The Realities of Wheelchairs and Medicare

Statement by Madonna Long

“The public would be better served if policymakers left their desks in Washington and met with us in our homes, where every day is a struggle.”

I have been in a wheelchair since being severely injured in a school bus accident as a teenager. For many people like me who live full lives with physical disabilities, the durable medical equipment provider who supplies mobility devices is one of the most trusted people in our lives. The equipment and service they provide keep us out of hospitals and nursing homes.

So it’s frustrating to see unfair accusations leveled at these providers. A small group of criminals who have posed as legitimate equipment providers have tainted the reputations of the many dedicated, hard-working wheelchair providers, like the ones I know. The bad guys, who are scamming the Medicare system, aren’t part of the durable medical equipment community; they are criminals who deserve to be locked up.

The media often focuses on the price that Medicare pays to provide power wheelchairs to its beneficiaries, but reporters frequently overlook the fact that the cost of mobility assistance is determined by a patient’s functional needs and the specific equipment and accessories required to address their unique physical conditions. Furthermore, the people who get power wheelchairs from Medicare don’t have them to cruise to the shopping mall. They can’t walk. The power wheelchair brings back their mobility. Oftentimes, it is the difference between living independently and being confined to a nursing home or other care facility.

It has been 30 years since I became a member of the wheelchair club. My life is no joyride. My manual wheelchair is a necessity. When I get out of bed in the morning, it helps me safely begin my day. I have to transfer from the bed to the wheelchair, and with one wrong move and I can fall to the floor, possibly injuring myself. The next challenge is getting dressed. It’s hard to accomplish when sitting in a wheelchair. Then, I must maneuver to the bathroom to groom and to the kitchen to prepare breakfast. None of this would be possible without a wheelchair. All of those tasks are even more difficult for those whose physical limitations require them to use a power wheelchair.

We do not choose to join the wheelchair club. But it’s our reality. We try not to whine about our circumstances because for many of us, it is just the way our life is.

Yet, we hear accusations that providers are delivering power wheelchairs to Medicare beneficiaries who don’t really need them. Nothing could be further from the truth. Data clearly shows that typical Medicare beneficiaries who receive power wheelchair prescriptions from their doctors are 70 years or older and suffer from chronic diseases, like COPD, diabetes, arthritis and heart disease. Their physicians have written the prescriptions because the patients need power mobility assistance so they can remain independent in their homes and groom, go to the bathroom, prepare food and do the other daily necessities of life when a walker or manual chair isn’t sufficient.

Wheelchairs are life-changing devices for the people who need them. It’s hard to understand why the federal government continues to add more and more barriers for Medicare beneficiaries to receive power wheelchairs. Over the years, policy changes ranging from reimbursement cuts, the so-called competitive bidding process, elimination of the first-month purchase option and other polices have made it difficult for suppliers to provide quality equipment and services. Surveys indicate that more and more home medical equipment providers are choosing not to sell power wheelchairs because of all the challenges presented by the government.

There must be more consideration of how these policies impact real people and families. As the number of providers decline, so does access to care and equipment, especially in rural areas where small businesses serve wheelchair users who are spread over vast areas.

It’s easy for bureaucrats to pronounce spending on power wheelchairs as “government waste,” even as the devices help to reduce overall healthcare costs and provide Medicare beneficiaries with the ability to live independently in their homes. The public would be better served if policymakers left their desks in Washington and met with us in our homes, where every day is a struggle. In all the congressional hearings on Medicare spending, rarely are the beneficiaries given a voice. What lawmakers would hear is passionate pleas for independence and dignity from some of the most vulnerable people in our society.

We may be overlooked. But we won’t go away. Mobility assistance allows us to embrace the spirit that our nation was built upon – it gives us freedom and independence.

Madonna Long, who has spent decades working on behalf of people living with disabilities, is a consumer advocate for Pride Mobility Products Corp.