WASHINGTON--Opposition to a recent Office of Inspector General report comparing Internet prices for power wheelchairs with Medicare reimbursements of the equipment continues to grow.
On Wednesday, Reps. Tom Allen, D-Maine, and Ron Lewis, R-Ky., sent a "Dear Colleague" letter to fellow House members blasting the report. "We find it inappropriate and misleading to compare those prices to the service delivery model for power wheelchairs under the Medicare program," the congressmen wrote.
Released Oct. 30, the OIG report found that Medicare's fees for PWCs were 45 percent higher than prices available on the Internet. For the first three months of 2007, the report said, the government could have saved nearly $40 million if its payments had been the same as those Internet prices. (See HomeCare Monday, Nov. 5.)
Subsequently, House Ways and Means Health Subcommittee Chairman Pete Stark, D-Calif., lauded the report in a letter sent to other representatives.
But the response from Allen and Lewis disputes the OIG's findings.
"There are extensive service-related costs associated with Medicare compliance that need to be considered in any comparison," the congressmen pointed out. "In particular, the Group 3 power wheelchairs available over the Internet cannot be customized to fit the individual needs of a person who is severely disabled ...
"Complex power wheelchairs (Group 3) need to be fitted, programmed and configured to fit the individual through extensive assessment and exact patient measurements. This can require multiple home visits as well as coordinating with a beneficiary's physical and/or occupational therapist. In addition, suppliers of Group 3 power wheelchairs employ specially trained staff knowledgeable in assessing and fitting these power wheelchairs to the unique needs of the beneficiary," the congressmen continued, noting that Internet providers are not required to provide any of these services.
Allen and Lewis are co-authors of H.R. 2231, which seeks to exclude complex rehab from competitive bidding. Bidding Group 3 chairs "can result in ill-fitting power wheelchairs and a decline in clinical outcomes and reduced function, independence and increases costs for the Medicare program and its beneficiaries who rely on these devices," their letter noted.
The American Association for Homecare sent its own letters to both Stark and Inspector General Daniel Levinson disputing the report.
"We firmly maintain that the cost of acquiring power wheelchairs used by Medicare beneficiaries through the Internet does not in any way compare to the cost of providing these devices to Medicare beneficiaries adhering to the appropriate standards of care," the Nov. 12 letters stated.
"Internet purchasing and the Medicare provider model are completely different ... Under Medicare, durable medical equipment providers must shoulder the expense of evaluating the beneficiary's specific needs, assessing the home, assembling the wheelchair, delivering the equipment to the home, conducting customized on-site fitting to accommodate the individual's seating needs, performing on-site training, processing claims for payments to insurers and maintaining facilities to provide service and repair.
"Any accurate analysis of costs required to provide the expected Medicare standard of care must take into account these services and administrative costs, which are distinct from the costs of acquiring the equipment," AAHomecare said.