Impact of Health Reform on People Who Require Wheelchairs, Oxygen, and Other Types of Home Medical Equipment, from Cleveland Plain Dealer April 2, 201

Q: How will the health care reform bill affect the elderly and people with disabilities who use wheelchairs, walkers, oxygen and other medical devices? Will a new medical device tax in the bill make it harder for them to get needed equipment?

A: To help the government raise at least $2 billion yearly to subsidize insurance coverage for those who lack it, the reform bill establishes a new, 2.3 percent excise tax on medical device manufacturers that starts in 2013.

"I have no doubt that manufacturers and importers of medical devices will try to figure out ways to lessen the impact of this tax," says Peter W. Thomas, a Washington, D.C. attorney who specializes in disability and rehabilitation issues and reimbursement. "One of the key ways is to pass the costs onto consumers."

But Thomas predicts manufacturers may have some trouble passing the new tax along to end users because many of the devices are bought by big buyers like Medicare, Medicaid, the Veterans Administration and private insurance companies, that have established fee schedules for the purchases. He said medical equipment suppliers, who act as middlemen between the manufacturers and big buyers, could end up on the hook paying more.

Andrew Imparato, who heads the American Association of People with Disabilities, cautions that the tax could drain money from medical device makers that they'd otherwise spend on research and innovation. He hopes potential problems can be fixed before the tax goes into effect.

"On the balance we think there are more positives in the bill than negatives for people with disabilities, but we think it will do harm for consumers in terms of wheelchairs, prosthetics and the things they need," says Imparato.

The device tax and a competitive bidding program for medical equipment could put many home care providers out of business, says American Association for Homecare spokesman Michael Reinemer. That would make it harder for patients to get the services they need when leaving the hospital, he says.

United Spinal Association legislative director Andrew Morris adds that a provision that requires Medicare users to rent a power wheelchair for 13 months before they can purchase it may result in health problems for wheelchair users, like pressure sores or infections, from equipment that isn't custom tailored to their needs.

"Once a power wheelchair is fitted for someone, it can't just be put back on shelf and given to someone else," says Morris. "It takes time and money to do all that adjustment. If a person is renting a power wheelchair, it is possible it won't be fitted to their needs, which could cause secondary problems."

See full story at: http://www.cleveland.com/medical/index.ssf/2010/04/health_care_fact_check_the_imp.html