CMS Will Lessen Proposed Reimbursement Rate Reductions For Medicare Beneficiaries' Power Wheelchairs

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Rehabilitation / Physical Therapy
Article Date: 12 Nov 2006 - 7:00 PDT

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CMS officials on Thursday announced that the agency will reduce proposed cuts to Medicare reimbursement rates for some power wheelchairs and scooters, the AP/Houston Chronicle reports (AP/Houston Chronicle, 11/9). CMS in October announced that beginning Nov. 15, it would reduce Medicare reimbursements for power wheelchairs by about 35% to help offset a significant increase in program expenditures for the devices in recent years. Under the proposed policy, Medicare reimbursements for standard power wheelchairs would have decreased from the current rate of as much as $6,130 to about $3,800 (Kaiser Daily Health Policy Report, 10/11). Manufacturers, suppliers and advocacy groups objected to the original proposal, which they said would force wheelchair makers and suppliers out of business and hamper access for disabled beneficiaries. CMS had said the reductions were necessary to stop fraud and abuse and improve the accuracy of reimbursement rates for power mobility equipment (Carey, CQ HealthBeat, 11/9). A 2004 CMS study found that Medicare expenditures for the devices increased from $43 million to $1.2 billion in the eight years prior to the study (AP/Houston Chronicle, 11/9). However, CMS officials on Thursday said that they decided to revise the proposed reductions based on newer data "that reflects the full and complete manufacturer applications, test results and attestation."

New Rates
Under the new proposal, Medicare reimbursements for "Group 3" power mobility devices for the severely disabled will be between $1,000 and $1,700 higher than the rates listed in the original proposal. Reimbursement rates for "Group 2" devices, which include the most commonly provided standard geriatric mobility wheelchairs, will increase to about $301 more than the rate proposed in October, according to CQ HealthBeat (CQ HealthBeat, 11/9). Sharon Hildebrandt, executive director of the National Coalition for Assistive and Rehab Technology, said suppliers still will face significant reductions. For example, she said, Medicare currently pays $7,137 for one type of wheelchair, but the amount will decrease to $5,173 under the new policy. "There will still be an access issue," Hildebrandt said. CMS spokesperson Jeff Nelligan said the changes would reduce fraud while ensuring beneficiaries have access to appropriate power mobility devices (AP/Houston Chronicle, 11/9). Tara Raeber, advocacy communications specialist at the National Multiple Sclerosis Society's Public Policy Office, said the new policy for Group 3 devices is "a victory for the disability community" (CQ HealthBeat, 11/9).

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