Mobility Today: Power Wheelchair Rental Proposal Will Have Devastating Impact on Medicare Beneficiaries and Suppliers

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Rental proposal will restrict access to mobility equipment, force suppliers to shut down.

Congress has been discussing a proposal that would deliver a major blow to Medicare coverage of power wheelchairs, which yearly help thousands of senior citizens and people living with disabilities regain their mobility and independence, according to Volume I, Issue 3 of Mobility Today, a newsletter that discusses issues related to Medicare’s mobility benefit.

Previous congressional and regulatory changes have chipped away at this valued benefit, but this time people on Medicare and the manufacturers and suppliers who strive to serve them may face their biggest legislative challenge yet.

While debating the State Children's Health Insurance Program, known as the CHAMP Act, some House members decided to help pay for expanded healthcare benefits for lower-income children – a very worthy cause – by significantly changing Medicare’s power mobility benefit. The House sought to eliminate doctors’ ability to prescribe power wheelchairs for long periods to Medicare beneficiaries, even if they are permanently disabled. Instead, the House established a 13-month rental period for all beneficiaries, regardless of their physical condition.

It may seem like a mere accounting change, but the real-life impact on suppliers, manufacturers and, most of all, beneficiaries, would be devastating.

Fortunately, the Senate version of the legislation paid for expanding children’s health insurance by increasing the federal tax on cigarettes. Since cigarette smoking adds countless costs to government health spending, the Senate felt justified in making the industry contribute towards improving healthcare for children.

In the Conference Committee, the final legislation dropped the language eliminating the purchasing of power wheelchairs, but like most revenue-enhancing maneuvers, this one is likely to resurface again as Congress seeks money to pay for other initiatives. It seems, however, that some lawmakers don’t understand that this is merely a budget gimmick: Renting equipment would allow the government to claim an immediate budget savings, but the government would actually pay more over the 13-month rental period than it would if the power wheelchair were purchased.

Moreover, a shift from purchase to rental would leave unanswered questions, such as the process for allowing patients to have the mobility equipment longer than 13 months. In addition, the change would have a devastating impact on the power mobility industry.

The government would essentially be asking suppliers to pay the upfront costs, such as obtaining a power wheelchair from the manufacturer, fitting a beneficiary to the chair, and complying with the voluminous government documentation requirements. But during the rental period, suppliers would receive monthly payments spread out over more than a year.

Many suppliers say they would not be able to survive this financial burden, especially after absorbing huge cuts in reimbursement for power wheelchairs and the implementation of competitive bidding. Many suppliers, particularly smaller ones, would no longer be able to provide power wheelchairs and scooters.

The big loser, once again, will be Medicare beneficiaries, some of the most vulnerable people in our society. Already, thousands of seniors and people living with disabilities are not getting the appropriate power mobility equipment that could vastly improve their quality of life. What happens is that when suppliers go out of business or no longer provide the products, it becomes very difficult for beneficiaries to find other places to fill their prescriptions. This is especially true in rural communities, where small suppliers cover large geographic areas. But these same small providers are the ones hardest hit by the government’s ill-conceived policies.

Previously, the Centers for Medicare &Medicaid Services (CMS) had estimated that 17,800 Medicare beneficiaries a month would need power wheelchairs in 2007. But the government’s own data show that since the reimbursement cuts last November, use of the power wheelchair benefit has plummeted. For instance, in February 2007, only 8,599 beneficiaries utilized the benefit, a steep drop from the 14,287 beneficiaries who obtained power wheelchairs or scooters in the same month a year earlier.

The major reason for the decline is that there are fewer suppliers providing power wheelchairs and scooters because the government has made it too difficult for the businesses to survive.

Clearly, lawmakers and regulators alike don’t fully understand the role that the power mobility benefit plays in lowering healthcare costs.

There is a huge misconception that Medicare beneficiaries obtain power wheelchairs and scooters, and then die shortly after receiving them. To the contrary, a study on the life-cycle of people with power wheelchairs shows that, on average, seniors and people with disabilities far outlive the 13-month rental period that the House tried to establish. Specifically, the data show that beneficiaries live, on average, 9.5 years after receiving mobility equipment. The data strongly contradict the reasoning behind the rental proposal, which is that the government won’t have to make all the monthly payments because patients will die before the rental period concludes.

Furthermore, data show that the government saves substantial sums because seniors and people with disabilities who use power mobility equipment don’t have as many falls that require hospital care and are less likely to be placed in nursing homes because they retain more mobility and independence.

The best outcome would be for lawmakers and regulators to gain a better understanding of the Medicare mobility benefit so it can continue to help improve the quality of life for our senior citizens and people with disabilities. They must begin to realize that the mobility benefit is a friend to beneficiaries and government; it shouldn’t be a target.

Mobility Today is published periodically by The SCOOTER Store to inform Congress, policymakers and the media about the latest developments regarding the Medicare power mobility benefit. We are committed to helping seniors and people living with disabilities regain their freedom and independence with power mobility equipment. The SCOOTER Store is the largest supplier of power wheelchairs and scooters in America. For more information, contact Mark B. Leita (830) 627-4717.

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Mark B. Leita

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