The following was written by Mark Johnson and Marilyn Hamilton:

Power Wheelchairs: A Reality Check

Okay, so what’s the reality concerning your next power wheelchair?  What
changes has CMS made this past year and a half? It all began November 15, 2006, but really started Jan 2007, when all power wheelchair payments made by Medicare were reduced by 27%.

Now starting July 1, 2008 the same power chairs will be reduced again by
19%.  This additional payment cut by CMS is from Medicare’s National Competitive Bidding (NCB) program.

Now to the Reality Check

If a consumer received a chair back before these dates a supplier would have been paid, let’s say $8,000.00 for example.
For a consumer to be given that same chair today the dealer will receive $5,840.00.
Okay now, after July 1st because complex rehab was competitively bid – the amount will go down to $4,730.40.

So the BIG question is … Will a consumer get the same quality chair as
your last one? Well…when you look at the cold hard economics ….it is
impossible to imagine. Most likely you will be provided with a chair of
lessor quality and fewer features because of the dramatically reduced
payments. How can a supplier purchase, service and provide to a consumer
the same quality chair and features as before with these dramatic
reimbursement reductions. Consumers will get a wheelchair but it will not be comparable.

While Medicare went into competitive bidding saying that consumers would
receive the same quality products and services, it’s not possible. With 2
serious power wheelchair reimbursement cuts since January 2007 amounting to
over $3250.00 on a basic $8000.00 chair it’s not likely.

THE DOMINO EFFECT: So who does this affect? Just Medicare, right? NO…WRONG!

PRIVATE INSURANCE:

It’s important to know ….all other insurers mostly base their payments off of the amount that Medicare pays. Which means the dealer will be receiving less that the $4,730.40 from even private insurance companies.

Again, consumers will receive products that will not be of the same quality
and features as they received previously from Medicare or Private
Insurance.

NOW WHAT ABOUT DUAL Medicare and Medicaid?

Are they hurt by this program? YOU BET!

Medicaid is different in each and every state, however; few if any pay the
Medicare price and in most cases they can not pay more than the amount that
Medicare pays. SO…. Read below where the head of Medicaid policy in Ohio
says they will set their payment at about 20 to 25% below the Medicare
rate!!!! Now the dealer will receive for the $8,000.00 chair of a year and
a half ago a grand total of $3,547.80 as full payment for the item.

Remember the "DUAL" Medi-Medi can not pay nor can the dealer collect money
from that person and must accept this amount as payment in FULL!

Under the Medicare program a consumer (NOT A MEDI-MEDI) can choose to do an upgrade and pay for "deluxe" features and options.

So what this wonderful program has done is to "Cost Shift" to the consumer
for payment if they want to receive the exact chair they have today or,
they must accept a much lessor chair.

CONCLUSION:

Wheelchair technology advancements over the past 2 decades have made incredible leaps offering consumers amazing functional features and options
allowing them to live a more independent, productive lifestyle. Medicare
provides consumers only the features and options that are medically
necessary for them “In The Home”. With the 2 new reduced complex rehab
payment rates consumers will receive inferior equipment and decreased
services than previous wheelchairs. We are at a serious turning point for
the worse. This is criminal. Equally bad is that other third party
insurers base their payment off of Medicare. Is it time for you to voice
your concern????

NEXT STEPS:  What can you do?

1.    Tuesday, April 22 – Participate on the CMS CONSUMER CALL

Voice your Power wheelchair concerns
When: Tuesday, April 22, 2008
Time: 2:30- 3:30 p.m. EDT
Topics: Update on competitive bidding program for durable medical equipment, prosthetics, orthodics, and supplies (DMEPOS)
Policy experts: Will be available to answer questions.
Call-in procedures: Dial toll-free: 800-475-0456 (Please call in 15 minutes before the session begins)
Pass code: NMTP
http://www.cms.hhs.gov/NationalMedicareTrainingProgram/EmailUpdates/itemdetail.asp?filterType=none=-99=1=ascending=CMS1209880=10 <http://www.cms.hhs.gov/NationalMedicareTrainingProgram/EmailUpdates/itemdetail.asp?filterType=none&filterByDID=-99&sortByDID=1&sortOrder=ascending&itemID=CMS1209880&intNumPerPage=10>

2.   Tuesday, April 22 – Participate with NCART – Healthcare Industry
Call-in Day to your 2 Senators and Representatives from your state

Objective:  Help make 1000 plus calls to Congress in support of Obtaining an Exemption for Complex Rehabilitation and Assistive Technology Products (HR 2231)
Who:  Hosted by NCART – pulling together consumers, suppliers, clinicians, manufactures, family and friends to help
When:  Tuesday, April 22, 2008
Why: Consumers of complex Rehab need access to quality products and providers
Website:  http://www.ncartcoalition.org  (bottom left hand corner, enter your zip code to find senators and representative in your area)
Log Your calls:  Take a minute to log your calls on the NCART website.

3. HR 2231, http://www.govtrack.us/congress/bill.xpd?bill=h110-2231

4. What CMS Wants You to Know

http://www.medicare.gov/Publications/Search/Results.asp?PubID=11307=PubID=English=Home=NAV%7CHome%7CSearch%7CResults%7CSearchCriteria=13=default=IE%7C7%7CWindows+Server+2003.x=20.y=4 <http://www.medicare.gov/Publications/Search/Results.asp?PubID=11307&Type=PubID&Language=English&pagelist=Home&dest=NAV%7CHome%7CSearch%7CResults%7CSearchCriteria&comingFrom=13&version=default&browser=IE%7C7%7CWindows+Server+2003&go1.x=20&go1.y=4>