Medical supplier to limit Medicaid Equipment firm says payback rates too low

PORTLAND – At least one of Maine’s major medical equipment suppliers plans to cut off some of its Medicaid customers because of low reimbursement rates, but others are saying they will continue to work with low-income customers for at least the time being.

Businesses that provide wheelchairs, oxygen apparatus and other home medical equipment say the state’s reimbursement formula doesn’t adequately compensate them for extensive maintenance and setup costs.

Alpha One Medical says it will now decide on a case-by-case basis whether it can afford to provide medical equipment to its Medicaid customers.

“Any equipment for which reimbursement is inadequate, we will be unable to provide,” said Jeff Farrell, the general manager. He said the company lost $100,000 on Medicaid sales last year.

This spring, major suppliers, including Alpha One Medical and Black Bear Medical, opened their books to state auditors to prove their point.

Those companies and other members of the New England Medical Equipment Dealers Association threatened to cut off Medicaid customers if the reimbursement wasn’t increased.

State lawmakers approved a bill that would increase the reimbursement, but the measure did not win funding in the state’s budget.

The increased reimbursements would have cost $400,000 over two years.

Black Bear Medical reported losses of $18,000 on $200,000 worth of Medicaid sales last year.

Treasurer Tom Jones said the company would continue to service Medicaid customers because of concessions made by the Department of Human Services. But Jones said he wants to look at “other avenues to make money and pulling out of the Medicaid business.”

Respiratory therapist Jack Higgins of Camden Drug said the midcoast business is too important to the community to drop its Medicaid customers.

“We have people right now on Medicaid and I’m not going to go and just take the oxygen out of their house,” he said.

The sponsor of the reimbursement bill, Rep. William J. Schneider, said he hopes to revive the measure when the Legislature is back in session in January.

The Durham Republican, who uses a wheelchair, said it’s essential for Mainers to have access to home health equipment and services.

“For someone who uses a wheelchair, if your wheelchair breaks down, it’s a pretty major thing,” he said. “You can’t wait for two or three weeks to get it fixed.”