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The Ohio Medicaid Program Could Significantly Lower Payment Rates for Selected Durable Medical Equipment and Supplies

The Ohio Medicaid program could have saved an estimated $3 million by establishing a competitive bidding program for durable medical equipment (DME) items similar to pricing that Medicare obtained through its Competitive Bidding Program. We determined that Medicare payment rates obtained through competitive bids in 2 Ohio competitive bidding areas (CBA) for the 43 selected DME items were significantly lower than the Ohio Medicaid maximum payment rate for the period April 1, 2010, through March 31, 2011. The Competitive Bidding Program sets lower payment rates than conventional Medicare payment rates for selected DME items while ensuring access to quality items and services.

We recommended that the State agency establish competitive bidding that functions similarly to Medicare's Competitive Bidding Program for the purchase of selected DME items, which could have resulted in cost savings of approximately $3 million for the 1-year period we reviewed. The State agency generally agreed with our findings and recommendation.

Filed under: Centers for Medicare and Medicaid Services