{"id":838,"date":"2015-02-24T08:48:21","date_gmt":"2015-02-24T16:48:21","guid":{"rendered":"https:\/\/abilitytools.org\/blog\/?p=838"},"modified":"2015-02-24T08:48:21","modified_gmt":"2015-02-24T16:48:21","slug":"medi-cal-repair-woes","status":"publish","type":"post","link":"https:\/\/abilitytools.org\/blog\/medi-cal-repair-woes\/","title":{"rendered":"Medi-Cal Repair Woes"},"content":{"rendered":"<p><a href=\"http:\/\/www.cfilc.org\/about\/cfilc-staff.php#Kim-Cantrell\"><em>By Kim Cantrell, CFILC\u2019s Program Director<\/em><\/a><a href=\"https:\/\/abilitytools.org\/blog\/wp-content\/uploads\/2015\/02\/Power-Wheelchairs-For-Sale-Electric-Mobility-Jazzy-Wheelchair_40188_image.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright wp-image-845 size-full\" src=\"https:\/\/abilitytools.org\/blog\/wp-content\/uploads\/2015\/02\/Power-Wheelchairs-For-Sale-Electric-Mobility-Jazzy-Wheelchair_40188_image.jpg\" alt=\"picture of three power wheelchairs \" width=\"454\" height=\"211\" srcset=\"https:\/\/abilitytools.org\/blog\/wp-content\/uploads\/2015\/02\/Power-Wheelchairs-For-Sale-Electric-Mobility-Jazzy-Wheelchair_40188_image.jpg 454w, https:\/\/abilitytools.org\/blog\/wp-content\/uploads\/2015\/02\/Power-Wheelchairs-For-Sale-Electric-Mobility-Jazzy-Wheelchair_40188_image-300x139.jpg 300w\" sizes=\"auto, (max-width: 454px) 100vw, 454px\" \/><\/a><\/p>\n<p style=\"text-align: justify;\">When Medi-Cal pays for durable medical equipment (DME), like a wheelchair or a scooter, the recipient actually gets the device from a DME vendor. Vendors are independent businesses that contract with the state of California to provide DME to Medi-Cal recipients. Sounds simple, right?<\/p>\n<p>It gets complicated when we start talking about repairing the devices. Since Medi-Cal only replaces most DME every 5 years, it may be necessary to fix equipment like wheelchairs in the interim.<\/p>\n<p style=\"text-align: justify;\">Sometimes the repairs are covered by the item\u2019s warranty. That\u2019s easy.<\/p>\n<p style=\"text-align: justify;\">But it gets tricky when repairs need to be paid by Medi-Cal. Medi-Cal currently reimburses the vendor that procured the device to fix the equipment upon approval, but only if the vendor still accepts Medi-Cal as a form of payment. And vendors that don\u2019t contract with the state to provide DME to Medi-Cal recipients don\u2019t even qualify.<\/p>\n<p style=\"text-align: justify;\">Many durable medical equipment (DME) vendors around the state are no longer accepting Medi-Cal as payment for equipment repair, especially for items like wheelchairs and scooters. This is a problem when a Medi-Cal recipient receives DME from a vendor and then the same vendor stops accepting Medi-Cal. Another scenario occurs when people move out of the area where they received a device. In either of these situations, when DME breaks, getting it repaired becomes difficult.<\/p>\n<p style=\"text-align: justify;\">Where do you go?<\/p>\n<p style=\"text-align: justify;\">We have talked to many Medi-Cal recipients in just this situation, and they commonly decide to:<\/p>\n<ul style=\"text-align: justify;\">\n<li>Pay out of pocket<\/li>\n<li>Wait it out until they qualify for a new device again<\/li>\n<li>Ask for Medi-Cal to approve another Medi-Cal contracted DME vendor to approve (uncommon for Medi-Cal to approve)<\/li>\n<li>Call Ability Tools toll-free line and ask for gently used equipment<\/li>\n<\/ul>\n<p style=\"text-align: justify;\">None of the options above are ideal. Medi-Cal has a responsibility to repair the DME devices they initially purchased.<\/p>\n<p style=\"text-align: justify;\">Even when repairs are eventually approved, the process is long. If a new part or accessory needs to be ordered, then the approval process may take a new twist and the user is often stuck with nothing in the interim.