Decision doesn't solve repair woes, stakeholders say

WASHINGTON - CMS's decision to pay for repairs for capped rental DME provided by The Scooter Store and transferred to beneficiaries on Oct. 24 is a step in the right direction, but not a solution, industry stakeholders say.

“Before this, no provider could touch those chairs,” said Martin Szmal, founder of The Mobility Consultants. “Now providers can follow the same guidelines of any beneficiary-owned power wheelchair.”

CMS stated in a bulletin last week that Medicare would pay for repairs on or after Oct. 24, so long as contractors deem the repairs reasonable and necessary in accordance with Medicare regulations.

Stakeholders still worry, however, that audits down the road could result in providers having to turn around and return those payments to Medicare.

“It really makes no difference,” said Bob Miller, president of Hackettstown, N.J.-based Bach's Home Health Care. “Proving medical necessity is the first barrier; the second is, what happens if the original claim is audited and recouped? That's a lot of work and risk for a $100 repair.”

Michele Gunn agreed.

“This doesn't change how Browning's is going to do business,” said Gunn, a seating specialist at Orlando, Fla.-based Browning's Health Care. “If we didn't sell the wheelchair, we're not interested in repairs.”

A real solution will require policy changes, stakeholders say.

“They need to divorce the repair claim from the base,” said Peter Rankin, government affairs manager at AAHomecare. “CMS needs to act soon, because with providers going out of business because of competitive bidding, this problem is only going to get worse.”

In the meantime, former customers of The Scooter Store remain in a tough spot, says Alexandra Bennewith, vice president, government relations for the United Spinal Association, who was part of a group of stakeholders that met with CMS in November to discuss barriers to providing repairs.

“We're continuing to work on that issue with CMS and will be pushing to see if we can make changes,” she said.