“Stronger When We Work Together”
We all know DME and related supplies are essential benefits covered by Medicare, Medicaid and private payors, enabling older adults and those with disabilities to remain healthy and in their communities.
We also know there are multiple barriers to access, dependent upon the type of DME/supplies needed, the availability of DME in a community or region, payor sources, workforce availability and the ever-changing federal and state requirements. With such variables, it is important our voices as DME providers and the patients we serve be clearly heard and in a strong and unified voice.
Recently, the California Association of Medical Product Suppliers (CAMPS) and its members were heard and successfully reversed proposed changes to Medi-Cal’s DME reimbursement - Even after the proposal was transmitted to the Centers for Medicare and Medicaid Services [DMC] in Region IX.
As the newly elected President of CAMPS, I stand in awe at how we came together and the outstanding accomplishments we had in 2019. I wish to thank all who contributed, dedicated their time, resources, commitment and energy! We accomplished much more than we ever thought possible!
We had over 170 California DME providers sign on a letter to DHCS that we were unwilling to accept the discounted non-rural rate reimbursement rate. There are, we believe about 604 active DMEs in California in 2019. Many of us who stood tall together currently don't belong to CAMPS.
We are hopeful that 2020 will prove to be even more successful by providing continued benefit to CAMPs members, including working on the goals of making progress towards:
- Building upon our collective success, by establishing CAMPS priorities and tackling long-standing barriers, such as –
- Reversing the 10% reduction in Medi-Cal rates. Currently, it is in the Governor's proposed 2020-2021 budget to stop that reduction;
- Making the State Plan Amendment request for the change to the 2019-2020 budget be ongoing and not retroactive to January 1, 2019;
- Eliminating the 80% of Medicare reimbursement rate that is currently in statute by passing a law to make it not less than 100% of the Medicare reimbursement, and working with AA Homecare to talk to DHCS to alleviate their fear that if they pay DMEs too much, they could end up with a penalty from CMS;
- Adding the KU modifier that are used by Medicare to increase the reimbursement for those items to the equivalent of the Medicare reimbursement rate;
- Establishing and nurturing an ongoing relationship with DHCS (managed care, long term operations, policy, finance) and hopefully earn inclusion of DMEs at the table for decisions that are made that impact our businesses and patients.
- Non-Bid Area Relief & O2 Rural Reimbursement
- HR 2771 – Protecting HOME Access Act of 2019
- Keeping Non-Invasive Ventilators Out of Bidding Program
- HR 4945 – SMART Act of 2019
- Actively interacting with our local California Legislators, both Senate and Assembly members and educating them about the needs we have for our patients, and to be successful as DME businesses;
- Meeting with different managed care organizations to discuss concerns with problems such as claims management and authorizations;
- Working closely with national groups so that they can help to support our statewide efforts;
- Working more closely with consumers, patient advocacy groups, licensing boards and other provider organizations to work on shared issues of concern; and
- Other important issues, concerns and goals as established by CAMPS membership.
- Offering webinars that you can participate in from your own office around your busy schedule and that meet your needs.
Your membership and participation are imperative. By working together, we will be able to overcome our perceived segregations of product categories, geographic areas, company’s size and payer services and look at the bigger picture:
Which is to improve and strengthen our influence with various stakeholders, decision makers as well as each other.
How can we begin to accomplish these and other ambitious goals? With your help, by:
- Increasing the membership in CAMPS to include a large majority of DMEs.
- Approaching manufacturers and distributors to become sponsors and help support these changes.
- Strengthening our grassroots efforts to include each of us to get involved and stay involved.
I know two things for sure:
- If we fail to build on our successes, we must accept whatever comes our way – and that means we continue to be very vulnerable.
- In 2019, we were tremendously effective in impacting positive change for all DME and Related Suppliers, our partners and the patients we serve.
So here it is, our call to arms... please join CAMPs too and demonstrate that we are STRONGER WHEN WE WORK TOGETHER!
Thank you for taking the time to read this and please consider being an integral part of CAMPS!
