Will power wheelchairs continue to be available to Nevada’s Medicare patients following a series of federal regulatory and policy changes?
There are grave concerns among consumer groups, Medicare beneficiaries and homecare equipment providers in Nevada that the changes in Medicare policies may severely hamper the ability of providers to supply quality products and services to beneficiaries.
One of the biggest threats is a new law establishing that the Medicare program will pay rental payments over a 13 month period to homecare equipment providers after they supply power wheelchairs to Medicare beneficiaries. The change will create significant cash flow problems for providers, who will be forced to purchase the equipment from manufacturers, and then receive reimbursement payments stretching over 13 months. Previously, Medicare beneficiaries could request that the government purchase the equipment for them in the first month of use.
“We fear that the Medicare mobility benefit won’t be available for the people who need it because there won’t be providers around to fill the power wheelchair prescriptions once doctors order them for their patients,” said Corrie Herrera, rural director for the Northern Nevada Center for Independent Living in Elko, Nevada. “Our organization, as well as others across the state who represent people living with disabilities, feel that the Washington policymakers don’t understand how much a power wheelchair means to the people who need them. We must ensure that Medicare patients continue to have access to this equipment.”
Herrera said physicians prescribe power wheelchairs to patients needing assistance with critical daily activities, such as grooming, getting to the bathroom and preparing food. By continuing to perform these tasks in their homes with power wheelchairs, Herrera said it often delays the necessity of placing beneficiaries in expensive nursing homes. Mobility assistance also reduces emergency room visits for Medicare patients, who are less likely to suffer injuries from falls.
Jason Turner, 43, of Las Vegas, said his power wheelchair has made a dramatic difference in his life. Turner, who has multiple sclerosis, said he has used a power chair for a dozen years. “It is like getting my legs back,” said Turner. “I can help my daughters with their homework; and I have the freedom and independence to go wherever I need to go.”
Moreover, Turner said that he is relieved not to be a “burden” on anyone because he can do so many things for himself. “I hope that power wheelchairs remain available for other Medicare beneficiaries,” he said. “Being mobile changes your life.”
But in recent years, changes in Medicare policies have significantly impacted providers, hampering their ability to supply quality home medical equipment and services to Medicare beneficiaries. Over the last five years, the Medicare program has cut reimbursements for power wheelchairs by more than 35 percent. At the same time, the providers are experiencing excessive government audits and extended delays in reimbursement payments.
The new rental reimbursement policy will slash providers’ cash-on-hand by 40 percent in the first year. Because of the struggling economy, providers are unable to obtain loans or credit lines that would allow them to purchase power wheelchairs from manufacturers and do the necessary servicing so that Medicare beneficiaries have properly-adjusted equipment. Many Medicare patients would receive chairs stored in warehouses that haven’t been specially fitted to address the individual needs of the patients.
To read the full story, click here or visit www.aahomecare.org/mobility for more information about this issue.
Friday, November 5, 2010
Thursday, November 4, 2010
Round One Bid “Winners” Finally Announced as New Questions Arise about Flawed Program
The Centers for Medicare and Medicaid Services announced winners of Round One of the “competitive” bidding program. The overdue announcement leaves little time to make the required administrative and operational changes before the January 1 implementation. Those changes relate to regulations including “grandfathering” notifications to patients, subcontracting arrangements, and changes in company ownership. Medicare beneficiaries have received little information to date about the coming changes.
Click here to see the full list of bid winners.
Meanwhile, another study, by Cal Tech economics professor Charles R. Plott, outlines the severe design flaws in the bidding system. The new study concludes that the fundamental flaws in the Medicare bidding system will prevent any “quick fix.” A draft report of the study dated October 2010 concludes that:
• Good auction architectures for procurement applications do exist.
• The proposed Medicare supplies auction is not a good procurement auction. It is based on an inappropriate architecture that cannot deliver services at competitive rates and qualities.
• The Medicare supplies auction architecture cannot be adjusted in some simple way. There is no “quick fix”. The two central pillars of the auction are flawed. First, the price determination by the median accepted bid is not an appropriate method for determining price. Second, the ability of bidders to cancel bids is an inappropriate guide for competitive bidding strategies.
See the full study here.
This adds to the argument made by 166 economists and auction experts, including two Nobel laureates, who have urged key congressional leaders and committees in Congress to scrap the system and start over. Click here to view letters.
Click here to see the full list of bid winners.
Meanwhile, another study, by Cal Tech economics professor Charles R. Plott, outlines the severe design flaws in the bidding system. The new study concludes that the fundamental flaws in the Medicare bidding system will prevent any “quick fix.” A draft report of the study dated October 2010 concludes that:
• Good auction architectures for procurement applications do exist.
• The proposed Medicare supplies auction is not a good procurement auction. It is based on an inappropriate architecture that cannot deliver services at competitive rates and qualities.
• The Medicare supplies auction architecture cannot be adjusted in some simple way. There is no “quick fix”. The two central pillars of the auction are flawed. First, the price determination by the median accepted bid is not an appropriate method for determining price. Second, the ability of bidders to cancel bids is an inappropriate guide for competitive bidding strategies.
