New fed wheelchair rules criticized

Users and suppliers of power wheelchairs for Medicare recipients predict devastating impacts from new federal rules that go into effect today.

Various industry and advocacy groups had sought a delay in the implementation of the new rules, which reduce reimbursement rates by up to 40 percent in some cases. The changes also include new eligibility requirements that could restrict, in some cases, a beneficiary's ability to qualify for a mobility device.

The Centers for Medicare & Medicaid Services declined to postpone implementation, but late last week the agency did refine the fee schedule, which was originally released in October to a huge public outcry.

Under the newest version, the reimbursement rate for the most commonly provided mobility chair went up $300, said CMS public affairs specialist Mike Fierberg.

For those who have fought against the new rules, however, the change was of little consequence.

"They threw us a bone is really what they did," said Jay Broadbent, owner of Alpine Home Medical in Murray.

The most recent alteration may allow most users to get a wheelchair, he said, but not the one they need for their specific needs.

"What they're trying to do is they're trying to cram everybody into one wheelchair," he said. "They're basically saying one size fits all, and they don't really care what the diagnosis is."

Wheelchair dealers, of which there are some 30 in Utah, worry they will no longer be able to afford to sell wheelchairs at the prices now required by Medicare. According to a recent study by the American Association for Homecare, the changes will drive some 1,500 suppliers out of the power mobility business.

CMS has spent several years considering the changes, prompted mainly by a 20-fold increase in the amount the government was paying for power wheelchairs, Fierberg said.

"The amount of money that we have spent on these devices have increased exponentially over the last 10 years," he said. "It's just been through the roof. It went from, like, $50 million 10 years ago to well over $1 billion last year."

With such dramatic cost increases, CMS also became worried about fraud, Fierberg said.

Users of power wheelchairs worry they will now have to bear more out-of-pocket costs for their devices, as suppliers are unlikely to decrease retail costs in concert with the Medicare change.

"What it means are people who are on fixed incomes will have to pay more," said Barb Toomer of the Disabled Rights Action Committee. "Those of us who need it, really, really need it, are being shafted."

Fierberg challenged the idea that the new rules would leave anybody without necessary equipment.

"That's not to say that the truly needy are going to be denied them; they're not," he said. "We want to make sure that they get the equipment that's appropriate for their needs, but we have a fiduciary duty to the taxpayers to make sure the price is fair."

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