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Change in Medicare [replacement supplies]
#1
my supplier says that medicare now requires reasons for ordering replacement supplies instead of just going by the recommended schedule(which they say is the minimum ) --does anyone know what is going on and --i use a quattro fx mask --what reason would i give to get replacements
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#2
(11-08-2012, 09:27 AM)hgite@cox.net Wrote: my supplier says that medicare now requires reasons for ordering replacement supplies instead of just going by the recommended schedule(which they say is the minimum ) --does anyone know what is going on and --i use a quattro fx mask --what reason would i give to get replacements

I have not heard that! My husband and I are both on Medicare. Our DME never has called me regarding supplies but my husband gets called regularly. In fact they called just a couple of days ago to see if there was anything he needed. They are really sticklers for dotting i-s and crossing t-s. They are sending a new mask cushion because it's, well, time to do so. As far as reasons go, I feel it's important to have a spare of everything you use and the reason you give can be as simple as because I need a new one. Once you have accumulated your spares, I see no need to continue ordering stuff just because you can. I'm sure there's enough abuse of the system to justify asking why you need a replacement but it might be a DME issue and not Medicare.

Suz

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#3
Hi hgite@cox.net,
WELCOME! to the forum.!
I hadn't heard about this change but hang in there for more suggestions.
Best of luck to you.
trish6hundred
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#4
I find that it is strange that your DME/provider has given you this info. Altho things change rapidly sometimes with Govt sponsored programs,,anything is possible. I have not heard of any Medicare statement to that effect..
However, Medicare is the one that set the standard sked of replacements for the durable medical equipment. Your DME's response about ordering unless its necessary, doesn't make any sense to me. The schedule of replacements is due to the fact that the Govt determined that the manufacturers product looses its intended medical value after a certain time. We all know that sometimes we use them for a lot longer periods of time.
Yesterday is history; Tomorrow is a mystery; Today is a gift; Thats why its called "The Present".
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#5
First of all, welcome to the forum!!! We are glad you joined us!!! Welcome

I am also on Medicare and am unaware of this. As long as your DME meets or exceeds the Medicare "standards" for equipment, Medicare shouldn't have an issue.

Keep us informed.
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#6
Scuttlebutt is that this is because a lot of DMEs were milking the system by always ordering many parts automatically every time they could.

Apparently, Medicare doesn't really care that much as long as the patient is initiating the request, not the DME.

Look at your mask parts and see if they're getting yellow and not sealing well. If this is happening, tell your DME and request replacements.

It may take a while before the DMEs figure out the best way to ease the process for patients to order replacement parts.
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#7
(11-08-2012, 09:27 AM)hgite@cox.net Wrote: my supplier says that medicare now requires reasons for ordering replacement supplies instead of just going by the recommended schedule(which they say is the minimum ) --does anyone know what is going on and --i use a quattro fx mask --what reason would i give to get replacements

This IS in fact a new requirement by Medicare.

DMEs can NO longer just send you out supplies on a pre-determined schedule withOUT 1st determining that you DO need those supplies.

And Yes, just asking you whether or not you need those supplies does seem to meet the Medicare requriements.

This change will only affect those of you who have agreed to let your DME just send you out supplies every 3 months, 6 months, etc without 1st determining a need - So, Yes it is aimed at the DMEs.
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#8
My information agrees with what Archangle and Stu have described. Medicare hasn't changed their xPAP supplies' replacement schedule (i.e., 3 months for replacement mask, etc.). It's just that now you need to request a replacement from your DME. It's aimed at saving some taxpayer money, and it's easy to understand. Previously, some DMEs were automatically sending out replacement supplies to patients on Medicare's replacement schedule, whether or not they were needed by the pt. And I've read posts where the pt. didn't need or request replacement supplies but continued to receive them from the DME. It's my understanding that Medicare has also tightened up somewhat on replacing a pt.'s machine after the 5 year period has been completed. The DME now, as I understand it, needs to indicate to Medicare that the machine needs to be replaced, not simply because it's been used for five years. If the type of machine is to be changed, it must be backed up by a script from the pt's doctor.
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#9
Medicare can save more money (real money Not peanuts) if they include online providers on their DME approved list
so the patient get the right machine and Not get screwed by the DME
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#10
(11-08-2012, 04:46 PM)zonk Wrote: Medicare can save more money (real money Not peanuts) if they include online providers on their DME approved list
so the patient get the right machine and Not get screwed by the DME

But the online DME also has to agree to accept Medicare.

If they don't now accept any insurance, what are the chances of that happenning?

Letting me buy online & then file my own Medicare claim could be the best solution. But then, who wants to deal with paperwork with Medicare?
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