Ventilator Rentals Cost Government a Bundle
Whenever Lisa La Pierre ventures out of her Lomita home in her wheelchair, she takes along a portable ventilator to enable her to breathe. Another ventilator remains at her bedside.
The rental on each is $657 a month -- and Medi-Cal and its federal partner, Medicare, have been paying that for more than eight years. The total amounts to roughly $125,000 -- almost 10 times the cost of buying the devices.
The practice seems absurd to La Pierre, 35, who has been paralyzed since a teenage robber shot her in the neck in 1994. “Oh, my God, they have been paying rent all these years,” she said. “It makes me feel sorry for taxpayers, to be blunt.”
State auditors in December found that Medi-Cal saved money by renting a variety of medical equipment -- except for oxygen supplies and breathing devices such as La Pierre’s ventilator.
Buying that equipment would have reduced Medi-Cal’s bill from $12 million to $4 million during the 1999-2001 period audited.
Health officials said the $8 million in waste resulted from a miscommunication between headquarters and field staffers who believed that under no circumstances were they to buy ventilators, even those being rented year after year. “It was a pure mistake on our part,” said Stan Rosenstein, deputy state health director for medical services.
Medical equipment dealers want to preserve the rental system, auditors concluded, because the ventilators represent a “cash cow.”
Life Care Solutions in Pasadena has provided the ventilators to La Pierre from the start.
For the first five years, Medi-Cal was responsible for the rent of $15,784 a year. Then it split the cost with Medicare.
Rene Moreno, the dealer’s respiratory care manager, said renting allows Medi-Cal to avoid paying directly for important services such as delivery, training, liability insurance, adjustments and repairs.
A respiratory therapist initially makes repeated house calls to teach the patient and family how to use and monitor the equipment. Then there are monthly visits to make sure the equipment is putting out the proper amount of air.
Also, “every ventilator needs service every year,” said Moreno, who was a therapist for 20 years. “It can be $500 to $2,000.... Normally, the equipment goes back to the manufacturer and would need an overhaul, with certain parts replaced.”
Plus, he said, dealers periodically replace the ventilator motors and other costly parts to avoid breakdowns that can lead to injury or death.
If Medi-Cal buys the ventilators, asked Bob Achermann of the California Assn. of Medical Product Suppliers, “who will service them and respond to patients at night if it stops functioning?”
The rental agreement, he said, “requires the company to provide those services.”
Achermann acknowledged, however, that “you could include a service contract” if the state started buying breathing equipment.
