Competitive DME Medicare Contractors Not Filling Orders

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Wulfman...

Re: Competitive DME Medicare Contractors Not Filling Orders

Post by Wulfman... » Sat Oct 19, 2013 10:24 am

hyperlexis wrote:
jdr999 wrote:Honestly, Medicare has made some major changes and frankly the new system is unsustainable. Competitive bidding has accomplished exactly what it set out to do -- it put the caring, mom and pop providers out of business leaving only the largest and cheapest in a futile attempt to undercut one another.

In my neck of the woods "bid winners" are actually turning away customers due to the sheer volume of people forced to switch providers..

How this is going to improve our quality of care is beyond me......
Um, you're on Medicare?
I don't think he said he was. Maybe he's just familiar with what's going on in his area.


Den

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jdr999
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Re: Competitive DME Medicare Contractors Not Filling Orders

Post by jdr999 » Sat Oct 19, 2013 7:36 pm

Wulfman... wrote:I don't think he said he was. Maybe he's just familiar with what's going on in his area.
Correct -- I've got a few more years before I'm eligible for Medicare. However I am a Medicare provider and what I'm seeing isn't pretty. Medicare required all suppliers to submit their rock bottom, lowest priced bids on various categories of equipment. Medicare then picked the bottom few bids and non bid-winners can no longer supply said equipment to Medicare recipients. On paper it may make sense, but in practice it isn't working out very well.

What's happening here is one company won the bid for beds, another company won oxygen, a completely different company is supplying walkers and wheelchairs, and many medications and diabetic supplies are mail-order only. This is very confusing for patients -- no one has any idea how to get what they need and there are so many suppliers coming to the house no one knows who to call for what..

And as I mentioned earlier some bid-winners cannot meet the current volume of patients so many are falling through the cracks.. Suppliers are getting much more careful about which patients they'll accept and I've seen many having to call 6+ suppliers before someone takes them on. Something's got to give..

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Re: Competitive DME Medicare Contractors Not Filling Orders

Post by archangle » Sat Oct 19, 2013 11:07 pm

Be sure to write your congressnakes every time you get screwed by medicare/etc. They don't really care about those of us who don't bribe them via lobbyists and campaign contributions, but nothing will happen unless a lot of us voters complain.

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Re: Competitive DME Medicare Contractors Not Filling Orders

Post by Janknitz » Sat Oct 19, 2013 11:58 pm

Just a FYI for Medicare users....If you use a Medicare Advantage plan, the competative bidding does not apply. You can get your supplies from any DME in your plan. This is the time period you can select your plan for the next year. If you have Medicare Advantage Plans in your area, at least look at them. There are some good ones and some not so good. I have used the AARP Medicare Complete Plan for 3 years and love it.
Not so. It depends entirely on which Advantage plan you have. MOST limit you to one provider. Kaiser uses only Crapria--I just filed a complaint against Crapria.
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Re: Competitive DME Medicare Contractors Not Filling Orders

Post by bwexler » Sun Oct 20, 2013 9:44 am

I could use some help on exactly how to go about filing a complaint against Crapria.
If I demonstrate a calm knowledgeable position when I speak to them about the copayment on my new ASV machine and my SleepWeaver mask, that they don't normally carry, I may have a more successful encounter.

I am considering a multiprong approach, Medicare, local DA, State Attorney General, US Attorney General, and local (LA) TV News channel.

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Re: Competitive DME Medicare Contractors Not Filling Orders

Post by msla » Sun Oct 20, 2013 12:08 pm

bwexler wrote:I could use some help on exactly how to go about filing a complaint against Crapria.
If I demonstrate a calm knowledgeable position when I speak to them about the copayment on my new ASV machine and my SleepWeaver mask, that they don't normally carry, I may have a more successful encounter.

I am considering a multiprong approach, Medicare, local DA, State Attorney General, US Attorney General, and local (LA) TV News channel.
You might want to add Boxer, Feinstein and your representative to the list.

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Re: Competitive DME Medicare Contractors Not Filling Orders

Post by chunkyfrog » Sun Oct 20, 2013 12:11 pm

And make a compelling video that will go viral on YouTube.

