Rural Medicare Beneficiaries to Lose HME Access on January 1

WATERLOO, IOWA (December 10, 2015)—Medicare beneficiaries, individuals with disabilities and veterans in rural states will have to drive farther to obtain prescribed home medical equipment beginning January 1, 2016.

A recent study completed by the GeoTree Center at the University of Northern Iowa, Cedar Falls, concluded the rural residents in Montana, North Dakota, Oregon, Washington, West Virginia and Wisconsin will now have to travel further to reach an HME supplier.

The study was the continuation of an earlier study in August that showed similar outcomes for five other rural states. The table of information below derived from both studies summarizes the details of HME coverage following the reimbursement cuts.

The release of the study comes just as members of the U.S. Senate and House weigh legislation that would grant relief to hundreds of providers in rural areas expecting reimbursement cuts of up to 45 percent on January 1. The cuts scheduled are the continuation of the phased Medicare DMEPOS Competitive Bidding program that has been criticized widely for using flawed bidding procedures, resulting in widespread business closures since 2007. In this phase, competitively bid rates in urban areas will be expanded to rural ones.

“HME suppliers in rural areas contend with different business challenges such as the cost of delivery and smaller patient volume that are not accounted for in this across the board cut,” said John Gallagher, vice president-government relations, for VGM Group, Inc., which commissioned the study. “Businesses will be put in dire situations, forcing coverage reduction or even closures. Naturally, when there are fewer providers, patient access suffers, hospital discharges are delayed, which costs the government more money.”

In the past six years, there has been a 17 percent reduction of suppliers throughout the U.S., a direct result of the competitive bidding program.

Medicare beneficiaries and their HME suppliers are holding out that S. 2312, the DME Access and Stabilization Act of 2015 and H.R. 4185, the Protecting Access through Competitive Pricing Transition Act of 2015 will be included in the 2015 Omnibus Spending packages, set for vote next week.  

“It’s urgent that people in rural states speak out to their elected officials to stop the expansion of the Medicare competitive bidding program that will devastate rural health care,” said Gallagher.

See graphics below.