PFQC spotlights South Carolina

CHARLESTON, S.C. - It's a scenario that's likely playing out in competitive bidding areas (CBAs) across the country: Medicare beneficiaries that can't get the equipment they need.

Richard Drake, a retired businessman who suffers from hereditary neuropathy in both legs, which has left him unable to walk or stand, is one of those beneficiaries. Just prior to the July 1 start date of the program, he learned he qualified for a power wheelchair.

The problem: There isn't a local provider contracted to do Group 2 power wheelchairs, said Sarah Gassman Schultz, an occupational therapist and director of Charleston Home Health Agency, who has been working to help Drake get a power wheelchair.

“The next closest is in Savannah, Ga.,” Schultz said during a July 11 press teleconference hosted by People for Quality Care (PFQC). “I asked CMS what they were going to do, but they really didn't have any answers for me, so here we sit. We are scrambling now to find an out-of-state (supplier) for a piece of equipment he desperately needs.”

PFQC, the advocacy division of The VGM Group, hosted the teleconference to highlight concerns in South Carolina, which has several CBAs in Round 2. Mainstream media participating in the conference included the Charleston Post and Courier.

Because Savannah is about 150 miles from Charleston, Drake would have to travel by special ambulance—at a cost of more than $350—and then would have no local provider to service the equipment after he gets it.

“As a clinician, I have grave concerns about not being able to work with a local provider on a chair like this,” Schultz said. “It's going to require maintenance, batteries, adjustments. Our hands are tied; we do not have any options.”

The problems in South Carolina are the problems providers and beneficiaries are experiencing everywhere, says Kelly Turner, director of PFQC.

“The prices are artificially low—this means the quality of equipment and services to seniors and people with disabilities is dramatically lower than the past,” she said. “Also, winning providers were awarded contracts despite the fact that they are located far away from the beneficiary, in some cases over 1,000 miles away.”

Meanwhile, Drake is left using a manual wheelchair.

“I can't operate the chair myself,” he said. “I have a condition that causes me to rely on others to get me out of bed and move from room to room.”