Clarification sends providers reeling

Friday, March 20, 2015

WASHINGTON – Providers are bracing for the fallout from CMS’s decision to apply competitive bid pricing for standard wheelchair accessories to complex rehab wheelchair accessories.

The plan would reduce payment rates by 20% to 40%, according to NCART.

“The hits just keep coming,” said Michelle Gunn, a seating specialist at Orlando, Fla.-based Browning’s Health Care. 

The industry first learned of the plan in an FAQ CMS released to clarify a final rule on the expansion of competitive bidding.

If the plan moves ahead, providers say the decrease in reimbursement will likely encourage consolidation.

“I think a lot of mom-and-pop companies will be more interested in selling,” said Gunn. 

The plan would also create confusion in states like Colorado, which has established a separate benefit for complex rehab within the DME category.

“It would negate the things we did at the state level, especially for dually eligible folks,” said Patrick Mahncke, owner and president of USA Mobility in Denver. 

The plan would also leave providers scrambling.

“There are no services left to cut,” said Gunn. “You either cut back on personnel or going out in the field. We’ve hit the floor and now we’re tunneling under.”