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Medicare News
Power Wheelchair Industry Lines Up 44 House Members
Opposing Medicare Fee Cut
They say cuts up to
41 percent will restrict access for senior citizens
 November 3, 2006 – The power wheelchair industry
has lined up a bi-partisan group of 44 House members have asked Health
and Human Services (HHS) Secretary Michael Leavitt to delay Medicare
cuts to power wheelchairs, which the group says will make it difficult
for senior citizens and other beneficiaries to receive mobility
equipment. This battle will join the effort by the American Medical
Association to stop a five percent pay cut by Medicare on the
Congressional agenda after the election recess.
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Mobility Industry Predicts Dire Circumstances if
Medicare Proceeds with Pay Cuts for Power Wheelchairs
On Nov.15 Medicare
will reduce reimbursements for power wheelchairs by about an average of
35%
October 11, 2006 - The Scooter Store announced
today that the Centers for Medicare and Medicaid Services' decision to
cut reimbursements by up to 41 percent for most power wheelchairs "will
be devastating" for senior citizens and people living with physical
impairments. And, Black Bear Medical, a leading supplier of durable
medical equipment, said that the cut by Medicare will likely force
lay-offs at their company, as well as other suppliers.
Read more...
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In an Oct. 31 letter to Secretary Leavitt, the 22
Republican and 22 Democratic lawmakers said they are "troubled" by the
potential impact of the new fee schedule on the ability of Medicare
beneficiaries with disabilities to obtain medically necessary and
appropriate power mobility technology.
"Specifically, we understand that the fee schedule
would result in reductions for the higher category of power mobility
devices -- Group 3 devices used by individuals with disabilities such as
Multiple Sclerosis, ALS, spinal cord injury and others -- in excess of
30 percent," said the letter, which was signed by Republican Rep. Ron
Lewis of Kentucky, Democratic Rep. Thomas Allen of Maine, and 42 of
their colleagues.
Moreover, the lawmakers wrote: "We understand that
the reductions for Group 3 power mobility devices are below the cost for
suppliers to acquire the product and perform the clinically necessary
services in order to furnish these power mobility devices to disabled
beneficiaries.
"Accordingly, we respectfully request that you
intervene to ensure that implementation of the fee schedule is postponed
until revisions can be made to protect the access to medically
appropriate care for individuals with disabilities."
In October, the Centers for Medicare & Medicaid
Services (CMS), which is under HHS and oversees the Medicare system,
issued a new fee schedule calling for cuts of 21 percent to 41 percent
to reimbursements for power wheelchairs.
Manufacturers and suppliers of power wheelchairs
assailed the cuts, saying the reductions would force suppliers out of
business, cause lay-offs throughout the industry, and restrict access to
mobility equipment for senior citizens and people living with
disabilities.
As the lawmakers' letter states, the reimbursement
cuts hit particularly hard at the most sophisticated mobility equipment,
which is needed by people with the most severe physical disabilities.
For instance, a supplier who has been receiving a $6,500 reimbursement
from Medicare for one such wheelchair will only receive $3,800 after the
new pricing is effective on Nov. 15.
In their letter, the lawmakers said CMS utilized a
methodology for establishing the fee schedule that the agency itself has
acknowledged "can lead to very high or very low fee schedule amounts
without validation that these amounts are realistic and equitable
relative to the cost of furnishing the item." Their letter cited the CMS
proposed rule on competitive bidding as the source for acknowledging
flaws in the methodology.
The lawmakers said a recent survey of suppliers
found that 76 percent of current suppliers of Group 3 wheelchairs would
no longer be able to afford to supply these devices under the new fee
schedule.
"The problem that CMS doesn't understand is that we
don't have anything to cut," said Carol Gilligan, president of Health
Aide, of Ohio, Cleveland, Ohio. "At these reduced rates, the cost of
acquiring a wheelchair, fitting the patient, servicing the chair and
doing the documentation paper work will exceed the amount that Medicare
will pay for the chair. We can't stay in business operating in the red.
Patients are not going to have outlets to get the mobility equipment
that they need."
Scott Meuser, CEO of Pride USA, a major
manufacturer of mobility equipment, said: "What we have is a regulatory
body that has been focused on restricting access to the benefit. Now,
they have gone too far. The message from these price cuts is that CMS no
longer wants the most physically disabled person in our society to have
access to a power wheelchair through Medicare that will help him or her
perform essential daily activities, such as grooming, preparing food and
going to the bathroom. Medicare is turning their backs on the people who
need help the most."
Mal Mixon, Chairman and CEO of Invacare Corp.,
another major manufacturer, adds: "We expect serious access issues for
consumers with severe disabilities, as well as seniors with mobility
impairments. We have an Americans with Disabilities Act that is supposed
to ensure the highest quality of life possible for people living with
disabilities. Yet, this Administration's payment policy for power
wheelchairs will effectively prevent people with disabilities from being
able to obtain the power wheelchair they need to get around in their
homes, as well as in their communities."
Andrew Imparato, president and CEO of the American
Association of People with Disabilities said: "The Medicare mobility
benefit as we knew it is gone. CMS has chipped away at the benefit over
the last three years, and this latest step ensures that people living
with disabilities will get little help from Medicare when they need a
power wheelchair to remain independent, and out of institutions."
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