Year in review: Capped rentals, repairs, bundling and bungling

Friday, January 23, 2015

Though I’ve only held this post for four months, after reviewing this year’s list of top mobility stories, there is one trend that stands out—even to a newbie: Providers are fed up with CMS.  

The No. 1 mobility story in 2014 was “CMS didn’t think through capped rental change, providers say,” which outlined CMS’s plans to make 78 codes for complex rehab equipment capped rental items, including manual wheelchairs with tilt-in-space and power assist. Because only certain parts of the wheelchair would be a capped rental item—the others purchased—providers wondered what exactly they would be retrieving: parts of the wheelchair or the wheelchair itself?

When those complex rehab items transitioned to capped-rental status in “Capped-rental rule takes effect,” some providers waited for CMS to scrap it, some reassessed which products they carried and which manufacturer they purchased them from, and some stopped offering power-assist devices all together. 

Repairs were also a popular topic this year. When CMS said it would pay for repairs for DME provided by The Scooter Store in “Decision doesn’t solve repair woes, stakeholders say,” industry leaders feared that future audits could send those payments right back to Medicare. 

Though 2014 held few silver linings for providers, they were encouraged when CMS said providers could repair wheelchairs without having to obtain the original documentation from the original provider (“CMS applies ‘logic’ to documentation requirements for repairs”). Erring on the side of caution, stakeholders encouraged providers to continue obtaining medical records for items they didn’t initially provide. 

Rounding out the list of this year’s top 5 stories, “CMS’s proposal oversimplifies wheelchair provision.” CMS’ proposal to implement bundled monthly payments for standard manual and power wheelchairs, which would require providers to submit a single bid for each HCPCS code, including accessories and repairs, left stakeholders on edge.