MAMES aims to pack more punch in Missouri

JEFFERSON, Mo. - The Midwest Association for Medical Equipment Services (MAMES) hired a lobbyist in early December to foil, members hope, any further HME reimbursement cuts in Missouri. MAMES represents seven states, but the association decided to place its first lobbyist here, largely because last year Missouri handed down a Medicaid cut that reduced HME expenditures from about $57 million to $30 million. Adding salt to the wound: An October report from the state auditor suggests Missouri could save an additional $5.4 million if it competitively bid HME. "In the last legislative session, the state was under a financial crisis, and we took a huge hit in funding," said Brady Vestal, the Missouri chair for MAMES. "Part of this is a reaction to that. We want to prevent that from happening again." MAMES hired Jorgen Schlemeier of Gamble & Schlemeier, which is located two blocks east of the state capitol, for the part-time, one-year position. Schlemeier has also lobbied for a state association representing pharmacies. Having a lobbyist in Jefferson City gives HME providers more face time with legislators, Vestal said. "As business owners, we're all very busy people," said Vestal, the HME manager at Stephens Pharmacy in Bolivar, Mo. "We don't have time to be in Jefferson City every day meeting with legislators and making things happen. We can make phone calls, but having someone there will be more effective." A lobbyist can help MAMES educate legislators about the importance of the HME benefit. Moreover, a lobbyist can help the association take things up a notch by showing legislators how they can reshape the benefit to make it more effective and efficient, Vestal said. An example of changes MAMES would like to see more of: The state recently tweaked its CPAP policy to cap equipment at 13 months but continue paying for supplies. Under the previous policy, the state rented CPAPs "forever" but didn't pay for supplies. "(By changing the CPAP policy), we've calculated savings of $500,000 over two years," Vestal said. "The DME program is years behind in terms of policies and reimbursement."