Clock is Ticking for Home Medical Equipment Providers

C.N.Y. Medical Products is one of many home medical equipment (HME) companies in New York, and across the country, who did not receive a contract in the Centers for Medicare and Medicaid Services (CMS) competitive bidding program. “We have a large retail store and when Medicare customers come in we have to turn them away. It makes no sense!” says Lynn Komuda, vice president of C.N.Y. Medical Products in Syracuse. “I have a sense of shame having the equipment right in front of them and telling them they have to pay out of pocket if they want to support their local vendor.” Komuda said she even has to turn away her own family, friends and neighbors because they live in these bid regions.

At the heart of the problem is preserving services and equipment to individuals and the elderly with severe disabilities, as well as the livelihood of local and county businesses and residents. HME providers like C.N.Y. Medical Products, care for the medical needs of millions of Americans who require oxygen equipment and therapy, mobility assistive technologies, medical supplies, inhalation drug therapy, home infusion, and other home medical equipment, therapies, services, and supplies in the home.

But the clock is ticking. The first phase of implementing new reimbursement cuts, set by applying pricing from CMS’ competitive bidding process to rural areas not previously covered by the program, took effect January 1, 2016. And just a few days from now, on July 1, 2016, a new round of deep cuts for HME providers in these rural areas will take effect. The HME community feels strongly that these further payment cuts to rural areas will decimate the HME safety net that supports some of America’s most vulnerable patient populations.

C.N.Y. Medical Products was started in 1981 by John and Lynn Komuda. Over the years the company has employed family, friends, and neighbors. They have had as many as 35 employees but due to continuous cuts to Medicare payments, the company has had to reduce staff to 16, yet continue to cover 22 counties in New York State—the majority of these counties will have Medicare payments for HME reduced again, by 25-30% come July 1.

The American Association for Homecare and many consumer groups and partners in the HME community believe six months to monitor for disruption in Medicare beneficiaries’ access to DME items in rural areas is not enough time. Several factors come in to play when considering the cost of providing HME to rural areas of Texas, such as:

·      Employee time, fuel costs, and mileage to drive to the beneficiary’s residence

·      Widely ranging geological and road characteristics that could require specialty vehicles, including 4-wheel drive, ATVs, tractors, and more sparsely populated areas that don’t offer the same routing efficiencies as dense urban areas

We believe this program will have a devastating effect on HME providers in New York and across the country, as well as for the elderly and severely disabled patients they serve in these communities come July 1. To learn more, visit www.aahomecare.org/issues/competitive-bidding.