PMD pricing: A glimmer of hope?

Sunday, October 15, 2006

WASHINGTON - There are signs that the rehab industry's efforts to stop CMS from slashing reimbursement for power mobility devices up to 40% are making an impression on legislators.

Industry sources report that key legislators met with CMS officials last week to discuss the agency's plan to implement new pricing Nov. 15 and the industry's concerns.

"(Legislators) presented our arguments and asked (CMS) for answers," said Sharon Hildebrandt, executive director of NCART. "It appears we have some friends on the Hill who understand us."

However, "We also know that CMS appears pretty firm that their prices are right," Hildebrandt acknowledged.

The industry believes the new pricing will force providers to lay off employees or shut their doors. The end result: Beneficiaries will no longer have access to appropriate power wheelchairs and scooters.

In addition to key legislators, the rehab industry has clinicians and consumers on its side. In a statement released last week, the American Association of People with Disabilities, the Clinician Task Force and the Independence Care System all came out against CMS's new pricing.

"The Medicare mobility benefit as we knew it is gone," stated Andrew Imparato, president and CEO of the American Association of People with Disabilities. "CMS has chipped away at the benefit over the last three years, and this latest step ensures that people living with disabilities will get little help from Medicare when they need a power wheelchair to remain independent."

AAHomecare's rehab council also sent CMS a letter last week outlining its "strenuous objections to drastic payment rate cuts." In the five-page letter, the council asks CMS to withdraw the new pricing and postpone the Nov. 15 implementation date.

CMS also plans to implement new codes and coverage criteria Nov. 15.