A Center for Medicare and Medicaid Services official admitted that there are “areas within Montana a Medicare beneficiary may experience supplier access issues in obtaining certain durable medical equipment and supplies,” in an Oct. 30 email sent to Montana home equipment suppliers, according to the National Association of Independent Medical Equipment Suppliers.
NAIMES reports that CMS official Lucretia James noted the patient access problems are due to a shortage of suppliers meeting the agency’s new surety bond and accreditation requirements, and added “some have chosen not to stay enrolled.”
According to a NAIMES news relase, the email states Medicare patients might have experienced problems accessing oxygen, enteral nutrition (tube feeding), parenteral (intravenous nutrition), and power wheelchairs in eight Montana counties, Daniels, Sheridan, Roosevelt, Phillips, Musselshell, Fergus, Stillwater, and Carbon.
In addition to this burgeoning access problem, NAIMES reports that the letter says that Medicare patients will be penalized financially if they use a supplier they’ve being going to for years, which doesn’t meet the new requirements, but may be the only supplier in their area. James warns, “If a beneficiary continues to get supplies from a supplier who has not met these requirements, Medicare won’t pay and the beneficiary may have to pay the full cost for the supplies.”
“While CMS claims these requirements were aimed at preventing fraud and increasing patient quality standards, it’s clear the $50,000 surety bond mandate per store combined with up to $25,000 accreditation cost is a financial burden too great for many small independent suppliers to shoulder. These well-intended, but misguided policies are clearly reducing the number of qualified suppliers to serve patients, thereby restricting patient access to services and equipment in Montana and who knows how many other states,” said NAIMES President Wayne Stanfield, president, National Association of Medical Equipment Suppliers (NAIMES).
“Durable medical equipment (DME) is a small player in Medicare, comprising less than 1.7% of CMS’ estimated $460 billion Medicare costs each year. If home medical equipment was such a wildly profitable industry, suppliers could afford to meet these costly albeit misguided requirements,” noted Bob Sherman, outgoing President of the Big Sky Association of Medical Equipment Suppliers representing Montana and Idaho suppliers.
