Maine Providers Win One, Others Continue Medicaid Battles

AUGUSTA, Maine — As home medical equipment providers across the nation battle with Medicaid officials to hang on to their reimbursements, Maine providers scored a bit of a triumph Wednesday.

Providers managed to sidestep Gov. John Baldacci's proposal for a 10 percent across-the-board Medicaid cut when the Maine Health and Human Services committee refused to go along with the idea. The cut would have been on top of a $700,000 reimbursement drop for the state's HME providers that went into effect Oct. 5.

"Now they were looking at $1.3 million more," said Karyn Estrella, executive director of the New England Medical Equipment Dealers association. NEMED heard about the proposed cut just last week and quickly alerted its members, she said.

"Our members did a great job. They had their staffs calling and emailing," Estrella said. Beleaguered providers told legislators they couldn't take any more cuts and would have to cancel their contracts with Medicaid.

Estrella said that in Wednesday testimony, HHS committee members said they had been hearing from providers and were concerned about beneficiaries' lack of access to HME. They did not recommend the cut to the powerful state appropriations committee.

"We got a little win today," Estrella said.

Still, assaults continue on other fronts in NEMED territory. In Massachusetts, Estrella said, providers are fighting a proposed $2.3 million cut for HME that was to take effect Jan. 1.

"We were able to get a delay, but as it stands now, they are still mandated to make that cut," said Estrella, who added that she and others from NEMED would meet Monday with members of the state legislature to talk about the issue.

Estrella said the state plans to close four health care institutions over the next four years, which would put people back in their homes, into group homes or some other setting. The legislature does not understand that the home medical equipment sector needs to be intact to serve those people, she said.

"They are just not connecting the dots. You can't expand that type of care while you are simultaneously cutting the industry that can help you make that happen," Estrella said.

In Rhode Island, the state is attempting to reduce the Medicaid provider pool to one provider for each of three DMEPOS categories. NEMED's letters to state officials objecting to the plan went unanswered, Estrella said. The request for bids was issued in August, and the bid window closed Dec. 3. While the state Medicaid agency has said it received bids, "we don't know if they were qualifying bids. We're in a holding pattern right now," Estrella said.