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On the Editor's Desk

by: Liz Beaulieu - Monday, January 25, 2010

I'm sure you read the brief in our NewsWire today about Fortune Magazine naming The Scooter Store one of the 100 best companies to work for in America. The magazine ranked The Scooter Store 38th, above companies like Microsoft and FedEx.

Here are a few other interesting tidbits on The Scooter Store from Fortune:

Here's what Fortune had to say about how it selected the companies:

To choose the 100 Best, we conduct the most extensive employee survey in corporate America. More than 81,000 employees from 353 companies responded to a 57-question survey created by the Great Place to Work Institute.

Liz Beaulieu

by: Liz Beaulieu - Thursday, January 21, 2010

ericaYou know, you really do learn about some cool things on Twitter. I saw this tweet from MagicWheels this morning:

T minus 48 hours before Erica Davis and the "Through the Roof" Kilimanjaro climbing and filming crew leaves for Tanzania. Today we shipped the new MagicWheels climb wheels—check them out!"

Who's Erica Davis, I thought? A Google search turned up this story. Erica is a 28-year-old paraplegic athlete, and she's planning to climb the 19,340-foot Mout Kilimanjaro to benefit the Challenged Athletes Foundation (supporting sponsors include MagicWheels and Colours Wheelchairs). She'll climb the mountain with help from a group of individuals, including Tara Butcher, a 27-year-old below the knee amputee. The the trip to Tanzania and the climb will be filmed and turned into a documentary titled "Through the Roof":

So cool. Good luck Erica and crew!

Liz Beaulieu

by: Liz Beaulieu - Wednesday, January 20, 2010

rhb-alpine-kid-and-fam2I wrote a story for the October issue about Alpine Home Medical Equipment's "Ride for a Reason," an event, in its second year, that raises money to provide children with new wheelchairs. The folks at Alpine sent me an e-mail last week letting me know that they delivered on their promise, outfitting 13-year-old Francisco Avila-Suarez with a new custom wheelchair. Suarez was diagnosed with cerebral palsy at birth. Because he didn't qualify for a new wheelchair through his insurance, he used a power wheelchair at school but only a manual wheelchair at home. That meant his father had to carry him over his shoulder wherever he needed to go outside of school. Alpine's "Ride" raised $10,000. The folks at Alpine also delivered a new wheelchair to 5-year-old Christian Tellez. Alpine's owner, Jay Broadbent, and his wife, Kristine, started a foundation called "B in Motion" to organize the ride each year.

Liz Beaulieu

by: Liz Beaulieu - Monday, January 18, 2010

Companies like Invacare and organizations like United Cerebral Palsy (UCP) have donated wheelchairs to help with relief efforts in Haiti, where a 7.0 magnitude earthquake devastated the country on Jan. 12. Invacare has donated 175 wheelchairs through MedWish International and UCP Wheelchairs for Humanity has donated 100 wheelchairs to Direct Relief International and 65 wheelchairs to Operation USA. The UCP doesn't want to stop there. It seeks donations so it can provide additional wheelchairs to the most vulnerable—children and adults with disabilities, and victims of the earthquake who have become temporarily or permanently disabled. Click here to help today.

Liz Beauileu

by: Liz Beaulieu - Friday, January 15, 2010

Industry stakeholders reported last week that they’re one step closer to stopping a provision in both the Senate and House healthcare reform bills that would eliminate the first-month purchase option for standard power wheelchairs.

The Congressional Budget Office (CBO) has determined that a “payment reduction alternative” that industry stakeholders helped to craft is budget neutral, says said Seth Johnson, vice president of government relations for Pride Mobility Products.

“As long as it’s budget neutral and as long as there are no other objections, it’s possible that this provision could be air dropped into the healthcare reform bill, effectively replacing the provision that’s currently in there,” he said.

The alternative proposes setting reimbursement rates for standard power wheelchairs for 2011-2014 at consumer price index-urban (CPI-U) less 3.5%. That means, for example, if the CPI-U were 2% in 2011, reimbursement would be negative 1.5%.

Stakeholders encourage providers to lobby their representatives and senators to support the alternative.

Liz Beaulieu

by: Liz Beaulieu - Wednesday, January 13, 2010

We continue to get heated feedback from our TV interview and our subsequent story in the January issue with Doug Harrison, CEO and president of The Scooter Store. First, we heard from "Angry Man." Today, we heard from a reader out in California. He sent us this letter to the editor:

Dear HME Editor:

I read with great curiosity the article in the January edition regard the Scooter Store, and Mr. Harrison’s various and obviously unrestrained and not fully thought out comments. I am still shaking my head in disbelief.

Does Mr. Harrison, in his infinite wisdom, really believe that a DME/HME company can really make a profit from being reimbursed $1,000 for a power wheelchair? Does Mr. Harrison sincerely feel that operating costs, both fixed and variable, in the coming years will be reduced to an extent to allow this? Does Mr. Harrison know something the rest of the world doesn’t?

Our industry has reduced its operating costs to the bone (at least smart providers have), and any room for further reductions is limited, at best. I highly doubt the manufacturers of power wheelchairs will be reducing their selling  cost to a level that would allow any level of profit on a $1,000 ($800 net from Medicare) reimbursement. Is he serious?

