Home healthcare companies in West Virginia are upset about impending cuts to their Medicare reimbursement rates, which are expected to go into effect this July.
Representatives with those medical device and healthcare service companies met in Charleston Friday morning to voice their opposition to the continued cuts in those federal reimbursement rates.
The business owners, many of which are members of the West Virginia Medical Equipment Suppliers Association, spoke with Earl Gay, the U.S. Small Business Administration's national ombudsman, and members of the SBA's Regulatory Fairness Board at the Charleston Area Alliance office.
The medical device suppliers said the cuts to Medicare spending, which would drop reimbursement rates that are paid to the companies by roughly 23 percent for things like wheelchairs, oxygen machines and hospital beds, would harm their businesses that provide home healthcare to people throughout West Virginia.
The healthcare officials explained that they have continued to feel the effects of Medicare reimbursement cuts since the early 2000s when President George W. Bush signed the Medicare Modernization Act of 2003. They said those cuts have continued under President Barack Obama's administration with the Affordable Care Act of 2010.
The competitive bidding process for companies receiving reimbursement under Medicare is meant to reduce federal spending on healthcare and save taxpayer money. According to the U.S. Department of Health and Human Services website, those efforts are expected to save Medicare over $26.8 billion over 10 years.
But the medical device providers at the meeting Friday said the reimbursement rates being implemented by the Centers for Medicare and Medicaid Services are causing their businesses to be pushed to the limit.
Several of the business owners said they had to reduce the number of people they employ and, in some cases, had to close regional offices. They said they don't understand why parts of the state, like Boone and Wayne counties, are designated as urban communities, which reduces the Medicare reimbursement rates received in those areas.
The business owners said that spending on home health services in West Virginia was comparatively higher than some locations in the country because of the large elderly population and the state's low standard of health overall.
Many of the home medical providers believe they are being adversely targeted by the federal government and argued that by providing health services in people's homes, their businesses are saving the federal government money by not having those patients admitted to hospitals or nursing homes.
"Why are they coming after us? Because we don't have paid lobbyists," said Regina Gillispie, owner and president of Best Home Medical, a Barboursville-based home medical supplier.
The West Virginia Medical Equipment Suppliers Association is part of the American Association for Homecare, a national lobbying group in Washington D.C.
Gillispie, who pushed for the meeting Friday, said she had been to Washington on numerous occasions and contacted Sen. Joe Manchin's and Sen. Shelley Moore Capito's offices about her concerns.
In the past couple of years, Gillispie said she lost the federal bidding process to be a federally-approved Medicare provider in the Barboursville area, which is now served by larger national companies. As a result, Gillispie said she opened up a different office in Nitro, where she was able to treat Medicare recipients.
Eugene Weems, the president of Boll Medical in Charleston and the president of the state's medical equipment suppliers, said the association's members have to deal with a lot, especially in rural areas, including delivery of equipment, home assessments, equipment setup and installation, insurance verification, writing clinical notes to obtain the equipment and being on call around the clock.
Weems understands the impetus behind the Medicare reimbursement cuts, which he believes stems from some prominent fraud cases, but he said the new cuts are making it difficult to even provide the home health services to West Virginians.
Twelve years ago, Weems said his company employed around 89 people who traveled to people's homes providing care, but now his staff is down to 35 people, largely because of reimbursement cuts, he said.
Weems said in-home oxygen service costs the federal government around $10 a day, but if that patient had to be hospitalized, it would cost $4,500 to $5,000.
State Senator Tom Takubo, R-Kanawha, spoke during the meeting in support of the medical device providers. Takubo, a pulmonologist who sees patients with lung disease, said the home care services are essential in southern West Virginia, which has high rates of smoking and many former and current coal miners that suffer from black lung and other respiratory issues.
Patti Todd, the owner of Allay Home Care, based in Beckley, told the federal officials that parts of West Virginia, especially Boone County, being designated as an urban region showed that the reimbursement system was flawed.
She explained that many of the patients she serves may only be 30 miles away from her office, but it can often take more than an hour on winding back-country roads to reach their homes.
"Most of our patients just don't live in town," she said.
Todd said the reimbursement cuts need to end.
"There's nothing left to cut," she said. "It's to the bone."
Reach Andrew Brown at andrew.brown@wvgazettemail.com,
304-348-4814 or follow @Andy_Ed_Brown on Twitter.