Healthcare reform plan whacks power wheelchairs

Sunday, June 21, 2009

WASHINGTON – Lawmakers fired a shot across the bow of the HME industry Friday, when the U.S. House of Representatives released a healthcare reform bill that calls for eliminating the first-month purchase option for power wheelchairs.

“It’s very disappointing to see the first-month purchase option in there,” said Walt Gorski, vice president of government affairs for AAHomecare. “The power wheelchair benefit has been hardest hit in the HME structure, incurring a 26% cut in 2007 and a 9.5% cut in 2009.”

The elimination of the purchase option applies to both complex and consumer power products, he said.

Gorski was poring over the House bill Friday afternoon, and from what he could tell, it did not call for cutting oxygen reimbursement. That does not mean oxygen lucked out.

There’s talk that a reform bill being crafted in the U.S. Senate may propose cutting oxygen reimbursement and eliminating the first-month purchase option. Senators apparently want to reduce reimbursement for stationary oxygen to pay for a slight increase in reimbursement for portable oxygen. The net impact, however, would be a decrease in oxygen reimbursement, sources said.

To reform the U.S. healthcare system and expand coverage to nearly 50 million uninsured, lawmakers must come up with $1 trillion dollars over 10 years through a combination of spending cuts, tax increases and other offsets.

“We are being told that everyone is on the chopping block this year,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “It’s going to be a tough year.”

Eliminating the first-month purchase option for power wheelchairs would create all kinds of problems for providers and, ultimately, decrease access for beneficiaries, said Seth Johnson, vice president of government affairs for Pride Mobility Products.

“There’s no way providers in the business today can change their business model to accommodate a mandatory rental policy,” he said. “The fact of the matter is, more than 90% of Medicare beneficiaries choose the purchase option because they have long-term debilitating conditions.”

Johnson expressed hope that those points might help persuade lawmakers not to eliminate the first-month purchase option to help pay for healthcare reform.

Industry watchers do not expect the Senate to release its version of a reform bill until after July 4. The Senate and House will then have to work out their differences before sending a final bill to President Barack Obama, most likely toward the end of this year.

“This is what I view as the most significant threat to the industry this year,” Johnson said. “We need to gear up.”