Michigan Medicaid: DME Vendors Work to Get Services Back on Track

Home modifications by occupational therapist (OT) based on principles of universal design and accessibility.

Universal/accessible design of the home from an occupational therapy and a construction perspective. This blog is part of a quest for cool, convenient, functional design that makes life safer, easier, and as maintenance-free as possible. It's about the lifestyle.
On February 1, 2011, Wright & Filippis, along with several other Michigan medical equipment providers decided to not participate with the Michigan Medicaid and Children’s Special Healthcare Services (CSHCS) Programs for the provision of complex rehab products.  There were policy changes at Medicaid that prompted us to make this difficult and unprecedented decision.  Since that decision, we have been meeting with representatives from Michigan Medicaid in hopes of resolving these issues.  After 3 months of these negotiations, we can again participate with Michigan Medicaid and Children’s Special Healthcare Services for the provision of rehabilitation and mobility/seating equipment, effective immediately.

I finally have some good news to share with you.  The key issues under discussion have been resolved through these negotiations and will certainly have a positive impact on the patients that we both serve.  Policy has been clearly defined and should eliminate the need for resubmission of prior authorizations that are frustrating to not only you and the patient, but to the vendors as well.  Items that have always been able to be billed-for, will again be able to be provided, and not at a loss to the vendor (ie:  bus tie-down brackets, for example).  And the allowable for non-coded/NOC (ie:  bath chairs, car seats, etc.) items have been given a more realistic reimbursement amount, so we can continue to provide appropriate, functional, and quality products for your patients.
Some things, however, have not changed.  We are still required to fill out the 1656 form (the 11 page form) for mobility and seating items as well as standers.  These have to be filled-out in their entirety, with accurate and relevant information.  This is best accomplished by having both yourself, to address the clinical issues, as well as myself to address the equipment concerns.  Please contact Angie Osborn at the Grand Rapids Office to arrange for a scheduled appointment.

We will still have to be conscious of the limits allowed for the various items you are requesting.  Wright & Filippis will continue to make every effort to provide the very best equipment to accomplish the outcomes we expect, while still being profitable.  I dont anticipate any problem with fulfilling your patients needs and staying within that framework.

I want to thank you for your patience and understanding throughout this effort.  And Wright & Filippis would like to thank you for your continued support and look forward to working with you in the future.

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