See the full study here.
This adds to the argument made by 166 economists and auction experts, including two Nobel laureates, who have urged key congressional leaders and committees in Congress to scrap the system and start over. Click here to view letters.
Monday, November 1, 2010
Mobility Matters: Power Wheelchairs Change the Lives of Medicare Beneficiaries
Ten years ago, Keli Babcock faced a crisis. A medical condition was affecting her legs and her lungs, requiring that she use a ventilator. She couldn’t walk or even maneuver a manual wheelchair. Mobility had become a difficult challenge.
But Keli wasn’t about to give in, she aspired to accomplish much in life. The Medicare program provided the teenager with a power wheelchair, one that is powered by batteries and includes equipment that allows a ventilator to ride along with her.
Keli is supported by her loving family, but with the power wheelchair she was able to care for herself and not be dependent on others. She can get to the bathroom, prepare meals and perform other daily necessities of life in her home.
What transpired exemplifies the impact that a power wheelchair can have on someone with limited mobility: Medicare helped vastly improve Keli’s quality of life. With the mobility issues mitigated, Keli went on to achieve many of her goals, as well as give back to her community. Keli finished high school, and then earned a Bachelor’s Degree in Social Work from Weber State University.
“I wouldn’t have been able to accomplish much without the power wheelchair,” Keli says. “It has made a tremendous difference in my life. I can move around my home, I work, and I’ve been able to travel. None of those things would have happened if it weren’t for the power wheelchair that Medicare provided.”
Keli, now 27, works at the Tri-County Independent Living Center in Ogden, where she helps patients with mobility limitations overcome their challenges. “I tell people my story, and what I have had to overcome, and hope it will inspire them,” says Keli, who a year ago was crowned Ms. Wheelchair Utah for 2010. Her winning platform was: “You are unique. Live it. Love it. Rock it!”
And Keli reiterates the importance of her power wheelchair: “My wheelchair has meant everything to me. It means so much when people are able to gain more freedom and independence from mobility assistance.”
Around the country, there are thousands of power wheelchair users who are just as thankful to Medicare for providing the mobility assistance they depend on. But in Washington, it certainly seems that the Medicare mobility benefit is undervalued. Far too often, when Congress or the Administration searches for budget cuts, the Medicare mobility benefit is the target. It’s unfair that some of the most vulnerable Americans—senior citizens and people living with disabilities, bear more than their share of sacrifices.
Due to a series of pricing, policy and regulatory changes, there is widespread concern about whether power wheelchairs will continue to be available for Medicare patients after their doctors prescribe mobility assistance. There also could be lengthy delays before wheelchairs are delivered.
These circumstances will result from decisions to eliminate a Medicare patient’s right to have a new power wheelchair purchased for them in the first month that they receive it and a badly flawed procurement “bidding” program that will reduce the number of providers in specific locations rather than create competition. Many home medical equipment providers and consumer advocates have asked Congress to take steps to ensure that these policy changes won’t restrict Medicare patients’ access to power wheelchairs.
If prescriptions for power wheelchairs can’t be filled in a timely fashion, it’s clear that many Medicare beneficiaries, people like Keli Babcock, as well as senior citizens and patients with medical conditions that severely limit their mobility, will suffer in the future. Thousands of Americans depend on their Medicare power wheelchairs. Power wheelchairs can prevent Medicare beneficiaries from suffering injuries from falls, delay placements in expensive nursing homes and allow patients to age gracefully in their homes.
Richard Gaskin, of Montclair, N.J., suffered injuries 23 years ago that limited his mobility. Until a few years ago, Richard was able to maneuver a manual wheelchair. But eventually, he no longer had the strength to do it and constantly needed help from family and friends.
Today, he is grateful that in 2008 Medicare provided him with a power wheelchair that has changed his life.
“I couldn’t get around in a manual wheelchair anymore,” Richard says. “I was stuck in one place, and it was so difficult to get around. I needed someone to push me all the time. Now I have more independence. The power wheelchair does so much for me. I can get around on my own.”
Jason Turner, of Las Vegas, also depends on his power wheelchair. Jason says his power wheelchair has made a dramatic difference in his life. Jason, who has multiple sclerosis, received a power wheelchair though Medicare 12 years ago. “It is like getting my legs back,” Jason says, adding that it is so much easier to perform simple tasks at home such as helping his young daughters with their home work. “I have the freedom and independence to go wherever I need to go.”
Just as importantly, Jason is relieved not to be a burden on his family and friends because, with his power wheelchair, he can do things for himself.
Tyler Wilson, president of the American Association for Homecare (AAHomecare), says Washington policymakers should hear the stories of people like Keli, Richard and Jason.
“Far too often, policies and regulations are concocted in Washington by people who don’t fully understand the impact that their actions will have in places like Ogden, Montclair and Las Vegas,” Wilson says. “The Medicare mobility benefit has successfully allowed many people to overcome physical challenges that limit their mobility. It has kept Medicare beneficiaries out of hospital emergency rooms by reducing their falls and helps increase their mobility in their homes and their communities.”
