Opposition Builds to OIG Pricing Report on PWCs
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.
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