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cpapist

Re: Competitive DME Medicare Contractors Not Filling Orders

Post by cpapist » Mon Oct 21, 2013 6:57 am

"On paper it may make sense, but in practice it isn't working out very well. "


No, it doesn't even make sense on paper. Stuff done by politicians, rule makers and government employees. None of them ever ran a business. They don't have a clue how the everyday world works.

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Re: Competitive DME Medicare Contractors Not Filling Orders

Post by hyperlexis » Mon Oct 21, 2013 7:31 am

cpapist wrote:"On paper it may make sense, but in practice it isn't working out very well. "


No, it doesn't even make sense on paper. Stuff done by politicians, rule makers and government employees. None of them ever ran a business. They don't have a clue how the everyday world works.
See, this is hysterical -- a lot of hyperbole and folksy nostrums, but when it comes down to it, such comments are a lot of hot air. Believe me there are far too many millionaire business leaders in Congress....

People scream how Medicare and 'entitlements' need to be cut, absolutely must cut, or else our grandchildren will be living in a dystopian Thunderdome picking through trashheaps for food, but when finally something is done to make the healthcare system cheaper and more efficient (cut all that 'waste, fraud and abuse,' blah blah blah....), the same exact people howl and cry! Oh please don't touch my socialized medical system! Go after someone else's! Don't give younger people insurance, as long as I can keep my unlimited Medicare.... Oh please don't make me change DME's, because I may have a delay getting a new cushion and heated slimline hose to throw into the hoarding drawer this month, oh woe is me!

Puhlease! People can't have their cake and eat it too. You truly want a more cost-efficient Medicare to save it for future generations? Then competitive bidding is one of many changes being implemented to cut waste. The customer service kinks in the system will be worked out eventually, and until that time people need to be more self sufficient. Someone who owns or works for a DME and upset he or she didn't get a contract complaining about how bad the system changes are is obviously not an objective source either.

Complaining on a blog wont help you with some uneducated clerk at Apria. Get on the phone with a supervisor and deal with it. You'd think Americans were helpless spoiled children who don't even know how to pick up a phone. From a country that won WWII, that's pretty sad.

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Re: Competitive DME Medicare Contractors Not Filling Orders

Post by chunkyfrog » Mon Oct 21, 2013 7:47 am

Competitive bidding was a lousy idea, which narrows the supply line to a few large companies
with little or no patient involvement or sense of medical responsibility.
It would make far more sense to allow reimbursement to patients for all supplies,
INCLUDING those bought online. Of course, this would naturally force competitive pricing,
and even local DME's would have to offer better prices or WAY better service!
With transparent pricing a REQUIREMENT!
I would happily submit receipts to Medicare if they would allow online purchases.
If I need a "fitting", it should be billed separately; why pay for a service that is not needed or given?

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Re: Competitive DME Medicare Contractors Not Filling Orders

Post by hyperlexis » Mon Oct 21, 2013 8:04 am

chunkyfrog wrote:Competitive bidding was a lousy idea, which narrows the supply line to a few large companies
with little or no patient involvement or sense of medical responsibility.
It would make far more sense to allow reimbursement to patients for all supplies,
INCLUDING those bought online. Of course, this would naturally force competitive pricing,
and even local DME's would have to offer better prices or WAY better service!
I would happily submit receipts to Medicare if they would allow online purchases.
If I need a "fitting", it should be billed separately; why pay for a service that is not needed or given?
I love the frog dearly, but Medicare doing it the other way would be a logistics nightmare and not work nearly as well simply because 99% of patients, including Medicare patients, have neither the time, nor the ability to do that kind of intense legwork to check best prices, shop to shop, before buying, renting DME items, etc. That kind of 'competition', placing the burden of pricing on the patient, will simply allow the DMEs to gouge the patients in their locales for whatever they will pay. And, the fact is that because of its enormous buying power, Medicare is able to obtain prices far, far lower, on average, on its own, than any individual could ever dream to.

I was very frustrated when I bought my cpap machine -- I found it for less online by a few hundred dollars, but Blue Cross would not reimburse me if I bought it from the online source. I even called them about it and complained. However I realize they have contracts with their DMEs to get 'preferred pricing' that forbid these kinds of outside deals, etc., or there may be other financial incentives they get for promoting or paying for only their 'preferred' providers other than the actual cost of the equipment. So the bean counters at Blue Cross have worked this out far better than I ever could and have determined its in their best interest to pay for DME supplies this way, rather than allow me and others to 'price shop' on our own.