A hard sell on DME: How suppliers try to game Medicare

Aggressive marketing tactics by durable medical equipment suppliers can put doctors in a tough spot with patients.

By Markian Hawryluk, AMNews staff. Sept. 1, 2003.

Melvin Kirschner, MD, was pleased to see his patient making progress walking after his hip surgery. The man had abandoned his walker for a cane.

But then the man's neighbor received a motorized scooter. And even though the patient didn't meet Medicare's criteria, he easily found a supplier who insisted he was entitled to one, too.

He brought an authorization form from the supplier to Dr. Kirschner, a family physician from Van Nuys, Calif. The heat was on.

"If I write down honestly what I know to be true about you, you won't get this scooter," Dr. Kirschner told the man.

The patient pondered the situation a moment. "Well, write down the truth, and we'll take our chances."

The gamble paid off for the patient, who got his scooter. But for Dr. Kirschner, the experience was just another example of how suppliers of durable medical equipment game the Medicare rules. He and other physicians are getting fed up.

"I want my patients to have what they need, but I don't want durable medical equipment people fishing around in the guise of filling a need," he said. "You name it, there's durable equipment being sold that the patient doesn't need or doesn't want."

Because Medicare requires a physician to certify that the equipment is medically necessary, doctors are stuck being the ones to tell patients "no" and to resist the hard sell from persistent vendors.

"Medicare is making us the cop, and the durable medical equipment suppliers are making us the patsy," Dr. Kirschner said. "There are caring people in the DME field, but there are also an awful lot of scalawags."