MAMES Testifies to State Medicaid Commission

JEFFERSON CITY, MO.–Members of the Midwest Association for
Medical Equipment Services recently testified before the Missouri
Medicaid Commission to argue the need for updating DME policies to
help providers, patients and save state funds.

“We’re confident we have a strong argument to convince them DME
is a vital part of home care and a very cost effective component of
the health care dollar,” said MAMES Missouri State Chair Brady
Vestal, director of home medical equipment at Citizen Memorial
Health Care in Bolivar, Mo.

The group testified in response to recent Medicaid reforms in
the state, including a bill that eliminates coverage of most HME
other than oxygen, manual and power wheelchair bases, ostomy
supplies, diabetic supplies and prosthetics.

Although there is nothing that can be done to change these
policies during next year, Vestal said he hopes the organization
can influence policy in the future. “Our goal is to work with the
reform commission,” he said. “There is a great opportunity to
update these policies and do so in a way that would provide
significant cost savings for the state.”

Most of the state’s Medicaid DME coverage policies, he
explained, were written in the early ’80s and are in inconsistent
with Medicare guidelines.

“We highlighted how little sense these cuts made,” Vestal said.
“Medicaid will pay for respiratory medications under the pharmacy
benefit, but won’t pay for a nebulizer compressor. The committee
agreed that makes no sense at all.”

Vestal said the reform commission was “very receptive,” and
MAMES members will be developing a list of recommended policies
that could be changed or updated.

But as the cuts stand currently, Vestal continued, “I see the
possibility where if patients who just had heart surgery cannot get
a hospital bed and go home, the hospital isn’t going to discharge
them. This is going to have a ripple effect on hospitals, emergency
rooms and long-term care facilities.”