Medicare cuts hurt disabled

Manufacturers of power wheelchairs say coming Medicare payment cuts will force suppliers out of business and leave severely handicapped consumers out of luck.

The Centers for Medicare and Medicaid Services, the federal agency in charge of the Medicare program, recently announced that beginning Nov. 15, the maximum amount Medicare will pay suppliers for power wheelchairs will be around 35 percent less than what they currently receive.

Medicare now pays up to $6,130 for a typical power wheelchair. That amount will be reduced to around $3,800, a 38 percent payment cut.

Across the country, large and small suppliers of wheelchairs are concerned about the effect the payment cuts will have on their businesses and beneficiaries with severe diseases such as muscular dystrophy, cerebral palsy or spinal cord injury victims, who most often purchase power wheelchairs.

"It's clear we won't be able to supply the same products and service that we have in the past. These prices are just absurd. This policy change is motivated strictly by saving money, and does not take into effect the devastating effect it will have on the consumer, supplier or manufacturer. Someone should lose their job over this," said Jim Greatorex, president of Maine-based Black Bear Medical, a leading supplier of home medical equipment in the Northeast.

Invacare Corp., an Ohio-based company and the largest manufacturer of power wheelchairs in the country, has hundreds of millions of dollars at stake in the power wheelchair market.

"This is a devastating blow to rehabilitation providers across the country,"said Cara Bachenheimer, vice president of government affairs for Invacare. "Most suppliers do not have the kind of margins to sustain these cuts."

The effort to lower Medicare payments for wheelchairs started in response to a significant growth in expenditures for these items in recent years.

"Medicare was paying for the equipment at a much higher rate than what it was being sold for on the market and the beneficiary was paying a higher co-payment as a result," said Ellen Griffith, a spokeswoman for the Centers for Medicare and Medicaid Services. "The payment rates are now closer to their market rate and the beneficiaries will pay closer to what they should pay."

The new payment system creates a number of payment codes that are intended to more accurately reflect new technologies associated with modern home medical equipment. However, industry representatives, who worked with the Centers for Medicare and Medicaid Services on the new payment model, said the new payments will not cover the cost of some wheelchairs.

"For many years Medicare was paying one price for wheelchairs. For some chairs that was too high and for some it was too low.

"This new payment model does not pay higher for more complex equipment and is going to be done at the expense of beneficiary access to the equipment," said Ms. Bachenheimer.

The demand for power wheelchairs has gone up significantly as Americans age, home medical equipment suppliers said.

From 1995 to 2003, the latest year cost data is available, Medicare payments increased from $43 million to $1.2 billion, the Centers for Medicare and Medicaid Services reported.