Mobility stakeholders: Repair issues bigger than GAO says

Friday, May 9, 2014

WASHINGTON – The brief mention of repair issues in a recent Government Accountability Office (GAO) report on competitive bidding doesn’t speak to the severity of the problem, say mobility stakeholders.

“I think the GAO report brought some acknowledgement of the problems in the competitive bidding areas, but I think what we want to continue to focus on with CMS is that this is a broader problem requiring fixes not just in the competitive bidding program, but the Medicare program in general,” said Don Clayback, executive director of NCART. 

For example, when companies go out of business, beneficiaries should be allowed to sign a statement saying their previous provider no longer offers the services they need, clearing the way for a new provider to make repairs, said Clayback. And, certain diagnoses—like spinal-cord or brain injury—should be enough to establish ongoing need and not require repeated doctor visits, he said.

In its report, the GAO made this mention of repairs: “Although too soon to determine the full effects, The Scooter Store’s 2013 termination as a contract supplier could potentially result in access issues for beneficiaries residing in the CBP round 1 rebid competitive bidding areas.”

The collapse of The Scooter Store isn’t the only source of repair woes, but it is a big factor, says Martin Szmal, founder of The Mobility Consultants. 

“Providers are still dealing with those documentation issues when they feel the previous provider’s documentation does not meet their standards in regard to doing the repair,” he said. “The other thing, of course, is the competitive bidding rates in place for providers: Any Medicare provider can do a repair but they have to accept the competitive bidding allowable if the person resides in a competitive bidding area.”

The outcome of repair issues, in many cases, has been denied access. For providers, it’s often not worth backtracking to find out if the beneficiary really qualifies for the equipment that needs repair. 

“The best way, if you’re going to repair, is to help the person try to find another billing source or see if they can pay for it themselves,” said Jan Soderquist, CEO of Rehab Equipment Associates.

Unfortunately, the GAO report doesn’t make a big enough deal about repair issues to give stakeholders ammunition with CMS, says Peter Rankin, government affairs manager for AAHomecare.

“We’ve offered to help, we’ve offered some solutions and they are really unwilling to work with us on how to solve the problem,” he said. “I think being willing to work with us will begin with acknowledging the problem is bigger than they think it is.”