<\/p>\n<p style=\"text-align: justify;\">Clearly the system is broken.<\/p>\n<p style=\"text-align: justify;\">But there is hope.<\/p>\n<p style=\"text-align: justify;\">Medicare found itself in a similar situation and has since \u201cfixed\u201d its repair policy. <a href=\"https:\/\/www.aahomecare.org\/press\/medicare-admits-problems-with-equipment-repairs\">In November 2014 Medicare lifted its repair restriction<\/a> that included reviewing the initial medical justification of the device, and now Medicare recipients can have their DME repaired by any contractor that accepts Medicare.<\/p>\n<p style=\"text-align: justify;\">We need Medi-Cal to follow Medicare\u2019s lead and ease their DME repair restrictions.<\/p>\n<p style=\"text-align: justify;\">This is where you come in. To encourage Medi-Cal to change its current policy, we need to show how the current repair policy is affecting Californians.<\/p>\n<p style=\"text-align: justify;\"><strong>Share Your Story<\/strong><\/p>\n<p style=\"text-align: justify;\">We need to hear your story. If you or someone you know is a Medi-Cal recipient who has not been able to get equipment repaired by a local DME vendor, please email me at <a href=\"mailto:kim@cfilc.org\"><strong>kim@cfilc.org.<\/strong><\/a><\/p>\n<p style=\"text-align: justify;\">Please include the following details in your email:<\/p>\n<ul style=\"text-align: justify;\">\n<li>Your name<\/li>\n<li>Your email and\/or phone<\/li>\n<li>Type of device (power wheelchair, scooter, etc.)<\/li>\n<li>Name and address of the vendor who denied repair service<\/li>\n<li>Name and address of the vendor from whom the chair was purchased<\/li>\n<li>The payer who purchased the chair (e.g., Medi-Cal, private insurance, other)<\/li>\n<li>Health plan involved<\/li>\n<\/ul>\n<p style=\"text-align: justify;\">Collecting your stories is an important step to improve DME repair options in California.<\/p>\n<p style=\"text-align: justify;\">Please spread the word.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Kim Cantrell, CFILC\u2019s Program Director When Medi-Cal pays for durable medical equipment (DME), like a wheelchair or a scooter, the recipient actually gets the device from a DME vendor. Vendors are independent businesses that contract with the state of California to provide DME to Medi-Cal recipients. Sounds simple, right? It gets complicated when we&hellip;<\/p>\n","protected":false},"author":2,"featured_media":845,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[14],"tags":[9,2,7,24,16],"class_list":["post-838","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-legislation","tag-advocacy","tag-at-network","tag-at-professional","tag-insurance","tag-mobility"],"_links":{"self":[{"href":"https:\/\/abilitytools.org\/blog\/wp-json\/wp\/v2\/posts\/838","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/abilitytools.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/abilitytools.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/abilitytools.org\/blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/abilitytools.org\/blog\/wp-json\/wp\/v2\/comments?post=838"}],"version-history":[{"count":11,"href":"https:\/\/abilitytools.org\/blog\/wp-json\/wp\/v2\/posts\/838\/revisions"}],"predecessor-version":[{"id":850,"href":"https:\/\/abilitytools.org\/blog\/wp-json\/wp\/v2\/posts\/838\/revisions\/850"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/abilitytools.org\/blog\/wp-json\/wp\/v2\/media\/845"}],"wp:attachment":[{"href":"https:\/\/abilitytools.org\/blog\/wp-json\/wp\/v2\/media?parent=838"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/abilitytools.org\/blog\/wp-json\/wp\/v2\/categories?post=838"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/abilitytools.org\/blog\/wp-json\/wp\/v2\/tags?post=838"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}