Medicare Cuts To Wheelchair Reimbursements Prompt Opposition From Lawmakers, Suppliers

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Rehabilitation / Physical Therapy;  Public Health
Article Date: 24 Oct 2006 - 20:00 PDT

email to a friend   printer friendly   view / write opinions

Lawmakers from several states recently criticized Medicare cuts that will change reimbursement rates for power wheelchairs, the AP/Columbia State reports. The changes, which will take effect Nov. 15, are intended to eliminate widespread fraud identified in a 2004 study by HHS. According to CMS, expenditures on power wheelchairs increased by 2,705% from $43 million to $1.2 billion between 1995 and 2003. Agency spokesperson Jeff Nelligan said the increase is a "direct result of the excessive prices Medicare pays for these products" (Jalonick, AP/Columbia State, 10/19). In a letter sent Oct. 13 to HHS Secretary Michael Leavitt, six Ohio House Democrats wrote that such reimbursement cuts would hurt "patient access for those most in need, as well as dramatically impacting small businesses in our communities and across the country" (CQ HealthBeat, 10/18). On Wednesday, the entire South Dakota delegation sent a letter to HHS requesting additional information about the cuts. In addition, Pennsylvania Sens. Arlen Specter (R) and Rick Santorum (R) last week requested that HHS delay the change, citing concerns about the payment formula, which does not always account for current market prices (AP/Columbia State, 10/19). Suppliers based in Ohio also have asked Rep. Deborah Pryce (R-Ohio) and House Majority Leader John Boehner (R-Ohio) to halt the payment changes, which they say will cause layoffs, close businesses and affect those with disabilities (CQ HealthBeat, 10/18). Tim Pederson, CEO of supplier WestMed Rehab, said the changes "do eliminate the fraud and abuse, but it also eliminates the benefit." WestMed and other retailers have said they will no longer be able to provide power wheelchairs to most Medicare beneficiaries after the Nov. 15 changes are instituted (AP/Columbia State, 10/19).

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.