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EDITORIAL: Rural health care

With just weeks remaining before Senate Minority Leader Harry Reid retires, he has a chance to help fix a problem that’s victimized thousands of rural seniors — including many in Nevada.

The issue is the cost of home medical equipment and supplies. The Centers for Medicare and Medicaid Services, the federal agency in charge of administering Medicare and Medicaid, created a new method to set Medicare reimbursement rates for things such as oxygen tanks, walkers and other critical items based on a bidding process in large, densely populated urban centers.

At the start of the year, however, CMS took prices derived from the bidding program in major cities and applied them to rural communities — even though rural home medical providers have expenses that more populous areas don’t.

For instance, rural companies have additional fuel costs associated with serving patients spread across wider geographical areas. More staff time is also needed to make deliveries of equipment, or to provide fresh oxygen supplies to patients with respiratory issues. Small rural providers also rarely have the profit margins or buying power to offer items as cheaply as their big-city counterparts.

The decision drastically reduced reimbursement rates this year by much as 60 percent for certain home medical products. Many rural businesses were forced to make dramatic changes to the way they serve their customers. Some cut services and products, others were forced to reject new Medicare customers.

One Danville, Ill., home health-care business closed its doors after 170 years in business. According to Steve Gulick, the former owner of Illiana Medical Equipment and Supply, the money his company received from Medicare for supplying in-home patients with items such as hospital beds, wheelchairs, oxygen and walkers was cut by 48 percent. ‘’We’re not big enough to survive that,” Mr. Gulick told the website Vermilion County First.

The decision is also impacting military families. TRICARE — a health-care program for members of the U.S. armed forces — uses Medicare reimbursement rates for the home health equipment it supplies to America’s heroes and their families. As a result of the slashed federal repayment amounts, a number of home health equipment companies have stopped taking TRICARE insurance, leaving some military members without needed supplies.

Sen. Reid has shown an interest in fixing this injustice, and was a leader on the issue when both the House and Senate passed legislation to address the problem before the July recess. Unfortunately, the two chambers of Congress have yet to agree on a final version of the bill.

There’s a pathway and an appetite in both chambers to settle this issue. Sen. Reid has the opportunity to help broker a deal that resolves the minor issues between the House and Senate and sends the president a final bill. Let’s hope he makes it a priority.

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