Capped rental: National companies brush by change

Friday, June 20, 2014

ROCKY HILL, Conn., and FRANKLIN, Tenn. – The capped rental rule will squeeze cash flow and generate more paperwork, national mobility providers say, but it’s not altering their strategies just yet.

The rule, which went into effect in April, requires providers to send claims to Medicare and secondary payers each month of a 13-month rental period to receive full payment.

“There may be a time in the future where we have to assess what products we put out the door,” said Kevin Harmon, vice president of finance for National Seating & Mobility (NSM). “We haven’t made that decision yet as a company how we’re going to approach that.”

Another impact of the rule: Although custom chairs require adjustments and fixes over time, providers aren’t paid for repairs, and should a patient pass away, the company is only paid for the rental up to that point, Harmon said.

Though the rental rule will affect cash flow, Numotion isn’t holding back.

“We have no plans to hold off on acquisitions,” said Spokesman Justin Richardson.

The rule shows Medicare doesn’t understand the needs of complex rehab patients, Richardson said.

“The mobility systems utilized by this portion of the Medicare population are not commodity type items and should not be treated as such,” he said. “This presents an entire set of unique circumstances never before experienced by this portion of the Medicare population.”

For example: A person with a purchased Group 3 power chair could end up using a rented replacement tilt actuator, or a person could be sitting in purchased seating system paired with a rented base.

The code most affected by the rule is E1161, an adult tilt-in-space wheelchair, which CMS says is a custom code, said Harmon.

“They’ve designated it custom, it requires a specialist evaluation and ATP involvement up front, and yet CMS has determined this should be a rented item, which really doesn’t make any sense,” said Harmon.