FURTHER MEDICAID REDUCTIONS PENDING:
Legislators Need To Hear From You! |
The 2012 Regular Session of the Washington State Legislature convened on January 9, 2012 with the intent to further reduce state spending in areas like state medicaid. By request of Governor Gregoire and the Legislature, the Washington State Health Care Authority (HCA) has developed a reduced 2011-2013 budget that will significantly reduce state investments and restrict patient access to medically necessary Home Medical Equipment (HME/DME).
Through drastic measures such as selective contracting for wheelchairs (July 2012) and nutritional & incontinence supplies (April 2012), the state intends to reduce spending on home medical equipment and related services by nearly $7.14 Million. Unfortunately, “selective contracting” has been attempted before and resulted in significantly higher state administrative costs, reduced patient access to essential services, forced many small businesses to cease serving our communities, and proved detrimental to Medicaid beneficiaries.
Without input from constituents in need of these services, Washington Medicaid beneficiaries will continue to see reduced access to vital medical equipment and related services and will no longer have the right to choose their provider.
LEGISLATORS NEED TO HEAR FROM YOU!
Washington State Legislative Hotline (toll-free): 1(800) 562-6000
MEDICARD REFORM:
Washington State Passes SB 5596 |
The 2011 Washington State Legislature adjourned on May 25th 2011. While the legislative session proved challenging for Washington’s elderly and disability communities, we at Care Medical & Rehabilitation Equipment have been proud to help maintain and promote protecting beneficiaries access to essential home medical and rehabilitative services.
One bill of particular interest was Senate Bill 5596 (SB5596), which passed out of the legislature with unanimous bipartisan support, and was signed by Governor Gregoire on May 31, 2011. SB5596 allows the State of Washington to request what is referred to as a “Block Grant” waiver from the Centers for Medicare & Medicaid Services (CMS) to develop a demonstration project and facilitate alternative payment methodologies for state Medicaid services.
As healthcare costs continue to rise, it is important for the state to reduce overall healthcare costs and develop more flexibility in how it pays for and manages healthcare costs. Home medical and rehabilitation equipment services continue to return some of the highest cost savings to the state while providing the mobility and independence to ensure a quality level of livelihood for our patients. While we understand the critical need to control healthcare costs, we are concerned that essential homecare services might become overlooked due to influence by more powerful special interests.
NOTICE TO WASHINGTON STATE HEALTH PLANS
RE: PASSAGE OF SSB6273 & IMPLEMENTATION OF RCW 48.43.290 |
We would like to inform you of a recent 2010 Washington State law (SB6273) codified as RCW 48.43.290 (attached). RCW 48.43.290 requires that health plans issued on or after January 1, 2011 that include coverage for prescribed Durable Medical Equipment and/or Mobility Enhancing Equipment (DME/MEE), must include sales or use tax as a covered benefit. These additional benefits must be reflected in negotiated provider agreements for the prescribed equipment, and must separately identify the geographically adjusted sales or use tax according to RCW 82.08 and RCW 82.12.
RCW 82.08.050 mandates that all Washington State sales or use tax be billed as a separate line item as stated under WAC 458-20-107 (2): “RCW 82.08.050 specifically requires that the retail sales tax must be stated separately from the selling price on any sales invoice or other instrument of sale, i.e., contracts, sales slips, and/or customer billing receipts.” For purposes of determining sales/use tax, the State of Washington operates under a “conclusive presumption” (WAC 458-20-107 (1) (c) which states that the selling price quoted in any price list, sales document, contract, or other agreement between parties doest not include sales/use tax.
A long history of court rulings throughout the nation including the State of Washington have determined that sales under Medicare Part B (which includes DME/MEE) are not considered made to the U.S. government, and are indeed subject to sales and use tax. (e.g.: Washington State Court of Appeals, AARO Medical Supplies Inc., v. State DOR (2006)). According to RCW 48.43.290, sales and use tax must be applied to all taxable DME/MEE and paid for through the health plan or default to the beneficiary. This is an obligation separate and apart from the amount charged and accepted under the Medicare agreement to which the supplier is responsible to collect these amounts and hold them in trust for the state.
It is our sincere hope that once state revenues are stabilized Washington State Legislators will exempt prescribed Durable Medical and Mobility Enhancing Equipment (DME/MEE) from sales and use tax to help make healthcare more affordable for both insurers and beneficiaries. It is our belief that it is unconscionable to place such disproportionate additional burden on our less fortunate communities. On behalf of all of us at Care Medical, thank you for allowing us to be your “Partner In Care”.
HISTORY OF SB6273
For the past ten years Care Medical Equipment has advocated for a sales tax exemption for prescribed Durable Medical Equipment. While Washington’s present economic situation cannot afford an exemption, the good Representatives and Senators of Washington’s legislature have succeeded in addressing the issue in a manner that makes good sense.
Care Medical is pleased to announce that on Friday, March 12th, 2010 Governor Christine Gregoire signed SSB 6273 into law. Starting January 1st, 2011, insurance companies will be held accountable for paying their sales tax responsibilities for prescribed medical equipment through the transparency of “separate line item” billing.
Not only does this legislation significantly lessen the heavy burden of sales tax often placed on the patient, but it also helps ensure that the state of Washington collects millions of dollars in potential lost revenues. Let me clearly state that this does not mean that we have given up our goal of a sales tax exemption, but rather we have simply worked within the realities of the state budget and will resume this task once state revenues have stabilized.
This legislation was led by the Pacific Association of Medical Equipment Services (PAMES) in cooperation with numerous patient advocacy groups throughout the State of Washington. Care Medical would like to thank each of these supporting organizations for remaining vigilant to advocating for our communities. Without your continued support and the dedication of our Washington legislators, SSB 6273 would not have been a success!
SUPPORTING ORGANIZATIONS OF SSB 6273 INCLUDE:
ALS Association of Oregon & SW Washington Ch.
American College of Emergency Physicians Washington Ch.
Care Medical & Rehabilitation Equipment
Developmental Disabilities Council of Washington
Home Care Quality Authority of Washington
National MS Society – Greater Washington Ch.
Invacare Corporation
Pacific Association of Medical Equipment Services
Paralyzed Veterans of America – NW Ch.
Physical Therapy Association of Washington
Pride Mobility Products Corporation
Washington State Medical Association
Washington State Neurological Society
Washington State Senior Citizens’ Lobby |
