Growing Contingent Opposes Wheelchair Prepayment Review Project

The American Association for Homecare and a growing contingent of home medical equipment providers and consumer advocates are calling on Congress to stop a controversial Medicare “prepayment” demonstration project that jeopardizes access to power wheelchairs for beneficiaries with disabilities and threatens to cause significant job losses.

The Centers for Medicare & Medicaid Services (CMS) project is supposed to start Jan. 2 and would require “prepayment review” for all Medicare power wheelchair claims in seven states – California, Florida, Illinois, Michigan, New York, North Carolina and Texas. AAHomecare says the project, which was unveiled in a surprise announcement Nov. 15, is will affect nearly half of all Medicare beneficiaries who require power mobility.

“We are calling on Congress to stop this demonstration project before it prevents older Americans and people living with disabilities from receiving medically required mobility equipment and causes irreparable harm to providers of home medical equipment and services,” Tyler J. Wilson, president and CEO of AAHomecare, said in a release from the organization last week. “Members of Congress should be worried about the impact of this program on many of the most vulnerable people in our society.”

Wilson said it was “inconceivable” that CMS would start this project while power mobility users and providers are still struggling to adjust to a 13-month rental reimbursement policy for mobility equipment that was implemented last January.

The United Spinal Association said the project will endanger people living with disabilities who need mobility assistance. “The process for receiving a power wheelchair has already become burdensome for Medicare beneficiaries and their physicians,” said Paul Tobin, president and CEO of the organization. “There are parts of the country where Medicare patients have to do business with reluctant providers who are hundreds of miles away. This demonstration project will make it harder for them to receive the wheelchair they need for everyday mobility.’’

Providers and manufacturers predicted the project will cause major job losses in states where providers go out of business and where manufacturers adjust to the reduced demand.

Medicare officials say the initiative is necessary to prevent fraud, claims errors and improper payments. HME industry authorities say there are better, less destructive ways to deal with those problems.