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CMS Begins Process to Reduce Medicaid Spending

Posted on in Government and Advocacy

From VGM Government Relations

CMS has initiated the process to adjust the amount of federal dollars being spent on Medicaid. This comes from the section of the 21st Century Cures Act, which mandated that the federal portion of Medicaid reimbursement for DME could not exceed the Medicare reimbursement beginning Jan. 1, 2018.

VGM’s Collin Brecher was quoted in the article, "Reimbursement rates for these products have been set by the highly flawed competitive bidding program, and patients are ultimately the ones who suffer because there are fewer and fewer providers remaining to supply this equipment.”

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States Establish Own Allowables

It is important to remember that state Medicaid programs, not the federal government, have the flexibility to set their own allowable for equipment. This increases the importance of having strong relationships with the policymakers in your states to demonstrate the value of durable medical equipment to state Medicaid programs. Durable medical equipment must not only be viewed as a significant cost reduction to health care as a whole, but as a value-add to state economies, allowing seniors and those with disabilities to remain participating, independent members of the community.

VGM has led the charge in several states facing harmful Medicaid cuts and program reductions. Recently Oklahoma, a state facing serious budget challenges, had threatened providers with losing a key waiver program which would have likely put several independent providers out of business. Due to the actions of grassroots providers, the newly formed Oklahoma state association, OMEPA, with assistance from VGM, was able to play a role in fending off severe cuts to DME.

VGM Here to Assist

VGM is prepared to assist providers in fending off cuts to durable medical equipment funding for Medicaid populations. Craig Douglas, VGM’s vice president of Payer and Member Relations, has played a key role in working with providers, state associations, and industry stakeholders to properly illustrate DME value. Additionally, VGM Government Relations is here to help drive your grassroots strategy in connecting with your Medicaid administrators and elected officials to prevent cuts causing patient access issues.