Anything lower than the current reimbursements levels will put additional strain on any DME providing power wheelchairs. Various cost studies (which one would assume Mr. Harrison is aware of) have shown that the current reimbursement level less standard operating costs of doing business with Medicare provides an average profit.

Lastly, to even imply that a $1,000 power wheelchair reimbursement could happen is irresponsible, misguided and undisciplined. Talk about leading a horse to water, in this case, CMS.

It’s not bad enough that the reason the industry is being subjected to these rampant audits of power wheelchairs is mainly due to utilization and over-exposure, for which we have only the Scooter Store and their ubiquitous commercials to blame.

Nice job, Mr. Harrison, of looking out for the best interests of our industry.

Liz Beaulieu

by: Liz Beaulieu - Tuesday, January 12, 2010

I had another eye-opening moment today when I read this commentary on Minnesota Public Radio's Web site (for more of these moments, go here and here).

In the commentary, the author, Haddayr Copley-Woods, talks about trying to maneuver the icy and snowy streets of Minnesota with a wheelchair. Even if a sidewalk is clear, the curb cut, where the sidewalk slopes into the street, isn't. Or if the curb cut is clear, it's only clear enough for a pair of feet, not a set of wheels. She wonders: "Why it is acceptable to clear things enough for some of us to pass, but not all?"

Copley-Woods answers that question with a powerful quote from disabled painter named Sunny Taylor:

"The disabled are viewed with sympathy as victims of 'bad luck' who will simply have to accept disadvantage as their lot in life, not as an identity group that is systematically discriminated against."

I don't know about you, but next time I'm shoveling, I won't skip the curb cut.

Liz Beaulieu

by: Liz Beaulieu - Monday, January 11, 2010

Since all the buzz in the wheelchair market these days is the recent OIG report, I thought it would be interesting to put together a rundown of recent OIG reports on power wheelchairs and another on the way:

October 2007: The OIG investigates how Medicare pricing for power mobility devices stacks up against Internet pricing (Read our story here).

September 2009: The OIG investigates supplier acquisition costs and services for power wheelchairs (Read our story here).

December 2009: The OIG investigates documentation error rates for power wheelchairs (Read our story here).

Up next: The OIG investigates the appropriateness of power wheelchair claims. “In addition to determining whether beneficiary medical records supported the medical necessity of the power wheelchair, OIG will determine whether documentation from the suppliers and prescribing physicians was consistent,” the December report stated.

Industry reaction: It’s one thing to review whether appropriate pieces of documentation were submitted or not; it’s another thing to review the medical records of physicians.

“Who at the OIG will determine medical necessity?” asked Don Clayback, executive director of NCART. “Will they have a medical background?”

Liz Beaulieu

by: Liz Beaulieu - Thursday, January 7, 2010

The steering committee working on a separate benefit for complex power wheelchairs expects to hold a Webinar for providers and manufacturers on Jan. 22 to discuss a new white paper detailing proposed changes. It also expects to hold Webinars for consumers and clinicians on Jan. 26 and 28, respectively.

“What the different work groups are working on now is taking concepts and making them specific changes,” said Don Clayback, executive director of NCART, earlier this week. “The group working on coverage and policy changes—they’re spending the most time doing that.”

The committee’s timeline also includes securing consumer support in February, finding legislative champions in March and developing legislative language in April and May. The committee plans to bring Avalere Health back into the fold to help it develop legislative and regulatory language. It contracted the consulting firm last year to identify its options for creating a separate benefit.

Liz Beaulieu

by: Liz Beaulieu - Wednesday, January 6, 2010

The legion of groups that represent wheelchair providers and manufacturers no longer includes the Power Mobility Coalition (PMC).

HME News called the PMC’s director, Eric Sokol,  this week and heard the following message: “You have reached the offices of the Power Mobility Coalition. The Power Mobility Coalition is now closed. For those who have inquiries regarding the PMC, please contact Steve Azia.” Azia, the PMC’s counsel, told HME News that the PMC has been closed for about a month.

“There are multiple organizations representing power mobility now, so it came down to industry consolidation,” he said.

Groups representing wheelchair providers and manufacturers include AAHomecare’s Complex Rehab and Mobility Council (CRMC), NRRTS, NCART and RESNA. Only the CRMC, however, represents standard power wheelchair providers and manufacturers; the rest represent mainly complex power wheelchair providers and manufacturers.

Another group, the Restore Access to Mobility Partnership (RAMP), closed in 2007 and rolled itself into the CRMC (then called the Rehab and Assistive Technology Council or RATC).

With a decreasing number of groups representing wheelchair providers and manufacturers, watch for the CRMC to gain power and play a bigger role, industry watchers said.

The PMC, which launched in 2000, made Medicare’s increasingly stringent documentation requirements its No. 1 priority. It also took on national competitive bidding.

“Over the years, we’ve testified before Congress and we’ve attended Open Door Forums,” Azia said. “We’ve done a lot to promote the power mobility benefit and to assure proper due process.”

Liz Beaulieu