Stakeholders, CMS talk wheelchair repairs

Friday, November 22, 2013

WASHINGTON – When CMS agreed to a meeting to discuss ongoing issues surrounding power mobility device (PMD) repairs, the agency had a rude awakening, industry stakeholders say. 

“CMS seemed shocked at the convoluted nature of the repair side of things,” said Peter Rankin, government affairs manager at AAHomecare. “They were also under the impression that repairs were a profit driver for providers, when they’re actually a loss driver.”

On Nov. 14, stakeholders met with the CMS ombudsman, along with other officials by phone, to share the results of repair-related surveys conducted by AAHomecare and the United Spinal Association.

Among the results from AAHomecare’s survey: The number of providers repairing PMDs fell from 75% in 2012 to 45% in 2013; 52% of providers said they would not repair PMDs provided by other companies; and 40 of 74 providers said they’ve had repair claims recouped as the result of an audit on the original wheelchair claim.

Consumers who completed United Spinal’s survey reported abandonment issues and access problems, says Alex Bennewith, vice president, government relations, for the association. A big issue: If consumers need repairs to their wheelchairs but can’t access the original provider’s documentation, they must have another face-to-face exam with their physician, adding time to the process.

“The documentation for repairs needs to be streamlined,” she said. “Even a simple repair can take weeks of waiting, and, in the meantime, wheelchair users are stuck in their homes.”

Stakeholders had the following recommendations for CMS: allow beneficiaries to attest that they’ve been abandoned (instead of the current drawn-out process); “divorce” repairs from the wheelchair so providers can feel safe doing repairs without worrying their money will be recouped if the wheelchair is audited; and carve out repairs from competitive bidding to clear up confusion about what providers can and can’t do under the program. 

“This needs to be fixed immediately,” he said. “Any willing provider needs to be able to do whatever it takes to make the wheelchair operable.”

While CMS seemed open to changes, fully convincing the agency will require consumers continuing to complain, Rankin says.

“We need to make sure the drum beat continues,” he said.