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New Medicare Harms to Home Health: Saving Dollars, But Costing Lives?

new-logo25Elizabeth Lee Vliet, M.D.


“The government says this is all in the name of “cost savings.”  So that makes Obamacare’s new slogan appear to be: “Saving dollars, costing lives.”  If you like your life, you may not get to keep it under Obamacare.


Here are my Top 6 harmful changes in home health services and bidding rules for DME vendors:

Obamacare has made drastic changes in Medicare procedures for obtaining durable medical equipment (DxME) for home health services. Most patients will not be aware of the hidden new rules until they are hit with higher costs or denial of services or needed supplies. 

Here are my Top 6 harmful changes in home health services and bidding rules for DME vendors:

obm1. Obamacare cut $66 Billion from the Medicare budget for home health services from 2013 – 2022, according to the Congressional Budget Office.

2. Obamacare cuts to home health services are the Democrats’ version of a War on Women: 60 percent of those needing home health services and equipment are elderly or disabled women. I say Democrats because there were zero Republican votes for Obamacare.

3. Obamacare cuts $17 billion from hospice care, another Medicare-covered service typically delivered in the lower-cost setting of homes instead of hospitals.

4. Medicare implemented new rules called “Competitive Bidding” (CB) for vendors of home health equipment and supplies.  Like so many federal laws and rules, the CB process has an effect opposite to the one its name suggests. The new bid rules are non-competitive and damaging in many ways:

  • Any vendor may place non-binding bids that can be rescinded –and prices raised –after a contract is awarded, and after long-standing local suppliers are knocked out of providing services.
  • Vendors are not vetted to insure they are actually qualified to provide the services and equipment.
  • Vendors can later change how they deliver services, without penalty, but with potential harm to patients who lose reliable service providers.
  • Medicare’s new rules cut prices by 45 percent below the current fee schedule, on average, and 72 percent below current rates for diabetic supplies.  What reputable business can survive a 45 percent or 72 percent cut in revenue?  
  • Vendors are no longer paid for providing education to patients on how to use the medical equipment properly.  For example, CPAP devices to treat sleep apnea require a properly fitting mask, adjustments, and proper cleaning and maintenance. Without careful instruction, many patients will not receive effective treatment and could die if they stop breathing during sleep.

5.  When patients’ home health services are cut, the hardest hit are patients with chronic lung disease, congestive heart failure, diabetes, and similar medical problems who then will need hospital admission to stabilize life-threatening situations. But new Obamacare rules deny payment if a patient is re-admitted within 30 days of discharge. So this means patients are in a Catch 22: less access to home services, and hit with having to wait 30 days to be re-admitted for treatment in a hospital.  We will likely see more deaths — ones that could have been prevented under the old rules.

6. Budget cuts to home health plus damaging new DME Bid rules are even more damaging because Medicare patients are not legally allowed to pay cash out of pocket for needed “covered” services if they see a Medicare-contracted physician, except for limited government-determined copayments. Thus, if services are no longer available at absurdly low Medicare-allowed prices, patients will not be able to obtain them at all unless they can find a physician who is opted out of Medicare.

The government may save money, but the elderly or disabled patients will often be left only with supplies from distant mail-order vendors, as established, reputable local providers are driven out of business.

As a physician, I see the damages that happen to patients when the focus is on cost over quality of care.  As a spouse, I experienced these problems personally when the local vendor for my husband’s CPAP machine and oxygen concentrator were forced out of business in Tucson because the bid went to an out-of-state contractor who had no patient services representatives in Tucson. Sending a machine by UPS does not help a patient learn how to use it or get a mask to fit properly. 

The government says this is all in the name of “cost savings.”  So that makes Obamacare’s new slogan appear to be: “Saving dollars, costing lives.”  If you like your life, you may not get to keep it under Obamacare.



Author/Contributor short bio:

Elizabeth Lee Vliet, M.D. is a 2014 Ellis Island Medal of Honor recipient, and the 2007 recipient of the Voice of Women award from the Arizona Foundation for Women for her pioneering advocacy for the overlooked hormone connections in women’s health. 

Dr. Vliet is a preventive and climacteric medicine specialist with medical practices in Tucson AZ and Dallas TX that take an integrated approach to evaluation and treatment of women and men with complex medical and hormonal problems.  Dr. Vliet is also CEO of International Health Strategies, SpA, a global medical consulting company based in Santiago, Chile whose mission is medical freedom and privacy while preserving the Oath of Hippocrates focus on individual patients.

Dr. Vliet is a past Director of the Association of American Physicians and Surgeons (AAPS). She received her M.D. degree and internship in Internal Medicine at Eastern Virginia Medical School, and completed specialty training at Johns Hopkins Hospital.  She earned her B.S. and Master’s degrees from the College of William and Mary in Virginia. 

Dr. Vliet has appeared on FOX NEWS, Cavuto, Stuart Varney Show, Fox and Friends, Sean Hannity and many nationally syndicated radio shows across the country as well as numerous Healthcare Town Halls addressing the economic and medical impact of the 2010 healthcare law.  Dr. Vliet is a co-host of America’s Fabric radio show.

Dr. Vliet’s health books include: It’s My Ovaries, Stupid; Screaming To Be Heard: Hormonal Connections Women Suspect– And Doctors STILL  Ignore; Women, Weight and Hormones; The Savvy Woman’s Guide to PCOS.

Dr. Vliet’s medical and educational websites are, and For more on healthcare, go to

DISCLAIMER: Dr. Vliet speaks as an independent physician, not as an official spokesperson for any organization or political party. Dr. Vliet has no financial ties to any health care system or health insurance plan.  Her allegiance and advocacy is to and for patients.

See Dr. Vliet on The Sean Hannity Show (discussing “Freedom gives Most Access to High Quality Medical Care. Socialism Fails”)

To book Dr. Vliet for interviews, contact media@herplace.comor 520-797-9131 (MST)


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