CHARLESTON, S.C., Oct. 29, 2013 /PRNewswire-USNewswire/ -- More than 2,000 Medicare patients, including dozens of South Carolina residents, have called an organization, People for Quality Care, desperately seeking assistance because their health and quality of life is being jeopardized by Medicare's bidding program for home medical equipment. Yet, the Centers for Medicare & Medicaid Services (CMS), insists there have only been a few complaints associated with the bidding program.
But Norma Westbrook, 81, of Charleston, S.C., is one of many Medicare beneficiaries who are suffering because they can't get repairs or new home medical equipment through the badly flawed bidding program that expanded to 91 new areas on July 1.
Her old power wheelchair won't hold a charge, making it difficult to accomplish even simple tasks around the house. Four months ago, Norma started trying to get a replacement. She had multiple medical examinations, filled out extensive forms, and called daily to speak with a new wheelchair provider that she was forced to switch to because of the Medicare bidding program, and who is based in Georgia. Despite her best efforts, Norma still doesn't have a usable chair.
The new provider did ship out a wheelchair, but it was too small, so Norma had to return it. She questions how the provider could have sent the wrong chair if they had read either her paperwork or her physician's instructions. Now, she's discouraged and doubts she'll ever get the chair she needs through Medicare. Instead, she has resorted to searching the local want ads on the off chance that a used one might become available.
Although Charleston used to have six Medicare-approved power wheelchair providers, there are none left because of the bidding program.
"Lots of dealers are deciding they just won't handle Medicare anymore," she explains. Norma doesn't want her or her husband to be institutionalized. She wants to stay in her home, but realizes that will be very difficult without the wheelchair that Medicare is supposed to provide.
"To be able to stay in your own home with hospice is a blessing. And it's the cheapest thing that the government can do to take care of people in their older age," Norma says. "It's scary to think that because you can't replace a chair, being put in an institution might be inevitable. I don't want to get to the point where my husband has to go to a nursing home, and I have to have someone come in to care for me. And that's exactly what would happen. In the long run it would be so much more expensive for everybody. It just doesn't make any sense."
Despite CMS claims to the contrary, people like the Westbrooks are suffering because of the badly mismanaged Medicare bidding program. It has put hundreds of providers of durable medical equipment (DME) out of business, created equipment shortages, and left beneficiaries without doctor-prescribed equipment, such as oxygen tanks, power wheelchairs, hospital beds, walkers, and diabetic supplies.
"It's disturbing that CMS is claiming everything is fine when people are suffering," said Tom Ryan, president of the American Association for Homecare (AAHomecare). "The bidding program is bad public policy that needs to be fixed or stopped. CMS must acknowledge the real problems that Medicare patients are encountering. How can they expect anyone to believe that they have only received a handful of complaints when more than 2,000 people have reached out to a private organization for help addressing their problems?"
According to a May 2012 Government Accountability Office report titled Review of the First Year of CMS's Durable Medical Equipment Competitive Bidding Program's Round 1 Rebid, the agency may be intentionally undercounting the number of problems. "CMS's definition of inquiry and complaint may be an optimistic characterization of beneficiary calls," the report states. "According to CMS, all calls are first classified as inquiries and are only classified as complaints when they remain unresolved by CSRs [customer service representatives]." However, CMS considers giving a caller a list of companies to research on their own sufficient. There is no assistance given and no follow-up done to ensure that beneficiaries get what they need.
Ryan said that CMS hasn't changed the way it classifies calls from beneficiaries or the level of assistance they give, so it is not surprising that their numbers are unrealistically low. However, he believes that even the People for Quality Care number is "just the tip of the iceberg."
The American Association for Homecare represents providers of home medical or durable medical equipment and services who serve the needs of millions of Americans who require prescribed oxygen therapy, wheelchairs, enteral feeding, and other medical equipment, services, and supplies at home. Visit www.aahomecare.org.
SOURCE American Association for Homecare