Fool’s Gold
Medicare reimbursement fees are arbitrary and artificial, bearing no resemblance to actual HME/DME market prices
There is a very serious virus spreading through the reimbursement structure for the DME industry. It started several years ago as a treatable disease, but has now reached epidemic proportions. That disease is the driving down of DME fees to a level below the cost of doing business. It is a disease that has been driven by the fact that every insurer seems to feel that the fees set by Medicare are the “Gold Standard” for everyone. Lost in this spreading disease is the fact that Medicare fees are both arbitrary and artificial. They were set by the application of complex rules that tied fees to amounts billed during a period in the 1980s and then were tweaked and adjusted by all sorts of mechanisms that have left them bearing no resemblance to actual market prices.
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