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Power Wheelchair Sales Down 50 Percent; Seller Claims
Medicare to Blame For Fewer Seniors Getting Power Mobility
Scooter Store to release 200 employees, cut
expenses
New Braunfels, Texas, Sept. 1, 2004 - The SCOOTER
Store, the nation's leading provider of power wheelchairs and scooters,
has announced the release of 200 employees who are no longer needed as a
"direct result of a Medicare policy change" that has drastically cut the
number of senior citizens who can receive such assistance.
"While we deeply regret having to part with any of
our employee family, the continuing impact of restrictive Medicare
policies leaves us no choice," said Doug Harrison, chief executive
officer of The SCOOTER Store. He pointed to industry reports that the
number of seniors who receive power mobility assistance this year will
be down by approximately 50 percent from 2003, despite a growing
population of Americans who are living longer then ever.
"As painful as this move is to all of us, the
greater tragedy is the denial of assistance to qualified
mobility-impaired individuals," he said. "Our elderly with severe health
problems, those who are most in need of assistance from the Medicare
system, are being hit hardest through no fault of their own."
Early this year The SCOOTER Store was forced to lay
off approximately 200 workers and has reduced numerous other
expenditures. Last week the company announced a restructuring that
included the appointment of Mike Pfister as president.
Pfister said the organizational changes are aimed
at preserving the company's stability through a time of industry change
and challenge.
"We simply must resize the company to the current
market environment to assure that we remain viable to carry on our
mission to provide freedom and independence to our nation's mobility
impaired," he said. "The SCOOTER Store remains committed to serving the
needs of current and future customers nationwide in any regulatory
environment."
Pfister explained that the drastic cutbacks in
Medicare reimbursements came after the Centers for Medicare and Medicaid
Services (CMS) reversed previous policies and issued on a retroactive
basis new "clarification" guidelines that he said have denied many
disabled elderly the assistance granted in the past. He said the action
was intended to help combat fraud and abuse of the system, but instead
has harmed seniors and scores of legitimate providers who have gone out
of business or stopped providing power mobility equipment altogether.
Medicare has provided coverage for such devices
since 1996 to people requiring this equipment to accomplish activities
of daily living inside their home.
"The 'clarification,' as interpreted by CMS
contractors, now frequently denies the power mobility benefit for any
person who can take more than a single step inside his or her home at
any time," Pfister said. Although CMS rescinded the "clarification," its
contractors continue to audit claims based on those guidelines, he
noted.
"The SCOOTER Store actively is appealing denied
claims worth millions of dollars in Medicare reimbursements for power
wheelchairs already delivered that were prescribed by patients' personal
physicians," Pfister said. He noted that historically 70 percent of
these appeals are successful, and Medicare is ordered to pay the claims.
In a related recent lawsuit, a U.S. District Court
ruled against CMS, re- establishing that Congress, not CMS, sets the
criteria for documentation of medical necessity. At issue was the
importance of the Certificate of Medical Necessity (CMN), a document
mandated by Congress for physicians to complete that affirms the medical
need for power mobility equipment. The court ruled that Congress
intended the CMN to be the sole document necessary for Medicare to
determine medical necessity, and that the agency should not second-guess
the decisions made by treating physicians.
Federal officials currently are re-examining
appropriate coverage standards, but further clarification is not
expected until early next year.
"Providing support to those who need assistance in
order to remain living independently in their homes not only is the
right thing to do for America's elderly, but also is sound business for
the federal government and the taxpayer," Harrison said. The
alternative, full-time nursing care, costs CMS thousands of dollars per
month for each covered beneficiary. Medicare data shows that among
beneficiaries with similar disabilities, those who received power
mobility equipment generated less cost to the system overall than those
who did not receive such assistance, even after paying the cost of the
power wheelchair.
"We are confident that our country will not turn
its back on our seniors," Harrison said.
The SCOOTER Store now has approximately 1,000
employee/owners, and will continue operating its current retail
locations and distribution centers across the country. All affected
employees will be provided severance benefits, career counseling and job
placement assistance.
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