Michigan Seniors and Disabled Population Face Restricted Access to Power Wheelchairs Unless Congress Stops New Medicare Program

Michigan Consumer Advocates Call on Senators Stabenow and Levin to Help Stop Program

DETROIT, Dec. 20, 2011 /PRNewswire-USNewswire/ -- Advocates working with the disability and aged communities in Michigan are urging the state's U.S. Senators and House members to help stop a Medicare change that would restrict Michigan beneficiaries from receiving power wheelchairs prescribed by their physicians.

Seven states, including Michigan, were chosen by the Centers for Medicare and Medicaid Services (CMS) for a prepayment review demonstration project.

The program will cause a delay of up to 16 months or more before Michigan's home medical equipment providers can be fully reimbursed for purchasing power wheelchairs and providing the equipment to Medicare beneficiaries.

But consumer advocates and providers are asking Congress to stop the program because it will disrupt service to Medicare beneficiaries. Many providers say the long delay for reimbursements will force their companies out of business, creating significant delays in filling power wheelchair prescriptions for Medicare patients who are in dire need of mobility assistance.

"This is a direct attack on some of the most vulnerable people in our society," said Mike Zelley, President of The Disability Network in Flint, MI.  "Senior citizens and people living with disabilities need power wheelchairs to live independently in their homes and to delay confinement in expensive care facilities and nursing homes.  Congress cannot allow CMS to restrict access to medical equipment that has been prescribed by physicians so that these Medicare beneficiaries can improve their mobility and enjoy a better life."

Zelley said that with Sen. Debbie Stabenow (D-MI) on the Senate Finance Committee and Sen. Carl Levin (D-MI) on the Small Business and Entrepreneurship Committee, "Michigan seniors and people living with disabilities have public officials to fight for them." Zelley said the state's disability and aged communities are depending on the state's U.S. Senators and their other federal lawmakers to lead the fight to stop the prepayment review project.

In 2009, there were 7,831 Michigan residents who received power mobility assistance through Medicare to improve their mobility so they could perform the daily necessities of life, such as preparing food, getting to the bathroom and grooming.

"The power wheelchairs provided impact not only the lives of beneficiaries, but also the lives of their families, neighbors and friends," said Zelley. "We have to fight for the senior citizens and people living with disabilities who depend on the Medicare system to improve their mobility so they can live independently in their homes." 

Consumer advocates around the country are also asking that the prepayment review program be stopped.

In a letter to Sen. Max Baucus (D-MT) and Sen. Orrin Hatch (R-UT), chairman and ranking members of the Senate Finance Committee, the United Spinal Association asked Congress to take immediate action to halt the project. The organization urged CMS to work with Congress and power mobility stakeholders to identify alternative approaches for reducing overpayment and fraud and abuse without significant disruptions to the disability and aged communities.

Furthermore, because the prepayment reviews will occur after the power wheelchairs have been delivered to beneficiaries, United Spinal raised the possibility that providers might be forced to "rescind care" or take back equipment if claims are denied. 

"With a considerable percentage of the currently high error rates reported on these claims being attributable to paperwork inaccuracies or omissions, suppliers are placed in the position of potentially having to remove denied mobility devices from beneficiaries' homes when the medical necessity may be genuine," the Association wrote in its December 8th letter. 

"Beneficiaries should not be burdened with the uncertainty of the pre-payment review phase or denied their mobility independence while CMS develops and implements their own, untested, prior authorization process," the letter said. "Nor should beneficiaries, often living on limited fixed incomes, be placed in a position of paying their deductible and 20 percent copayment only to be at risk for having the device repossessed if the claim is denied for any reason."

Meanwhile, there are also concerns about the economic impact on the cities and towns where Michigan's 286 home medical equipment providers are located.

"Our industry has been repeatedly hammered by CMS over the last decade," said A.J. Filippis, president and CEO of Wright & Filippis, a home medical equipment provider in Rochester Hills, MI. "A year ago, CMS implemented a rental reimbursement policy that spreads payments over a 13 month period in which the beneficiary rents the mobility equipment.  Now, this new program would delay the initial rental payments for an additional three months or more.  Providers cannot continue to deliver the same products and level of service and wait 16 months or more for full payment."

Filippis predicted that the prepayment project will cause layoffs at some businesses, while others close their doors and stop operating.

"The Administration is trying to implement a policy that will increase unemployment and cause hardship not only for Medicare beneficiaries, but also for home medical equipment providers and our families," Filippis said. "Is this what healthcare reform was all about? Allowing bureaucrats to overrule the decisions made by physicians on what medical equipment is needed by their patients? We need Congress to bring some sanity to this situation."

The American Association for Homecare represents providers of durable medical equipment and services who meet the healthcare needs of millions of Americans who require oxygen equipment and therapy, wheelchairs and mobility assistive technologies, medical supplies, inhalation drug therapy, and other medical equipment and services in their homes. Members provide homecare in all 50 states. 

CONTACTS:  Michael K. Frisby, 202-625-4328, [email protected]
                        Michael Reinemer, 703-535-1881, [email protected]

SOURCE American Association for Homecare