call from a longtime HME provider who's been working in the Philadelphia market for 25 years. She has been reading HomeCare that entire time, she said, and she was calling with a special request.

"How can I keep up my employees' morale?" she asked. "Is there any positive news?"

Some days I have to admit I wonder the same thing, and I told our loyal reader so. At times the barrage of bad news coming at this industry seems unending. But follow me on this one.

Medicare gets the lion's share of attention when it comes to this industry's problems. Lately, Medicaid issues, too, are horning in when it comes to HME battles over reimbursement. Providers across the country are getting hammered as program rolls swell and states chop their budgets.

The cuts are nothing new, there are just more of them. A number of states are also looking to reduce the Medicaid provider pool, and some are moving to single-source contracts for various items.

In North Carolina, providers scrambled to replace their patients' old diabetic supplies after the state tapped manufacturer Prodigy Diabetes Care as its only source for Medicaid patients who need those products.

Florida providers are fighting their state's plan to consolidate incontinence and diabetic suppliers, thus eliminating hundreds more providers from servicing those patients. Rhode Island closed its bid window in December in a move toward only one provider in each of three DMEPOS categories.

Last year in Georgia, new Medicaid fees were set at 80 percent of 2007 reimbursements. That's problematic enough, but the new rates took effect months before the state authority was prepared to implement them, so claims in the interim were paid at the old rates. Now the state is reprocessing all of those claims, thousands of them, to recoup the difference.

At a GAMES meeting last month, that was just one of the Medicaid issues providers had on their plates. And that came on top of the heaping helping of Medicare hurdles. And scary health reform provisions that, at least as of press time, could still do damage. And an hour-and-a-half recap on the über-threat of competitive bidding (which Invacare's Mal Mixon recently dubbed "suicide bidding").