Alarming Medicare price changes! What are we doing?
Description
Collection
Title:
Alarming Medicare price changes! What are we doing?
Text:
Medicare has cut the fees for all LSO products to a grossly unreasonable
amount. In region C corsets that we were being allowed $113.44 are now reduced to
$64.47, Warm - forms cut from $246.62 to $141.73, Custom made LSO reduced by
aprox $300 per brace. Pre fab LSO reduced to a level barely above what we
pay. I have been informed that other codes will be reduced in this fashion as
well. I thought Medicare is not allowed by law to reduce a fee for an L code
by more than 10% -15% (I forget the exact %) in 1 year. How is this legal?
What are we doing about it? Don't forget most managed care contracts are
discounted off of the Medicare rate. Now we are forced to take a loss on an item if
we are contracted to provide the service. This is a Huge problem that we must
fight. What are our associations doing about it? Region C is being
attacked! Besides these unreasonable reductions to below our costs, almost all
Medicare claims are being reviewed and delayed. The administrative burden has
tripled resulting in the need for increased staff. I thought a 3 year payment
freeze was bad. Now we are having our code allowables cut by 50% or more.
David Falk, LPO ,CPO (pre 2004)
amount. In region C corsets that we were being allowed $113.44 are now reduced to
$64.47, Warm - forms cut from $246.62 to $141.73, Custom made LSO reduced by
aprox $300 per brace. Pre fab LSO reduced to a level barely above what we
pay. I have been informed that other codes will be reduced in this fashion as
well. I thought Medicare is not allowed by law to reduce a fee for an L code
by more than 10% -15% (I forget the exact %) in 1 year. How is this legal?
What are we doing about it? Don't forget most managed care contracts are
discounted off of the Medicare rate. Now we are forced to take a loss on an item if
we are contracted to provide the service. This is a Huge problem that we must
fight. What are our associations doing about it? Region C is being
attacked! Besides these unreasonable reductions to below our costs, almost all
Medicare claims are being reviewed and delayed. The administrative burden has
tripled resulting in the need for increased staff. I thought a 3 year payment
freeze was bad. Now we are having our code allowables cut by 50% or more.
David Falk, LPO ,CPO (pre 2004)
Citation
“Alarming Medicare price changes! What are we doing?,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 27, 2024, https://library.drfop.org/items/show/223161.
