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by: Liz Beaulieu - Thursday, September 3, 2009

In “Power Wheelchairs in the Medicare Program: Supplier Acquisition Costs and Services,” the OIG found that, in the first half of 2007, Medicare allowed, on average, $4,018 for standard power wheelchairs that cost suppliers $1,048. Medicare and its beneficiaries paid suppliers $2,970 beyond the acquisition cost to perform an average of five services and cover general business costs.

Medicare allowed, on average, $11,507 for complex power wheelchairs that cost suppliers $5,880. Medicare and its beneficiaries paid suppliers $5,627 beyond the supplier’s acquisition cost to perform an average of seven services and cover general business costs.

To perform the study, the OIG requested documentation from suppliers that showed what they paid for 375 standard and complex power wheelchairs. It also requested documentation of the services that they performed in conjunction with supplying the power wheelchairs. It did not, however, determine the cost of performing these services or other general supplier business expenses, such as billing, accreditation, staff salaries or facility maintenance.

Wait a minute...

Why didn't the OIG take the next step and determine the cost of services and business expenses? Since many of the industry's arguments for preserving reimbursement have to do with the cost (and importance) of the services providers furnish and the business expenses they have (especially compared to Internet providers), isn't that where the rubber hits the road?

Is that what the OIG's eyeing for its next missive? Are providers prepared to justify $2,970 per standard power wheelchair and $5,627 per complex power wheelchair to cover services and business expenses?

Liz Beaulieu

by: Liz Beaulieu - Tuesday, September 1, 2009

The folks over at Alpine Home Medical Equipment in Salt Lake City sponsored a bike ride traversing 80 miles and climbing 6,400 feet over the weekend to raise money to provide children with new wheelchairs.

The second annual "Ride for a Reason" raised about $8,500. Alpine already has two children in mind for new wheelchairs: one child has arthrogriposis multiplex congenital, a rare congenital disorder characterized by multiple joint contractures; and one child has muscular dystrophy. Both were recommended by the local Shriners Hospital for Children.

“There are some families that fall through the cracks,” said President Jay Broadbent. “This is our way of trying to help them out.”

Check out the October issue for the full story—and pictures!

Liz Beaulieu

by: Liz Beaulieu - Monday, August 31, 2009

Erika Bogan of North Carolina was crowned Ms. Wheelchair America 2010 last week. Bogan, from Huntsville, is working on a bachelor’s degree in psychology. She began using a wheelchair in 2002 after an automobile accident. The runners-up were: Kimberly Yeoman of Utah (fourth runner-up); Amber Marcy of Michigan (third runner-up); Alyson Roth of California (second runner-up); and Jannette Saxton of Washington state (first runner-up). Bogan succeeds Michelle Colvard of Texas, Ms. Wheelchair American 2009.

Wait a minute: A while back, I posted a blog about Kate Matelan of Pennsylvania being crowned Ms. Wheelchair USA 2010.

Ms. Wheelchair America

Ms. Wheelchair USA

Shouldn't these programs join forces?

Liz Beaulieu

by: Liz Beaulieu - Friday, August 28, 2009

[caption id="attachment_221" align="alignleft" width="150" caption="The Wheelchair Recycler"]The Wheelchair Recycler[/caption]

If NRRTS wants more consumers to participate in its CELA lobbying day on Capitol Hill, I think Simon Margolis should call David "The Wheelchair Recycler" Heim, who has been in a wheelchair since a car accident in 1995.

I first read about Heim in the Boston Globe earlier this year. The Jan. 29 article detailed how he had just re-opened his business repairing and refurbishing wheelchairs and providing them to people for affordable costs. He had temporarily closed the company because he didn't have the space or money to keep up with demand.

I read about him again this week in USA Today. It turns out that he has received grants from the Christopher and Dana Reeve Foundation and has moved into his own 1,000 square foot space. He even has vans to pick up donated chairs.

Heim has helped more than 500 people get wheelchairs since he started his company in 1998.

Don't you think Heim would have quite a story to tell lawmakers? Coverage for power wheelchairs is so poor—often insurance will only pay a fraction of the $5,000 to $25,000 price tag—that there's a need for someone like Heim, a need that he has a hard time keeping up with.

Liz Beaulieu

by: Liz Beaulieu - Thursday, August 27, 2009

It looks like rehab providers in California dodged a bullet. AAHomecare reported this week that the state's Medicaid program, Medi-Cal, no longer plans to contract out manual wheelchairs.

AAHomecare stated that the state met with manufacturers, providers and advocate groups in May. One of those providers: ATG Rehab. On its Web site, ATG Rehab states:

The event was a tremendous success and Medi-Cal took away a better understanding what we do each and every day serving our consumers.

For more details on the now-canceled program, click here.

Liz Beauileu

by: Liz Beaulieu - Wednesday, August 26, 2009

I'm curious about...

