In a less-than-surprising finding by the Inspector General of the Department of Health and Human Services, power wheelchair prices paid by Medicare are higher than retail prices found on internet websites.
I find this incredibly troubling - not that Medicare is paying more than internet retail, but that the HHS IG believes that service levels of Medicare suppliers are equivalent to black-hole websites that will drop ship any piece of equipment to anyone without a proper fitting. Does the HHS IG understand how complicated a power wheelchair can be? Do they understand how essential the right wheelchair is to its user? There are many services that cannot be found over the internet which make this comparison ludicrous:
- Wheelchairs are customized pieces of medical equipment that can be detrimental to the user if improperly fitted. Pressure sores anyone??
- Medicare suppliers provide a range of services and supports that are unavailable from the comparison’s websites:
- Assistance with selection
- Customization for the patient’s individual needs
- Functional evaluation in the patient’s home
- Trial wheelchairs
- Wheelchair assembly, training and service
- Medicare codes are not a reliable indicator of equivalence. Different manufacturers assign the same Medicare code (HCPCS) to a wide range of wheelchairs with varying reliability, quality and performance.
If you would like to see the HHS IG’s full report: click here.
Finally, the folks at Independence Care Systems in New York City have taken issue with the IG’s report. Click here to see their letter to the IG, and click here to see the IG’s response.
Thank you to ICS’ Rick Surpin for taking issue with this report and its conclusions and for bringing it to the Council’s attention through Henry Claypool, ICS Director of Policy.
Integrity is not limited to brick and mortar operations only. There are good and bad dealers in both the virtual and real world. The issue of access to services is very real and important.
I think one of the solutions in Rick’s letter might resolve this in the Medicare process.
He suggests that Medicare get their best price and then establish separate contracts for pre and post support of the wheelchair and user. Good idea, and thank you VA for being a practitioner of this process.
Let’s assume that we are dealing with honest dealers both on and off line. That being the case, the source of the wheelchair no longer matters. Medicare could buy it were they prefer, low bid and all. The client/consumer would still get the local services that they required by way of the support contract.
Now, how to convince Medicare?