Bush's PWC proposal: 'It would be difficult to sustain'

Sunday, February 25, 2007

WASHINGTON - Industry stakeholders have kicked off their campaign to defeat President Bush's proposal to eliminate the first-month purchase option for power wheelchairs.

NCART, NRRTS and other stakeholders submitted written testimony last week to the Ways and Means Committee arguing that the proposal, part of Bush's 2008 budget, would decrease access to appropriate power wheelchairs. If providers have to rent out the equipment and wait 13 months for reimbursement, they'll be forced to provide generic equipment that might not meet the needs of beneficiaries, they argue.

"Because of its involved nature--the assessments, the mix-and-match components--there's a large up-front cost associated with providing these types of chairs," said Sharon Hildebrandt, NCART's executive director. "Not being able to recoup those costs for 13 months would be difficult for providers to sustain."

Simon Margolis, NRRTS's executive director, agreed: "Manufacturers would have to allow providers 13-month terms. It would become an installment payment not a rental. It would be devastating."

This isn't the first time the proposal has reared its head. Bush included the proposal in his 2007 budget, and it made it into a proposed Senate Medicare spending package last year. Ultimately, six industry allies in the U.S. Senate, including Sens. George Voinovich, R-Ohio, and Rick Santorum, R-Pa., crafted an amendment that removed the proposal.

In its written testimony, NRRTS pointed out that CMS has already turned the rehab industry upside down in recent years by doing everything from requiring face-to-face evaluations to implementing new codes, coverage criteria and pricing.

"Due to significant upfront costs and increased costs resulting from recent policy changes, Medicare beneficiaries will lack adequate access to power mobility devices if a 13-month rental is required," NRRTS stated in its testimony.

The proposal, if enacted, wouldn't even save the government money, industry stakeholders say, because it would end up paying 105% of the allowable over 13 months.

On a fundamental level, the proposal just doesn't make sense, said Cara Bachenheimer, vice president of government relations for Invacare.

"There's a false belief out there that there are short-term users of power wheelchairs," she said. "But if you meet the criteria for a power wheelchair, you have a lifetime need for a power wheelchair. It's a misunderstanding."