Bidding and wheelchairs: ‘The system is not working’

Friday, August 2, 2013

YARMOUTH, Maine – Industry warnings of access problems due to Round 2 of competitive bidding are becoming a day-to-day reality for power wheelchair users.

Providers report users are facing extended wait times for equipment and little or no options for repairs due to contract suppliers that are out-of-state or who have no experience with wheelchairs.

All of this has left users turning to non-contract suppliers for help, says provider Bernie Hamann.

“Our phones are ringing off the hook,” said Hamann, owner of Rochester, N.H.-based Lakeside Mobility. “I’m not aware of any local suppliers that got contracts, and now people can’t get service. One of the winners told a patient they wouldn’t give them a wheelchair. They said, ‘If you’re not an oxygen patient, we’re not going to supply anything else.’”

The wait time for companies that will provide equipment is around two to three weeks, Hamann said. 

Hamann isn’t the only one hearing complaints. People for Quality Care reported July 30 that its hotline has received 1,000 complaints since Round 2 started, including a complaint from a patient in South Carolina who would need to take an ambulance to get a power wheelchair from a provider 160 miles away.

So what are patients to do? Not necessarily rely on out-of-state contract suppliers to hire subcontractors. A lot of the time, these deals just aren’t feasible, says provider Rick Perrotta. 

“With the lower reimbursement, you can do everything yourself, efficiently, and still find a way to sustain your business,” said Perrotta, president of Charlotte, N.C.-based Network Medical Supply. “If you have to pay a subcontractor, you’re going to be in trouble.”

Non-contract suppliers may be able to help with some things, like repairs, but contract suppliers are still on the hook for replacement parts like batteries, arm pads or brakes. That may be news to them, says provider Bob Miller. 

“Most of these bid winners didn’t have a clue what they were signing up for,” said Miller, president and CEO of Hackettstown, N.J.-based Bach’s Home Health Care. “(Contract suppliers) think anyone can do these repairs, but there’s a difference between repairs and replacement.”

Non-contract suppliers contacted by users are often left with only once course of action: Tell them to make their voices heard, says provider Doug Tarchalski.

“I got a call from a gentleman who needed a new scooter battery and the new company had been giving him the runaround for several weeks,” said Tarchalski, president of White Lake, Mich.-based Huron Valley Home Care. “I had him call the hotline. The system is not working for him.”


<p>I think it is fair to anticipate that there will be a whole host of problems, both predicted and unforeseen, when it comes to implementing any new system, espcially one on the scale of national healthcare. &nbsp;What have been the benefits of the competitive bidding system? &nbsp;It was intended to help prevent fraud and save Medicare heaps of money. &nbsp;Is it at least meeting those goals? &nbsp;</p>

Amy I do believe there were good intentions behind the ACA & competitive bidding. However, I feel one of the major obstacles is the government underestimated the potential problems a program like CB would cause--like eliminating smaller, locally operated companies whose costs of goods are generally higher than national providers. This led to elimination of access, compromising product quality and choices to beneficiaries. On the flip side I feel that CB was a drastic measure to also reduce fraud and abuse-- and not just reduce spending on claims.  As you well know, DME providers have been and will continue to make tireless (and expensive) efforts to secure the proper documents/records/patient Hx to show medical necessity. What's odd is, that this is not a new concept.  I came into the industry about 20 years ago working for a small, locally-owned DME provider, and was taught from day one about establishing medical necessity with documentation/records.  However, at that time, proving medical necessity just wasn't enforced as much--sort of like an 'honor' system.  As fraud/abuse began to threaten the sustainability for government funds and profitability for commercial carriers, policies to enforce the documentation requirements had to be strong-- also, they have to be enhanced on a continuous basis to keep up with evolving technology and to prevent future fraud/abuse.  CB has definitely reduced costs for government, but at what cost to the beneficiary?  And who's really to blame for all these drastic measures?