Policymakers, says Wilson, should recognize the value of mobility assistance to those who need it.
“We need policies and regulations that help people increase their mobility,” Wilson says, “not measures that restrict access. That’s going in the wrong direction.”
To learn more about mobility issues, please visit www.aahomecare.org/mobility.
But Keli wasn’t about to give in, she aspired to accomplish much in life. The Medicare program provided the teenager with a power wheelchair, one that is powered by batteries and includes equipment that allows a ventilator to ride along with her.
Keli is supported by her loving family, but with the power wheelchair she was able to care for herself and not be dependent on others. She can get to the bathroom, prepare meals and perform other daily necessities of life in her home.
What transpired exemplifies the impact that a power wheelchair can have on someone with limited mobility: Medicare helped vastly improve Keli’s quality of life. With the mobility issues mitigated, Keli went on to achieve many of her goals, as well as give back to her community. Keli finished high school, and then earned a Bachelor’s Degree in Social Work from Weber State University.
“I wouldn’t have been able to accomplish much without the power wheelchair,” Keli says. “It has made a tremendous difference in my life. I can move around my home, I work, and I’ve been able to travel. None of those things would have happened if it weren’t for the power wheelchair that Medicare provided.”
Keli, now 27, works at the Tri-County Independent Living Center in Ogden, where she helps patients with mobility limitations overcome their challenges. “I tell people my story, and what I have had to overcome, and hope it will inspire them,” says Keli, who a year ago was crowned Ms. Wheelchair Utah for 2010. Her winning platform was: “You are unique. Live it. Love it. Rock it!”
And Keli reiterates the importance of her power wheelchair: “My wheelchair has meant everything to me. It means so much when people are able to gain more freedom and independence from mobility assistance.”
Around the country, there are thousands of power wheelchair users who are just as thankful to Medicare for providing the mobility assistance they depend on. But in Washington, it certainly seems that the Medicare mobility benefit is undervalued. Far too often, when Congress or the Administration searches for budget cuts, the Medicare mobility benefit is the target. It’s unfair that some of the most vulnerable Americans—senior citizens and people living with disabilities, bear more than their share of sacrifices.
Due to a series of pricing, policy and regulatory changes, there is widespread concern about whether power wheelchairs will continue to be available for Medicare patients after their doctors prescribe mobility assistance. There also could be lengthy delays before wheelchairs are delivered.
These circumstances will result from decisions to eliminate a Medicare patient’s right to have a new power wheelchair purchased for them in the first month that they receive it and a badly flawed procurement “bidding” program that will reduce the number of providers in specific locations rather than create competition. Many home medical equipment providers and consumer advocates have asked Congress to take steps to ensure that these policy changes won’t restrict Medicare patients’ access to power wheelchairs.
If prescriptions for power wheelchairs can’t be filled in a timely fashion, it’s clear that many Medicare beneficiaries, people like Keli Babcock, as well as senior citizens and patients with medical conditions that severely limit their mobility, will suffer in the future. Thousands of Americans depend on their Medicare power wheelchairs. Power wheelchairs can prevent Medicare beneficiaries from suffering injuries from falls, delay placements in expensive nursing homes and allow patients to age gracefully in their homes.
Richard Gaskin, of Montclair, N.J., suffered injuries 23 years ago that limited his mobility. Until a few years ago, Richard was able to maneuver a manual wheelchair. But eventually, he no longer had the strength to do it and constantly needed help from family and friends.
Today, he is grateful that in 2008 Medicare provided him with a power wheelchair that has changed his life.
“I couldn’t get around in a manual wheelchair anymore,” Richard says. “I was stuck in one place, and it was so difficult to get around. I needed someone to push me all the time. Now I have more independence. The power wheelchair does so much for me. I can get around on my own.”
Jason Turner, of Las Vegas, also depends on his power wheelchair. Jason says his power wheelchair has made a dramatic difference in his life. Jason, who has multiple sclerosis, received a power wheelchair though Medicare 12 years ago. “It is like getting my legs back,” Jason says, adding that it is so much easier to perform simple tasks at home such as helping his young daughters with their home work. “I have the freedom and independence to go wherever I need to go.”
Just as importantly, Jason is relieved not to be a burden on his family and friends because, with his power wheelchair, he can do things for himself.
Tyler Wilson, president of the American Association for Homecare (AAHomecare), says Washington policymakers should hear the stories of people like Keli, Richard and Jason.
“Far too often, policies and regulations are concocted in Washington by people who don’t fully understand the impact that their actions will have in places like Ogden, Montclair and Las Vegas,” Wilson says. “The Medicare mobility benefit has successfully allowed many people to overcome physical challenges that limit their mobility. It has kept Medicare beneficiaries out of hospital emergency rooms by reducing their falls and helps increase their mobility in their homes and their communities.”
Policymakers, says Wilson, should recognize the value of mobility assistance to those who need it.
“We need policies and regulations that help people increase their mobility,” Wilson says, “not measures that restrict access. That’s going in the wrong direction.”
To learn more about mobility issues, please visit www.aahomecare.org/mobility.
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