Pharmaceuticals and HME: No parity


Things have been tough for the HME community for the past few years but this summer has taken it to a whole ‘nother level. Not only has the Medicare reimbursement for DME been decimated, other payers have begun to follow suit.

AAHomecare has tasked itself with gathering anecdotes about the impact on businesses as well as beneficiaries and I know I’ve heard my own share of horror stories. The best thing providers can do right now, say stakeholders, is amplify that message.

Meanwhile, over in the fantasyland that is Big Pharma, Mylan execs are backing down a little from plans to increase the price of the EpiPen once again—since 2007, the price has been jacked about 500% for no reason other than they can. To add insult to injury, its execs aren’t even owning their responsibility in this mess. The only person on this planet who defended Mylan? Martin Shkreli.

Don’t even get me started on how much those same execs increased their pay especially after speaking with provider Chris Smythe yesterday who told me: “You can’t pay me $26 for a commode that cost me $25. It just doesn’t work.”

Or check out this convoluted tale of Optum, the PBM for United Healthcare, overcharged customers for prescription medication (often, more than what the drug itself cost) and then clawed back the “overpayment” from the pharmacist.

I’d say nice work if you can get it, but frankly, I prefer to sleep at night.

And finally, a headline that strikes fear in my diabetic little heart: "Soaring insulin prices have diabetics feeling the pain."