Remember when the contract winners were announced for the first round of national competitive bidding? Remember how The Scooter Store won 39 contracts, but only two of them were for standard power, its bread and butter. The  bulk of its contracts were for complex power, a market it had only recently entered; negative pressure wound therapy; and oxygen.

Both complex rehab (except Group 2 wheelchairs) and wound therapy have been carved out of Round 1.2.

How does that change The Scooter Store's strategy?

Liz Beaulieu

by: Liz Beaulieu - Tuesday, August 25, 2009

Here's a good example of the potential damage a consumer group can do (in this case, the AARP) when its views and the industry's views don't match up.

So, when I saw the news that the National Spinal Cord Injury Association (NSCIA) plans to poll wheelchair users on their ability to access appropriate technology and service, I thought: That's great; they're finally concerned that the average 27% reimbursement cut to power wheelchairs in 2006 and the 9.5% reimbursement cut in 2009 have affected access.

I spoke with Eric Larson, the NSCIA's executive director, this week. He is concerned about access, but he has no plans to jump into bed with the rehab manufacturers or providers. Here's what he had to say:

HME: So the poll is an effort by the NSCIA to add its voice to those of providers and manufacturers?
Larson: Exactly. It also addresses the need for more valid, objective data to enhance the argument.
HME: The rehab industry has long talked about strengthening its relationships with consumer groups.
Larson: We can’t align ourselves completely with the industry. In fact, we need to do the opposite—take a more independent stance and speak with a more independent voice.
HME: So how should the rehab industry and consumer groups work together?
Larson: The idea isn’t for us to become one, but for us to understand our strategic interests. We both need the same group of people to be healthy to fulfill our missions. We don’t need to agree with each other on everything—from time to time, I expect consumers will say things that those in the rehab industry aren’t going to be thrilled to hear—but 99% of the time, there’s enough alignment.

See the October issue of HME News for more.

Liz Beaulieu

by: Liz Beaulieu - Thursday, August 20, 2009

A few interesting things posted to the Web recently:

Jedi Mind, a company that develops thought-controlled technology, has launched a medical applications division. According to a release:

There are enormous opportunities in the medical field for products to make life easier for patients, such as people in wheelchairs and amputees. With the use of the wireless headset, a patient would be able to control his or her wheelchair with the power of their minds. Quadriplegics that currently control their mobility with use of their mouth and a joystick would be able to simply think the commands and move in the direction they were thinking. Amputees could control the use of robotic limbs through the power of their minds."

To date, Jedi Mind has been busy developing video games using the technology, but it has had "numerous enquiries" about medical applications. All of this is well and good, but the links for the company's Web site and its page on Pink Sheets don't work. Are they for real?

I've read articles before about organizations that collect used wheelchairs and loan them to people who need them. But the Bellingham Central Lions Club takes it to a new level. According to an article published in the Bellingham Herald in Washington state, the club loans about 2,000 wheelchairs a year. At any one time, it has 600 wheelchairs out on loan. That's a lot of wheelchairs! The club's customers include people waiting for their insurance to kick in. Do providers offer a similar service to their customers? To the public at large?

Liz Beaulieu

by: Liz Beaulieu - Tuesday, August 18, 2009

If you want a visual reminder of how frustrating it is to be a rehab provider these days, check out the cover of the summer issue of Directions magazine published by NRRTS.

The cover story, "Medicaid Madness," details NRRTS's decision to form a Medicaid Committee to "draw all the individual state Medicaid issues out into the open." The committee needs at least one NRRTS registrant and friend of NRRTS (FON) from each state to submit monthly reports, so the organization can aggregrate information and identify common themes.

Michelle Jackson-McMahan, NRRTS review chairwoman and president/CEO of Frontier Access & Mobility in Cheyenne, Wyo., will lead the committee. Contact her at medicaidmadness@nrrts.org to volunteer.

NRRTS believes: "If Medicare doesn't destroy complex rehab, Medicaid will."

Liz Beaulieu

P.S. Isn't this an initiative that NCART supposedly took on back in 2005?

by: Liz Beaulieu - Monday, August 17, 2009

So, we just sent our September issue to the printers last week, and after a long weekend of not really relaxing in Baxter State Park (primarily due to a trifecta of black flies, mosquitoes and noseeums), we're ready to start on the October issue. For the Rehab section, it looks like there's going to be a lot of follow-up news.

No surprise, there, when you think about all the issues still on the table. There are efforts to prevent the first-month purchase option for power wheelchairs from being eliminated. There are efforts to create a separate benefit for complex rehab. There are also efforts to create a specialty certification for wheeled seating and mobility.

On a state level, California is considering contracting for manual wheelchairs and Georgia is tinkering with how it pays for complex wheelchairs.

Here's one I haven't thought about in a while: There are efforts to revamp the manual wheelchair benefit.

Stay tuned.

Liz Beaulieu

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