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New Jersey Seniors and Disabled Policy Changes that Restrict Power Wheelchair Access in Medicare

  • Synopsis: Published: 2010-10-15 - Providers consumer groups and Medicare patients in New Jersey are asking Congress to ensure power wheelchairs continue to be available to Medicare beneficiaries. For further information pertaining to this article contact: American Association for Home-care.
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New Jersey's Seniors and Disabled Will Feel Impact of Policy Changes that Restrict Power Wheelchair Access in Medicare.

Providers, consumer groups, and Medicare patients throughout New Jersey are asking Congress to take steps to ensure that power wheelchairs continue to be available to Medicare beneficiaries. A series of regulatory and policy changes will hamper the ability of home medical equipment providers to supply quality products and services to Medicare beneficiaries.

A new law will end a Medicare patient's option to purchase a power wheelchair in the first month of use and will expand the flawed "competitive" bidding system. The program artificially limits the number of providers who can supply home-care medical equipment and will severely jeopardize access to power wheelchairs for seniors and those living with physical disabilities.

"Consumer organizations across the state representing senior citizens and people living with disabilities are concerned about the impact of these new measures," said Barbara Rogers, president and CEO of National Emphysema/COPD Association. "We need to ensure that New Jersey's seniors and people with disabilities continue to have access to mobility equipment that can dramatically change their lives for the better and actually save the government money."

Rogers said that power wheelchairs help Medicare beneficiaries perform critical daily activities, such as grooming, getting to the bathroom, and preparing food. She said the power chairs can delay admission in expensive nursing homes, while also reducing emergency room visits for Medicare patients, who are less likely to suffer injuries from falls when they have power wheelchairs.

"There must be broader recognition of the benefits of power wheelchairs," Rogers said. "America needs public policies that improve the quality of life for some of the most vulnerable people in our society, not new rules that restrict access to the medical equipment that they need."

In recent years, home-care equipment providers have been under siege from the changes in Medicare policies. Power wheelchair providers have endured reimbursement cuts of more than 35 percent over the last five years, while also experiencing excessive government audits and extended delays in reimbursement payments. Now the government is expanding the bidding program and eliminating the first month purchase option - two measures that will negatively affect providers and beneficiaries.

Under the new reimbursement policy, the government plans to pay providers rental payments over the first 13 months that a Medicare patient has a power wheelchair. This will create a cash-flow nightmare for large and small providers, slicing their cash-on-hand by 40 percent in the first year. Due to the struggling economy, providers are unable to obtain loans or credit lines that would allow them to purchase the equipment from manufacturers and do the necessary servicing so that Medicare beneficiaries have properly-adjusted equipment. Many Medicare patients would receive in stock chairs that haven't been specially fitted to address the individual needs of the patients.

Consumer groups, providers, and Medicare patients are asking Congress to delay implementation of the new policy for a year, allowing providers time to adjust their business models. The change is scheduled to take effect on January 1, 2011. The delay would be budget-neutral because providers have agreed to a one percent reduction to the Medicare consumer price index update for standard power wheelchairs.

Meanwhile, the bidding program for home medical equipment and services is scheduled to take effect in nine metropolitan areas in January 2011. An additional 91 areas including large portions of New Jersey are scheduled to start the bidding program later in 2011.

Yet, on September, 26, 166 bidding system experts and economists, including two Nobel laureates, sent a letter to Congress warning about major problems with the bidding system designed by Medicare. The experts concluded that the system will fail, citing the fact that the bids are non-binding, the rules encourage unsustainable low-ball bids, the design distorts bids, and the program lacks transparency. H.R. 3790, the bill in the House of Representatives with broad bipartisan support, would replace the bidding program with other types of cost savings but preserve patient access to mobility equipment. Organizations that favor elimination of this bidding program include the ALS Association, American Association of People with Disabilities, Muscular Dystrophy Association, National Council on Independent Living, National Spinal Cord Injury Association, and United Spinal Association, among others.

"The reality is that home-care equipment providers have reached the limit on cuts that they can endure and continue to provide quality products and services to Medicare patients," said Richard Lerner, president of Allcare Medical in Sayreville, NJ. "If these new measures are enacted as scheduled, it will be devastating for New Jersey Medicare beneficiaries and for communities where medical equipment providers will close their business and lay off workers. The last thing that America needs is policies that increase unemployment."

Lerner said that it is imperative that Congress act to ensure that Medicare patients can continue to benefit from power wheelchairs.

Richard Gaskin, 43, of Montclair, N.J., exemplifies the difference that a power wheelchair from Medicare can make in someone's life. Gaskin was injured 23 years ago and has been confined to a wheelchair since then. After years of using a manual chair, he got a power wheelchair in 2008.

"I couldn't get around in a manual wheelchair anymore," Gaskin said. "I was stuck in one place, and it was so difficult to get around. I needed someone to push me all the time. Now I have more independence. The power wheelchair does so much more for me. I can get around on my own and I don't have to wait for someone to push me from room to room."

The power wheelchair, he said, has made life much easier for him, his family and friends.

The American Association for Home-care represents durable medical equipment providers, manufacturers, and other organizations in the home-care community. Members serve the medical needs of millions of Americans who require oxygen equipment and therapy, mobility assistive technologies, medical supplies, inhalation drug therapy, home infusion, and other medical equipment and services in their homes. The Association's members operate more than 3,000 home-care locations in all 50 states. Visit www.aahomecare.org






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