WEST UNION, Iowa, Dec. 9, 2010 /PRNewswire-USNewswire/ -- Medicare beneficiaries residing in rural areas of the country may not be able to obtain power wheelchairs prescribed by their physicians if the Medicare program implements a mandatory rental policy as scheduled in January, according to home medical equipment providers and consumer groups.
Stakeholders are asking Congress to delay for a year the policy that would eliminate a beneficiary's option to have Medicare purchase the equipment during the first month the patient has it. In place of the first-month purchase option, a 13-month rental policy will be implemented for power wheelchairs. But that new policy will create financial burdens for providers, especially small businesses in rural areas, because they can't afford the upfront costs associated with supplying the power wheelchair and waiting more than a year for full reimbursement from the government.
"What I'm hearing from providers in the smaller communities is that if they have to start renting power wheelchairs, they will have to quit the business," said Julie Weidemann, president of the Midwest Association for Medical Equipment Services (MAMES), which has 280 providers in Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota and South Dakota.
Weidemann explained that the policy would cause cash flow nightmares for many providers, especially since in the current economic environment it is difficult for many providers to find lenders willing to extend credit to their businesses. While large and small providers alike are wrestling with how to deal with the new policy, Medicare patients in rural areas may be impacted the most because many small providers who service rural communities either won't continue supplying power wheelchairs or will go out of business.
Weidemann cited problems caused by the rental policy. For instance, if a provider supplies a power wheelchair to a beneficiary who dies or goes into a nursing home during the first 13 months of having the wheelchair, the Medicare program requires that the provider take the equipment back from the beneficiary and the government rental payments stop. This creates a high risk situation in which providers have to pay manufacturers for the wheelchairs, but never get fully reimbursed by the government.
"Small providers don't have enough volume in their businesses to cover those losses," Weidemann said. "When those chairs come back in, they are virtually useless to small providers because they have already been fitted for a specific patient, who won't be using it anymore. It's very unlikely they will be able to re-rent the equipment. I recently heard from two of my friends who have provided power wheelchairs, but now they have said they will quit providing that part of their business if the first month purchase option is no longer available."
Another issue for providers is that the new policy doesn't adequately address servicing for rented power wheelchairs. The Medicare program plans to provide little or no reimbursement for providers who have to service the power wheelchairs that have been delivered to beneficiaries.
"This is going to be a struggle," said Michelle McMahon, owner of Frontier Access and Mobility in Cheyenne, Wyoming. Her business, which has 13 employees, is one of three providers in the state that supplies complex rehabilitation wheelchairs. She has provided equipment for Medicare beneficiaries living up to 260 miles away, but doesn't know if she can continue doing so once the rental policy is implemented. She wants the policy to be delayed so she can plan the transition.
"I need the time to pull the numbers and figure out how to continue," McMahon said. "If a Medicare patient calls me, and they are out in a rural area, I may have to decline the business or put them on the bottom of the stack...under the rental policy, it is going to be a real problem trying to service chairs that are hundreds of miles away and not get reimbursed adequately by the government."
Tyler Wilson, president of the American Association for Homecare, said that many providers around the country are contemplating how to deal with these serious obstacles.
"This is simply the wrong policy, at the wrong time," Wilson said. "Some providers can't get the credit they need to survive this transition. We urge Congress to approve a one-year delay in implementing this policy so that providers will have time to make the transition to renting power wheelchairs. This is a major transition for many businesses. They need time to do it properly."
Members of the House and Senate have signed letters asking the chairs and ranking members of key committees to support the delay in implementing the policy. The delay wouldn't increase Medicare spending because the cost would be offset by a one-percent reduction in reimbursement rates for standard power wheelchairs.
In their letter, which was signed by 44 of their House colleagues, Reps. Jim Langevin (D-RI) and Glenn Thompson (R-Pa.) noted that "providers unable to secure financing and prepare for this substantial change in reimbursement policy will be unable to continue to provide power wheelchairs, resulting in a loss of jobs, economic revenue, and beneficiary access to a physician-prescribed power wheelchair."
Furthermore, the bipartisan letter underscored the benefit to patients receiving power wheelchairs and the savings in Medicare spending.
"Furnishing power wheelchairs to Medicare beneficiaries saves the program millions of dollars a year by allowing vulnerable beneficiaries to remain safe and independent in their homes and communities," the letter said. "Without access to power wheelchairs, thousands of beneficiaries would face additional hospitalizations, home health visits and other clinical services due to falls and other injuries that occur because of compromised mobility. In addition, power wheelchairs often postpone or alleviate the need to place an individual in a long term care facility."
Consumer advocacy groups are also asking Congress to delay implementation of the policy. Congress has received letters from groups such as the United Spinal Association, American Association of People with Disabilities, National Council on Independent Living, National Spinal Cord Injury Association, Paralyzed Veterans of America and the Association for Programs for Rural Independent Living.
"We are very concerned about the affect this new policy would have on Americans with disabilities who depend on Medicare for their mobility assistance," said Kelly Buckland, executive director of the National Council on Independent Living. "The rental policy will be most devastating to people in rural areas who will have delays in receiving power wheelchairs or won't get them at all. We urge Congress to delay implementation of this policy, so that providers can make the necessary arrangements.
For more information about the issue, visit www.aahomecare.org/mobility.
The American Association for Homecare represents durable medical equipment providers, manufacturers, and other organizations in the homecare community. Members serve the medical needs of millions of Americans who require oxygen equipment and therapy, mobility assistive technologies, medical supplies, inhalation drug therapy, home infusion, and other medical equipment and services in their homes. The Association's members operate more than 3,000 homecare locations in all 50 states. Visit www.aahomecare.org/athome.
SOURCE American Association for Homecare