Medicare DME payment changes can hurt patients, providers

Medicare's competitive bidding program for durable medical equipment (DME), prosthetics and other supplies--expected to save the program $25.7 billion by 2022--has come under fire for its effects on individual patients and providers. 

Jill Bryant, for example, a Michigan beneficiary with a degenerative lung disease, needs liquid oxygen to survive, the Midland Daily News reported. But Bryant's DME dealer wanted to replace her liquid oxygen with a cheaper concentrator that wouldn't meet her needs. The supplier eventually agreed to keep delivering liquid oxygen to Bryant despite financial loss.    

Bryant voiced concern for others in this predicament. "Liquid oxygen is being removed by some DME suppliers from patients' homes who are uninformed or unable to resist confiscation," Bryant told the Daily News. "DME businesses are no longer accepting new liquid oxygen patients. This is not quality care."

Meanwhile in Massachusetts, Judith Labonte was trapped in her apartment for almost two weeks after her power wheelchair broke, according to a WBZ-TV/CBS News piece. Labonte couldn't find anyone to fix her chair since suppliers aren't contractually obligated to do repairs, WBZ reported. So Labonte turned to U.S. Rep. Jim McGovern (D-Mass.) for help.

"It's frustrating as hell," McGovern told the station. "When your wheelchair breaks, you can't wait forever to get it fixed, and you shouldn't be making a thousand phone calls and be told no, no, no."  

McGovern and other representatives urged the Obama administration to re-examine the competitive bidding process, WBZ noted.

Finally in Virginia, a family-owned medical supplier trusted by its community since 1983 became a casualty of Medicare reimbursement changes, The Free Lance-Star reported. Pat Grimes, Inc. lost the last round of competitive bidding. This, combined with commercial payer rate cuts, made doing business unsustainable.

"I do not imagine it will be possible to find another company with such heart," a long-term customer told the newspaper in response to the company's closure.                     

Pat Grimes was always on-call for patients with chronic obstructive pulmonary disease who were released from the hospital and needed home oxygen tanks. But other suppliers refuse to provide tanks after-hours since that's not profitable, The Free Lance-Star noted. So patients may go home without life-sustaining equipment.   

For more:
- here's the Midland Daily News article
- see the CBS News/WBZ-TV piece
- read The Free Lance-Star article