PMD reimbursement: 'Almost every chair we prescribe would be out of reach,' hospital says

Sunday, October 29, 2006

ENGLEWOOD, Colo. - One of the largest and most well-respected rehab hospitals in the country has added its voice to the din of manufacturers, providers and consumers fighting to stop CMS from slashing pricing for power mobility devices by up to 40%.

At a press conference last week, industry and disability representatives, as well as consumers, joined Craig Hospital officials in describing the negative impact of CMS's new fee schedule for power wheelchairs and scooters. The industry expects the agency to release a revised product classification list this week, but as far it knows, CMS still plans to implement the fee schedule Nov. 15.

"Craig Hospital has always tried to remain neutral, but this is really going to hurt patients," said Marlene Tiffany, general manager of Adaptive Equipment Co., a hospital subsidiary that provides equipment to patients. "It's time to take a stand."

About 45 people attended the press conference, including four local TV stations and newspapers. The hospital held the event in a show of solidarity to its spinal cord and traumatic brain injury patients, as well as providers who have indicated they won't be able to provide PMDs under the new fee schedule.

The hospital knows that, if providers follow through on their threat, it will have trouble finding appropriate equipment for its patients, Tiffany said.

"With this new fee schedule, almost every chair the hospital prescribes would be out of reach for patients," she said. "After all the work the hospital does, the patients are just going to relapse because they can't get the wheelchairs they need."

For Craig Hospital to throw its hat in the ring means a lot, said Dr. Robert Hoover, a former CMS medical director who spoke at the event.

"It's a further indication to CMS that this is a critical issue that's going to have a wide-ranging impact on the severely disabled population," said Hoover, who's the senior vice president of global clinical services for Sunrise Medical. "This is not an issue that's limited to the cries of manufacturers and providers."

Hoover said several other hospitals have also come out and supported the industry's efforts to postpone the fee schedule for PMDs: Kessler Memorial Hospital in Hammonton, N.J.; Shepherd Hospital in Atlanta; and Ranchos Los Amigos National Rehabilitation Center in Downey, Calif.