Reimbursement for Durable Medical Equipment

The use of durable medical equipment in the home, while not a recent development, was formally recognized by the Congress with the passage of the original Medicare legislation. Since that time the statute has been amended to provide for a more workable, economical, and desirable interface among the administrative, supplier, and user communities. To assist in achieving this end, a research project was begun in October 1976 that has yielded data on Federal expenditures for reimbursement of rental and purchase costs of this equipment. Data were extracted from the Beneficiary History Files of five Part B carrier in 11 geographic areas covering the period 1976-1977. These data included the type of equipment; rental or purchase decision; submitted charges; allowed charges, and reimbursement by Medicare. Some 1.3 million individual records, from approximately 400,000 beneficiaries, were tabulated and analyzed. The exploratory nature of this research has provided a benchmark for future research and policy considerations. This article details various characteristics of the data collected for the project.