First-month purchase option: 'Positive development'

Sen. Max Baucus, D-Mont., unveiled a draft healthcare reform bill in September that included a provision to eliminate the first-month purchase option for power wheelchairs. But the news wasn't all bad.

Baucus and the Senate Finance Committee exempted complex power wheelchairs from the provision. They also moved the implementation date from 2010 to 2011.

“That essentially buys us 12 months,” said Seth Johnson, vice president of government affairs for Pride Mobility Products. “Clearly, we're still working to advance alternatives, but it's a positive development.”

Industry stakeholders are shopping around two alternatives: Front-loading payments in the first few months of what would become a 13-month capped rental period; or preserving the first-month purchase option, but allowing CMS to recoup payments for wheelchairs not used for 13 months.

Industry stakeholders say there's a “tremendous amount of concern” about the provision remaining part of healthcare reform legislation.

“The companies that already manage a rental fleet for manual chairs have a little bit of a handle on what it takes to manage a fleet,” said Julie Piriano, Pride's director of rehab industry affairs. “But the companies that don't—they have no idea what's involved with retrieving chairs, refurbishing them and then reissuing them.”

Providers like Tim Pederson say if the provision sticks around, they'll pull the plug on power wheelchairs for Medicare.

“I have no interest in owning a rental fleet of power chairs,” said Pederson, CEO of WestMed Rehab in Rapid City, S.D., and chairman of AAHomecare's Complex Rehab and Mobility Council (CRMC).

After complex power wheelchairs were dropped from the provision, the Congressional Budget Office (CBO) revised its “score”: Now it believes the provision would save $800 million over 10 years, not $900 million.