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California HME Update

Act Now to Help Stop
Drastic Medi-Cal Reductions

Please read the information below on the impending Medi-Cal rate reductions that will happen as a result of Medicare CB rate reductions and the current state law that requires DME to be reimbursed at either 80 or 100% of the Medicare rates. CAMPS is working hard to try and get this changed and the budget process is underway over the next two months. Of immediate importance is members contacting these key members of the Budget sub-committees who will be deciding on whether to stop these impending cuts over the next 30 days.

  • Assembly Budget Chair Eloise Gomez Reyes (D-Fontana / San Bernardino)
    • Capitol office: 916-319-2047
    • District office: 909-381-3238
  • Assembly Budget Member Jim Frazier (D-Fairfield)
    • Capitol office: 916-319-2011
    • District office: 707-399-3011
  • Assembly Budget Member Devon J. Mathis (R-Visalia)
    • Capitol office: 916-319-2026
    • District office: 559-636-3440
  • Assembly Budget Member Jim Patterson (R-Fresno)
    • Capitol office: 916-319-2023
    • District office: 559-446-2029
  • Assembly Budget Member James C. Ramos (D-Loma Linda/ Redlands)
    • Capitol office: 916-319-2040
    • District office: 909-476-5023
  • Assembly Budget Member Blanca E. Rubio (D-Baldwin Park)
    • Capitol office: 916-319-2048
    • District office: 626-960-4457
  • Assembly Budget Member Jim Wood (D-Santa Rosa)
    • Capitol office: 916-319-2002
    • District office: 707-576-2526
  • Assembly Budget Member Philip Y. Ting (D-Alternate)
    • Capitol office: 916-319-2019
    • District office: 415-557-2312
  • Assembly Budget Member Jay Obernolte (R-Alternate)
    • Capitol office: 916-319-2033
    • District office: 760-244-5277
  • Senate Budget Chair Richard Pan (D-Sacramento)
    • Capitol office: 916-651-4006
    • District office: 916-262-2904
  • Senate Budget Chair Richard Pan (D-Sacramento)
    • Capitol office: 916-651-4006
    • District office: 916-262-2904
  • Senate Budget Member Melissa Hurtado (D-Hanford)
    • Capitol office: 916-651-4014
    • District office: 661-395-2620
  • Senate Budget Member Jeff Stone (R-Palm Desert / La Quinta)
    • Capitol office: 916-651-4028
    • District office: 951-894-3530
Please write or call these legislators to let them know that these cuts will  decimate the availability of DME to Medi-Cal patient, delay timely discharge of patients further increasing hospital and other costs, and impact access to cost effective homecare.

Background
 
The State is planning to lower the Medi-Cal fee-for-service rates for certain DME items. Under the 21st Century Cures Act, California will not be eligible to receive federal match dollars if it pays more than the prevailing Medicare rates for DME. DHCS is currently drafting a State Plan Amendment (SPA) for CMS. Medi-Cal will pay either 80% or 100% of the Medicare rates for DME using the non-rural competitive bid rates effective January 1, 2019. Specifically, DME rates except for wheelchairs, wheelchair accessories and speech-generating devices & related accessories will not exceed 80% of the non-rural Medicare DMEPOS fee schedule. Rates for wheelchairs, wheelchair accessories and speech-generating devices & related accessories will not exceed 100% of the non-rural Medicare DMEPOS fee schedule. The proposed SPA is subject to CMS approval. DHCS intends to implement retroactive rate adjustments this fall.

Affected DME
 
The rate reductions apply to certain Medicare covered DME items that are also covered by fee-for-service Medi-Cal. For the most part these are DME items identified by HCPCS "E" series and "K" series codes. Those codes include items like canes, crutches, commodes, hospital beds, oxygen concentrators, wheelchairs, power mobility devices and more. It does not apply to medical supplies, orthotics or prosthetics, nor does it apply to items for which Medi-Cal is not the primary payer.
 
Impact to DME Providers
 
The impact of these rate reductions to Medi-Cal DME providers will be devastating. Below is a comparison of the Medi-Cal rates on just a few affected codes:
HCPCS Code
Description
2018 MCL Rate
2019 MCL Rate
E1390
Concentrator
$144.74
$55.19
E0470
Bi-Pap
$188.51
$83.06
K0001
Standard Wheelchair
$47.30
$17.46

CAMPS Response
 
CAMPS submitted a formal letter of opposition to DHCS on January 19, 2019. Now we are working with AAHomecare, VGM and others to mitigate these cuts. Our best avenue for relief is through the Legislative budget process. CAMPS has about 60 days to effectively lobby key state lawmakers.

CAMPS Call to Action
 
CAMPS needs the membership to get involved. Here are 3 ways to help:
  1. DONATE: CAMPS needs immediate funds for lobbying and public relations. These efforts are expensive and your donations are tax deductible.
    Send donations to the CAMPS office:
    California Association of Medical Product Suppliers
    One Capitol Mall, Suite 800
    Sacramento, CA 95814
     
  2. CONTACT: CAMPS needs providers to contact some key State representatives. Tell them how these rate cuts will negatively impact patient access and your business.
     
  3. ACTIVATE: CAMPS needs providers to get the word out. Inform your patients and referral sources. Tell your friendly DME competitors and manufacturers to get involved too.
The fate of the California DME industry is at stake here and there is not much time to act. Call Bob Achermann at CAMPS today for more information at 916-443-2115 or email [email protected] .
 
Sincerely,
 
David Fein
CAMPS President
Medtrade Spring Advance Rates in Effect Until April 6
 
Great deals to attend the Spring version of the nation's largest HME-focused trade show are still available. Advance Rates for Medtrade Spring are in effect until April 6. An Expo Pass provides access to exhibitors on the show floor, while a Conference Pass gains access to all educational sessions and the Expo Floor. Limited slots are also still available for networking events and workshops to round out the show experience. Medtrade Spring is scheduled for April 16-18, 2019, at the Mandalay Bay Convention Center in Las Vegas.
 
Click the following link to register for Medtrade Spring: https://registration.experientevent.com/ShowMTH192/?flow=ATTENDEE

About Medtrade Spring and Medtrade

Medtrade and Medtrade Spring are the two largest home medical equipment trade events in North America, bringing together manufacturers, providers, and retailers from across the country and around the world. Established in 1979, the shows gather hundreds of HME related brands, thousands of attendees, and are highly regarded industry events. Medtrade and Medtrade Spring are owned by Emerald Expositions, the largest operator of business-to-business trade shows in the United States, with most of our shows dating back several decades. We currently operate more than 50 trade shows, including 31 of the top 250 trade shows in the country as ranked by TSNN, as well as numerous other events. Our events connect over 500,000 global attendees and exhibitors and occupy more than 6.9 million NSF of exhibition space. We have been recognized with many awards and accolades that reflect our industry leadership as well as the importance of our shows to the exhibitors and attendees we serve. More info about Medtrade Spring and Medtrade can be found at www.medtrade.com.




One Capitol Mall, Suite 800
Sacramento, CA 95814 
t: (916) 443-2115 
f: (916) 444-7462