Current Healthcare Bill Forces Patients to Rent Ill-Fitting Wheelchairs that Can Lead to Pain, Skin Sores and Loss of Mobility

The American Association for Homecare expressed dismay about the unwarranted, disproportionate, and harmful impact of the health reform bill on homecare patients and providers. The health reform bill passed by the House last night

Last night, the House of Representatives passed the sweeping health care reform legislation that had been passed by the Senate on December 24, 2009. This bill will now be signed into law by the president as early as tomorrow. The House passed the Senate bill (H.R. 3590) by a vote of 219-212 last night. The bill contains several negative provisions that will hurt HME.

“Unfortunately, this health reform bill contains several provisions that will disproportionately hurt homecare providers and homecare patients,” said Tyler Wilson, president of the American Association for Homecare.

“The bill accelerates the controversial ‘competitive’ bidding program for durable medical equipment, which simply creates a race to the bottom in term of quality of care for Medicare seniors and people with disabilities. The misguided bid program will actually reduce competition by putting most providers out of business, even if they agree to rock-bottom reimbursements. The healthcare bill also eliminates the option that Medicare beneficiaries currently have to purchase power wheelchairs as soon as needed instead of renting them.”


Current policy allows patients to purchase power wheelchairs in the first month the product is prescribed. If the health care reform bill passes unchanged and the first-month purchase option is eliminated, it will be very difficult for patients to have their power wheelchairs customized to their individual needs. Instead, patients will be forced to rent ill-fitting wheelchairs that can lead to pain, skin sores, loss of mobility and freedom.

“If Congress passes healthcare unchanged, power wheelchair users will suffer,” said Paul Tobin, President of the United Spinal Association. “While Congress may be happy with the very small cost reduction in Medicare, this short-sighted policy would come at an alarmingly high cost to Americans’ quality of life.”

A wide range of advocacy organizations support preserving the first-month purchase option, including:
The ALS Association,
American Association of People with Disabilities,
Association of Program for Rural Independent Living,
Consortium for Citizens with Disabilities, Easter Seals,
ITEM Coalition (Independence through Enhancement of Medicare and Medicaid),
Muscular Dystrophy Association,
National Council on Independent Living,
National Spinal Cord Injury Association,
Paralyzed Veterans of America, and
United Spinal Association.

Power wheelchairs—unlike most standard wheelchairs, intended for temporary use—are often prescribed to those with lifelong medical needs and therefore require a high degree of customization to ensure the individual’s quality of life, mobility and independence. Nearly all beneficiaries elect the purchase option because they live with long-term, debilitating conditions that require customized equipment to meet their specific life-long needs. Medical consequences of poor-fitting power wheelchairs include pressure wounds that are prone to deadly infection, increased pain, and decreased mobility. Those results often result in higher costs in the form of increased care, hospital stays, or admission to nursing facilities.

“Forcing the rental of custom-configured power wheelchairs will severely reduce patient access because many providers are unable to finance the costs associated with renting,” said Tobin. “The additional cost to Medicare of paying for the injuries resulting from poor-fitting power wheelchairs will more than cancel out any financial gains of implementing this change in policy.”