State AT Programs Share
Medicaid Reuse Initiatives
Kansas: Sara Sack
Oklahoma: Linda Jaco
Vermont: Amber Fulcher
History/What’s Been Done
• Kansas-Sara Sack
– ATK approached by Medicaid to investigate the
design and operation of a cost-neutral DME
inventory tracking and recovery program
– Started program in 2003 to track and recover high
cost, lightly used DME (see card for equipment)
History/What’s Been Done
– Eligibility: 1) Medicaid beneficiaries, 2) Medicaid
eligibles, 3) Those likely to become eligible for
Medicaid, those eligible for limited medical
coverage by virtue of their limited income and
assets, their disability as determined by KDHE and
their pending application for disability through the
Social Security Act.
History/What’s Been Done
– 2011-2012 grant year collected 825 devices valued
at over $925,000 by Medicaid’s 75% cost
reimbursement rate.
– Worked with over 30 local DME providers to
refurbish the equipment
– 711 of the possible 825 devices were matched to
Medicaid beneficiaries and Kansans with health
conditions
History/What’s Been Done
– The value of the reassigned equipment was Total
number of Kansans who had a medical card and
received equipment was 443 and the value of
equipment received by Medicaid recipients was
$688,340.
– Budget for the program was $272,000.
History/What’s Been Done
• Oklahoma – Linda Jaco
– Medicaid legislatively mandated to
partner/contract with an organization to establish
a reuse program for durable medical equipment
that realizes a cost savings and provides access to
SoonerCare members and citizens of Oklahoma
– ABLE Tech responds to RFP; program started April
2012 to retrieve and/or receive, refurbish, repair
and reassign lightly used DME
History/What’s Been Done
• Eligibility: 1) Medicaid beneficiaries, 2)
Medicaid eligibles, 3) Those likely to become
eligible for Medicaid, 4) Citizens of Oklahoma.
– Application Packet
Doctor’s prescription, assessment, if required
– Priority given to Medicaid members initial 60 days
– Any Oklahoman eligible on day 61 with completed
application regardless of income
– Transferred to OK Equipment Exchange on day 180
History/What’s Been Done
• First grant year collected 449 devices valued at
over $265,000 by Medicaid’s 75% cost
reimbursement rate.
• Vendors initially saw program as competition;
but, many now asking to partner with
program to do DME repairs.
• 348 of the possible 449 devices were matched
to Medicaid beneficiaries and Oklahomans
with health conditions (41/77 counties)
History/What’s Been Done
• Of the 449 donations, only 3 items were
donated by a Medicaid member.
• Top 5 largest donations: commodes (35),
CPAPs (34), rollators and walkers (83), power
scooters (10) and power wheelchairs (23).
• Budget for program was $273,000.
History/What’s Been Done
• Vermont – Amber Fulcher
- 2007 Medicaid equipment retrieval project
began in conjunction with the Office of
Vermont Health Access (OVHA)
- Simplified bid was developed in ‘09 by OVHA
in conjunction with VATP’s Reuse Project for
DME Vendors to bid on refurbishment,
sanitization, education, fitting, and delivery
services to recipients of retrieved equipment
History/What’s Been Done
- It was determined by risk management that liability
was a concern for OVHA & assumption of ownership
became a barrier to DME vendors
- It was decided that VT would go forward with other
components of Medicaid Equipment Retrieval using a
distributed storage model
- OVHA: Revamped form; DME vendors placed labels
with return instructions on 8 categories of high-end
equipment (AAC Devices, Manual & Power chairs,
Power operated vehicles, standers, electric beds,
shower commode chairs, lifts); toll free number was
provided by Dept of Aging & Independent Living
History/What’s Been Done
• Relationships were established with area non-profits
so equipment could be transferred to their
ownership following retrieval
• Area non-profits transfer equipment to recipients
with priority given to individuals who are low income
(no formal means testing is used)
• Total dollar amount of Equipment Retrieved: 20082012 is $300,834 ($48,242 available for transfer at
end of 2012)
History/What’s Been Done
• Recognize need for continued improvement of
retrieval and redistribution process and began
sourcing leveraged funding to address core areas
regarding storage, retrieval, delivery, sanitization,
and storage
• In process of developing a pilot project with VT
Department of Aging and Independent Living
• Pilot involves utilizing Statewide DME Vendor
Network on a service agreement vs. contract basis to
transport, sanitize, and install/set-up equipment
Lessons Learned
• Kansas-Sara Sack
– Relationships with and support from our DME
providers is more important than ever before
– A good inventory and tracking system is important
– Develop and follow strong safety & liability
practices
– Stick to your program’s values….but remain open
to new ideas, i.e. Managed Care
Lessons Learned
• Oklahoma – Linda Jaco
• Very important to build relationships with
DME vendors and other statewide
stakeholders.
• Effective marketing of program so that
donations continue to occur.
• Inventory/tracking system that works well for
both the funder and RSA data collection.
Lessons Learned
• Vermont – Amber Fulcher
- Persistence pays off
- Start with sustainability in mind
- Be creative in sourcing funding (established
with MIG funding)
- Build and maintain relationships with DME
Vendors
- Labeling system encourages continued return
of equipment; outreach is needed to maintain
Questions