Forty-four Bipartisan House Members Urge HHS Secretary Leavitt to Delay Medicare Cuts to Wheelchairs

Reimbursement Cuts of 21 percent to 41 percent Will Restrict Access, Put Suppliers Out of Business

11/1/2006 1:33:00 PM


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To: National Desk, Health Reporters

Contact: Michael K. Frisby, 202-625-4328 or Mike@FrisbyAssociates.com

WASHINGTON, Nov. 1 /U.S. Newswire/ -- 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 that will make it difficult for beneficiaries to receive mobility equipment.

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.

Furthermore, 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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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."

this is so sad.

how much is medicare paying to have someone come in and help people in their homes? how does it cost annually to be in an institution?

and they cut costs so they can pay out more elsewhere? and people lose their independecy.

Curious,
I agree it is sad...
Medicare pays very little for helping someone stay in the home..equipment needs and training of skilled needs for the caregiver is all that is covered for most....
Now they are cutting back on equipment as well...
It is a disgrace..the states I guess are the ones that lose money once people go bankrupt..then they will cover institutional care..how much could they save by trying to keep people in there homes?...my guess is quite a bit...

Eric...hope you get the wheelchair before the cuts go into effect..these cuts are ridiculous and you and other PALS deserve better.....Lisa

how much could they save by trying to keep people in there homes?...my guess is quite a bit...

i agree lisa. that was my point. so i guess many of these institutions are government funded or owned?