CNN investigates Medicare reimbursement

Sunday, July 26, 2009

ATLANTA - CNN got it all wrong, industry stakeholders say, when it aired a piece on Medicare reimbursement for wheelchairs last week.

The six-and-a-half minute piece features Debbie Brown, a Sacramento, Calif., woman who uses a basic manual wheelchair due to an illness. It states Medicare paid Apria Healthcare $1,200 for her wheelchair, when an online provider sells the same chair for $440.

The piece then uses Brown as an example of why Medicare needs to change the way it pays for wheelchairs and other HME. The way to do that: national competitive bidding.

"These kinds of pieces are just distractions," said Michael Reinemer, AAHomecare's vice president of communications and policy. "They don't inform people of how Medicare really works."

Not coincidentally, industry stakeholders say, CNN aired the piece as AAHomecare and others lobby members of Congress to introduce a bill that would eliminate competitive bidding and include it in healthcare reform legislation. The program restarts Jan. 1, 2011.

What the piece fails to explain, industry stakeholders say, is that Medicare's rules have changed since Brown began using a wheelchair. It used to pay for wheelchairs under a 15-month capped rental period. At month 10, a beneficiary decided whether or not to purchase the chair; if he didn't purchase the chair, the agency paid a maintenance and service fee twice a year. Now Medicare pays for wheelchairs under a 13-month capped rental period. If medical need still exists after month 13, the beneficiary owns the chair and pays for service.

"CNN is giving the impression that ($1,200) is what Medicare pays today, when in reality, it pays about 60% of that," said Cara Bachenheimer, senior vice president of government relations for Invacare, the manufacturer whose is featured in the piece. "It's misleading."

Then there's the whole issue of comparing Medicare and Internet pricing for HME, industry stakeholders say. The industry has long argued that the two are apples and oranges because of the paperwork and service requirements required for Medicare beneficiaries.

When it comes to competitive bidding, the piece makes light of the concerns that industry stakeholders and members of Congress have with the way the program will roll out in 2011.

"We learned last year that the program isn't sustainable," said Tim Pederson, chairman of AAHomecare's Complex Rehab and Mobility Council (CRMC). "Yet we still have, essentially, the same program."