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Wheelchair funding to be cut

| Source: rockymountainnews.com

1025chair_oTo combat fraud, Medicare reducing reimbursements

There is no question that Keith Copen needs his motorized wheelchair. The 59-year-old is paralyzed from the thighs down and the chair helps him shop, get to his van, and travel over snow and ice.

But for the tens of thousands of seniors who got Medicare to buy them motorized scooters in recent years, the benefit is less clear.

Now the government is cracking down on fraud and abuse in wheelchair industry, and Copen might pay the price.

“Without this kind of chair, I can’t operate,” he said Tuesday.

Many wheelchair suppliers, including several in Denver, will no longer provide power wheelchairs to Medicare recipients after Nov. 15, when dramatic cuts in Medicare reimbursement go into effect.

“(The chairs) are just going to be out of reach, unfortunately, for these people who need them so badly,” said Marlene Tiffany, general manager of Adaptive Equipment Company, which is owned by Craig Hospital, an Englewood Rehabilitation and research center for patients with spinal cord injury and traumatic brain injury.

Medicare is planning to cut reimbursement for power wheelchairs on average 22 percent, and as much as 40 percent in some cases.

The changes were a reaction to a 2004 study conducted by the Health and Human Services Inspector General. It found that Medicare paid far more for certain wheelchairs than consumers and suppliers, at times $6,000 for a wheelchair that cost $1,000.

Also, between 1995 and 2003, the amount Medicare paid for power wheelchairs increased from $43 million to $1.2 billion.

“We’re cutting back only what we can call rampant fraud and abuse,” said Mike Fierberg, a spokesman for the Centers for Medicare and Medicaid Services.

The government took nine months to craft its new reimbursement schedule, which defines 56 categories of wheelchairs.

The changes were aimed at making it more difficult for moderately disabled seniors – people with “the dizzies and wobblies” – to get government-paid wheelchairs.

The severely disabled won’t be affected because “by and large, the more complex the chair, the smaller the impact of these (reimbursement) changes,” Fierberg said.

Suppliers, advocates and manufacturers agree that the payment system needs to be overhauled. But they say the government has gone too far, and will hurt severely disabled patients who rely on custom, complex chairs.

Patients with cerebral palsy, spinal cord injuries and muscular dystrophy need special chairs. The arm rests, head rest, joy stick and foot rests are specially fitted to match a person’s needs. The chairs’ suspension systems cushion curbs.

Suppliers say they will no longer stock such high-end chairs, since they’ll lose money selling them.

“For Keith, his only option is to go to a lesser chair,” Tiffany said.

Longmont-based Sunrise Medical, the No. 2 manufacturer of power wheelchairs in the U.S., will trim research and development, and be forced to push manufacturing overseas, said Sunrise’s Dr. Robert Hoover.

“We can certainly build chairs that can meet the new specifications,” Hoover said. “But I don’t think it’s a chair you’d want to put your family member in.”

By Rachel Brand, Rocky Mountain News
Copyright 2006, Rocky Mountain News. All Rights Reserved.

2 COMMENTS

  1. I have a child who uses a very specialized power chair and it is the main thing that gives her the quality of life she is accustom to. She attends Public school, plays in the band, attends church and a host of community activities. If she was not the recipiant of this “hi-tech” chair she would be home bound and isolated. This is a travesty against the most voulnerable citizens. Individuals with severe physical disabilities can be productive, happy members of our society at large if we give them the appropriate tools. When these tools are taken away so are the rights and indeed the very LIVES of these PEOPLE!

  2. I can’t get the chair I need under the new funding, I have to settle for
    next best, being a inside chair and one that does not elevate, so I won’t
    be able to reach anything to cook. That is pretty rotten over some seniors
    who got Huberound who can walk with walkers but rather have a power chair
    because it easyer to go in a huerround then use a walker. We real disabled
    have to pay the price.
    I was wondering did Europe,Canada cut funding for persons in wheelchairs who
    can’t walk or is this a U.S.A. problem? Just wondering if it is just U.S.
    disabled who will pay the price for hoveround for seniors waste who can
    walk on walkers and even cains.

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