Medicare to Cut Wheelchair Payments (elder, America, Mary, service)

[retrorich]

On Medicare? Need a power wheelchair? Tough! Although our government has billions to waste on senseless wars and useless, redundant space programs, it opts to pinch pennies when it comes to health care for its elderly and disabled citizens.

Cuts in Medicare Reimbursements May Mean Fewer Suppliers to Provide Wheelchairs to Disabled Undated handout photo provided by WestMed Rehab shows WestMed Rehab Chief Executive Officer Tim G. Pederson, right, and his patient Daniel Vaughn in Rapid City, S.D.. (AP Photo/WestMed Rehab)10-19-2006 6:38 AM
By MARY CLARE JALONICK, Associated Press Writer
WASHINGTON -- Patricia Meier, a 63-year-old quadriplegic and Medicare recipient, needs to replace the wheelchair she has used for five years. Normally, Meier could simply use her Medicare benefits to replace the power wheelchair, which adjusts her position to prevent sores, with another one from WestMed Rehab Inc., a medical supplier near her home in Box Elder, S.D. But WestMed, along with several other suppliers across the country, says it will no longer provide power wheelchairs to most Medicare recipients after Nov. 15, when cuts in Medicare reimbursements go into effect.
WestMed planned an announcement on Thursday.
The Medicare changes are intended to eliminate widespread fraud identified by the Health and Human Services Department, which oversees the program.
WestMed, based in Rapid City, S.D., is the only major wheelchair supplier within 300 miles of Meier's home. Concerned about the prospect of wheelchair supplies ending in their state, South Dakota's congressional delegation pressed federal health officials for more information.
If Meier were to replace her chair without using Medicare, it could cost her between $17,000 and $20,000. With Medicare, she would pay only 20 percent of that.
"When I was able-bodied I bought cars cheaper than that," said Meier, who was injured in a car accident 20 years ago. "I don't know how I would be able to afford it."
With other suppliers saying they, too, won't be able to provide mobility equipment to many of their customers, those living with multiple sclerosis, spinal cord injuries and other conditions could be without the wheelchairs they need to get around.
Many wheelchair users "are going to have to pay out of pocket," said Tim Pederson, CEO of WestMed Rehab.
A 2004 study conducted by the HHS inspector general showed that Medicare reimbursements for certain power wheelchairs were far higher than the prices paid by consumers and suppliers. According to the Centers for Medicare and Medicaid Services, which administers both health care programs, expenditures for power wheelchairs increased by 2,705 percent between 1995 and 2003 _ from $43 million to $1.2 billion in just over just eight years.
Agency spokesman Jeff Nelligan said the increase is a "direct result of the excessive prices Medicare pays for these products."
Most suppliers have supported overhauling the system, as many companies have abused it. But they say the government has gone too far.
The changes "do eliminate the fraud and abuse, but it also eliminates the benefit," said Pederson of WestMed Rehab. "They are painting the entire industry in that broad brush, and they look at all of us as crooks."
Cara Bachenheimer, vice president of government relations for Invacare, the country's leading wheelchair manufacturer, said suppliers across the country have informed the company that they will be purchasing less equipment because of the reduced Medicare reimbursements.
Carol Gilligan, owner of Health Aid of Ohio Inc., said she will have to stop selling power wheelchairs altogether.
"There's just no way you can make a living," she said of the new reimbursements. "We have to change our business model."
Andrew Imparato, president of the American Association of People with Disabilities, said Medicare is not asking what is in the best interest of the patient.
"People are either going to have to figure out a way to finance them outside of Medicare, pay it out of pocket or just use their current chair until it breaks down," he said.
Several members of Congress have written to the agency in the weeks since the announcement. The entire South Dakota delegation sent a letter to the Health and Human Services Department on Wednesday asking for more information. Pennsylvania Sens. Arlen Specter and Rick Santorum, both Republicans, wrote the department last week asking for a delay in implementation of the new fees.
The Pennsylvania senators expressed concern about the payment formula used to calculate the reimbursements, noting that the formula does not always take current market prices into account.

Copyright 2006 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

[cardero]

I didn't even click into the thread and I just read your topic heading and my mind automatically went to those commercials about the power wheel chairs. We (toll collectors union) also received a sort of reduction in our health plans this contract. It seems that many providers are not willing to fill name brand drugs that doctor's perscribe in favor of the least costing genreic brands. And here I thought a pill was a pill. It's tough all around (except possibly Canada).

[Booko]

Originally Posted by cardero

I didn't even click into the thread and I just read your topic heading and my mind automatically went to those commercials about the power wheel chairs. We (toll collectors union) also received a sort of reduction in our health plans this contract. It seems that many providers are not willing to fill name brand drugs that doctor's perscribe in favor of the least costing genreic brands. And here I thought a pill was a pill. It's tough all around (except possibly Canada).

I worked in aspects of the healthcare industry for 15+ years, and there's a pattern that hasn't changed in all that time. The companies want to make more profits and so do the providers. So they play this endless game of Provider: "Here's the thing you need most" vs Reimbursement:"Oh, but we don't cover that" back and forth, like it's some kind of dance.

Yeah, a dance, kind of like Shiva's dance of destruction, with the patients stuck in the middle.

Our entire model of healthcare, like it's a "product," leads to this absurdity.

[Booko]

[quote=Booko]I worked in aspects of the healthcare industry for 15+ years, and there's a pattern that hasn't changed in all that time. The companies want to make more profits and so do the providers. So they play this endless game of Provider: "Here's the thing you need most" vs Reimbursement:"Oh, but we don't cover that" back and forth, like it's some kind of dance.

Yeah, a dance, kind of like Shiva's dance of destruction, with the patients stuck in the middle.

Our entire model of healthcare, like it's a "product," leads to this absurdity.

(The dance has been going on for even longer, though...remember Nixon introducing DRGs? Same thing.)

[jamaesi]

I could go on for days about how disabled people are treated in this country. It's crap.

[Flappycat]

Originally Posted by retrorich

If Meier were to replace her chair without using Medicare, it could cost her between $17,000 and $20,000. With Medicare, she would pay only 20 percent of that.
"When I was able-bodied I bought cars cheaper than that," said Meier, who was injured in a car accident 20 years ago.

Someone write a letter to Ford. This sounds like a money-making notion and a way to benefit the infirm in a swell foop.

[Jaymes]

Wow. I knew Medicare didn't care if you were poor and not old or popping out kids left and right, but now you're screwed if you're disabled and need a wheelchair, too.