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
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."