WASHINGTON — Two congressmen are working to put the brakes
on elimination of the first-month purchase option for power
wheelchairs through a sign-on letter, but there is less than two
weeks to generate support.
Reps. Jim Langevin, D-R.I., co-chair of the Bipartisan
Disabilities Caucus, and Glenn Thompson, R-Pa., are leading the
congressional charge to delay elimination of the option for a year.
Mandated under the health care reform law, the measure currently
stands to be implemented Jan. 1, 2011.
The target date for the congressional letter, to be sent to the
chairmen and ranking members of the House Ways and Means and
Commerce committees, is Friday, Sept. 17.
"The industry needs to remain focused on reaching out to
legislators to educate them on why a delay in implementation is
necessary in order to preserve access to these products and
services and local jobs," said Seth Johnson, vice president of
government affairs for Exeter, Pa.-based Pride Mobility Products.
"We now have a letter to formally quantify the level of support for
the delay in the House, and a similar letter is expected to be
circulated in the Senate soon."
With elimination of the purchase option, mobility providers
would have to wait for 13 months before being fully compensated by
Medicare for a standard PWC (complex rehab chairs are exempt).
Payment in months one-three would be 15 percent of the purchase
price and 6 percent in the remaining 10 months. Hamstrung by the
floundering economy, which has basically caused financing to dry
up, most providers cannot make the sizeable cash outlay upfront
that a power wheelchair demands.
Without a delay, Langevin and Thompson point out, "this policy
will create significant access and quality-of-care issues as
providers of this equipment either struggle to make the significant
changes to their business model to adapt to a new payment model
that has the costs front-loaded with reimbursements from Medicare
spread over 13 months — or simply go out of business."
A one-year delay would allow providers to build up their rental
fleets and transition to the new system, the representatives
"Delaying implementation of this provision for one year will
give power wheelchair providers a much-needed transition period to
secure additional financing and adjust their business models so
that consumers will not see interruptions or reductions in access
to services," reads their letter to colleagues about the
The letter suggests the delay, estimated to cost less than $50
million, could be paid for by a 1 percent reduction to the Consumer
Price Index update to standard PWCs. Some stakeholders believe such
a delay might even be supported by CMS.
"We believe CMS is also open to a delay so they can make the
changes that are needed to implement this plan, and in a way that
is not going to jeopardize beneficiary access," Johnson told
HomeCare earlier. He said Friday the hope is for the delay
language to be inserted in legislation prior to Congress'
Johnson said a Medicare doc fix bill, which would remedy a steep
cut in physician reimbursement, is the primary vehicle that has
been identified for inclusion of the delay language, "but we have
been told there will be other opportunities as well."
One of the other opportunities, he said, could be what is known
as the "extenders bill," which covers certain tax provisions set to
expire this year and for which there is broad bipartisan support to
extend. That bill must be passed by Sept. 30.
Johnson said stakeholders including the American Association for
Homecare are actively courting not only providers but also
consumers and clinicians and urging them to educate their
representatives on the issue.
Already, several advocacy organizations have voiced support for
the delay, including the American Association of People with
Disabilities, Association of Programs for Rural Independent Living,
National Council on Independent Living, National Spinal Cord Injury
Association, Paralyzed Veterans of America and the United Spinal
Read the complete sign-on letter on the AAHomecare