Missouri

JEFFERSON CITY, Mo. - The state's Medicaid program made the following offer to HME providers in June: Come up with a way to slash $4.8 million from your budget and we won't reduce reimbursement to 80% of the Medicare allowable.

Providers knew a deal when they saw one. They proceeded to propose cutting reimbursement for stationary oxygen concentrators to $90 per month and increasing reimbursement for portable oxygen concentrators to $150 per month, a move that would cut about $2.5 million from its budget of about $50 million.

“We're calling it the 'Missouri O2 flip,'” said Patrick Naeger, a board member for the Midwest Association for Medical Equipment Services (MAMES) and an executive vice president for Healthcare Equipment & Supply in Perryville.

The governor had planned to reduce reimbursement across-the-board to 80% of the Medicare allowable on July 1.

To cut the remaining $2.3 million from its budget, HME providers also proposed, among other things, reducing reimbursement to 95% of the Medicare allowable.

“We scraped a few things together to get the remaining dollars,” Naeger said.

It's a good deal, especially for complex rehab providers.

“A 20% cut would have killed us,” said Ron Burns, Missouri chairman for MAMES and director of the rehab department at Home Support Systems in Springfield.

Providers like Naeger even believe the “Missouri O2 flip” could catch on elsewhere.

“It may be a good opportunity for the Medicare program to look at a state that's innovative like Missouri on how to modernize the reimbursement system,” he said. “So it's beneficial not only for us in Missouri, but also, I think, other states and, hopefully, Medicare.”