Kansas HME Providers Push Back Against Medicaid Rate Cuts

TOPEKA, Kan. (January 24, 2019)—The Kansas Dept. of Health and Environment has proposed cutting rates for most HME items to just 65 percent of the Medicare non-rural fee schedule, effective retroactively to Jan. 1, 2019.

HME stakeholders in Kansas, led by the Midwest Association for Medical Equipment Services & Supplies (MAMES), have pushed back with comments that point out how these cuts will further impact providers who are already dealing with a challenging Medicare reimbursement environment. MAMES’s comments highlight how the competitive bidding program has shrunk the ranks of HME suppliers in Kansas and detail the evidence that deep reimbursement cuts are impacting HME patient access, citing industry studies as well as findings from CMS and the Government Accountability Office.

“Further reductions to DME reimbursement for the Medicaid population at 65 percent of the non-rural Medicare fee schedule will devastate suppliers who care for the Medicaid population,” asserted MAMES in comments shared with Kansas regulators, CMS officials, state legislators and selected members of the Kansas congressional delegation. “In addition, it will eliminate any estimated Medicaid program savings by shifting those savings to long-term care expenses.”

MAMES later added that “absolutely no supplier would be able to sustain that type of reimbursement reduction over any period of time. Once the suppliers are gone, especially in the rural areas, there are no new suppliers coming in.”

“These proposed rates would be the lowest rates for a Medicaid program in the country,” noted AAHomecare’s vice president of payer relations, Laura Willard, who is working closely with MAMES’ executive director Rose Schafhauser on the issue and also submitted comments on behalf of AAHomecare. “Kansas Medicaid is 94 percent MCO-covered, so the actual amount at risk for the state is small, but the potential impact on HME providers and patients is huge. The HME community needs to continue to push back against the growing trend of MCOs further discounting Medicaid rates, or providers will be faced with very tough choices on serving this population.”

Visit aahomecare.org and mames.com for more information.