Medicare Changes On The Horizon

Medicare is starting a new program on January 1, 2011. The change is designed to combat the more than $60 billion in fraudulent claims each year. In addition, Medicare overpays millions of dollars for medical equipment.

The main focus of the law change relates to the purchase and rental of Durable Medical Equipment such as power wheelchairs. In the past, Medicare typically paid for any supplier that sold patients equipment. The new change will be such that Medicare will only pay for equipment sold from companies that are approved by the Competitive Bid Program.

Wes Goldberg, the owner of ‘In and Out Mobility’ in Palm Desert will feel the changes. “I said this from day one, before I got into this, I didn’t know why Medicare paid so much allowable when the items don’t cost that much,” said Goldberg. “And, in no other business do you make that kind of profit, when you shouldn’t be.”

Unfortunately for Goldberg, his company did not receive any of the Medicare bids for their products. “If you are under Medicare insurance, we can no longer take care of you, on Scooters if you qualify, on an electric wheelchair if you qualify,” said Goldberg.

The good news for smaller, private businesses like Goldberg’s is that people who have purchased from them prior to the end of the year, will be grandfathered with the new program. They will be able to continue renting or purchasing from the non-approved stores, and still be eligible for Medicare.

Here is a list of the cities and states where the program will be tested. If you live in or have family or relatives that live in any of these areas, you should pay close attention: -California – Riverside, San Bernardino, Ontario -Florida – Miami, Fort Lauderdale, Pompano Beach, Orlando, Kissimmee -Missouri, Kansas – Kansas City -North and South Carolina – Charlotte, Gastonia, Concord -Ohio – Cleveland, Elyria, Mentor -Ohio, Kentucky, Indiana – Cincinatti, Middletown -Pennsylvania – Pittsburgh -Texas – Dallas-Fort Worth, Arlington

There are the kinds of items that are called “Durable Medical Equipment” and must come from the new list of approved suppliers if you want to get them paid for by Medicare.: -Oxygen, oxygen equipment and supplies -Standard power wheelchairs, scooters, and related accessories -Complex rehabilitative power wheelchairs and related accessories -Mail order diabetic supplies -Enteral nutrients, equipment and supplies (tube feeding) -CPAP (Continuous Positive Airway Pressure) equipment and RAD (Respiratory Assist Device) and related supplies -Hospital beds and related accessories -Walkers and related accessories

For more information go to medicare.org.