Purchase option faces peril

WASHINGTON - The rehab industry in late July tried but failed to "knock out" a provision that would eliminate the first-month purchase option for power wheelchairs. The House of Representatives passed a bill Aug. 1 that eliminates the option as part of an effort to expand the State Children's Health Insurance Program (SCHIP). At press time in early August, however, the industry was lobbying members of the Senate to eliminate the provision in conference. Last year, a group of senators, including Sens. George Voinovich, R-Ohio, and Rick Santorum, R-Pa., removed the provision from a spending package. "We're doing everything we can," said Seth Johnson, vice chairman of AAHomecare's Rehab and Assistive Technology Committee (RATC) and vice president of government affairs for Pride Mobility Products, who worked Capitol Hill. "I'm still confident that there are opportunities to knock out this provision." The Congressional Budget Office (CBO) estimates that eliminating the purchase option for power wheelchairs would save CMS $600 million over five years. Groups like NCART and NRRTS have e-mailed alerts to more than 1,000 providers and manufacturers, urging them to lobby their representatives to pressure the chairmen of the Ways and Means and Energy and Commerce committees to eliminate the provision. "The same day we sent out the alert, I got back 20 responses from people who had jumped on it right away and contacted their representative," said Simon Margolis, executive director of NRRTS. "More people have to get off their butts. They have to believe that when industry leaders tell them to do something like this, they have to. We don't ask them unless there's good reason." Here's what's at stake: If Congress eliminates the first-month purchase option, fewer providers will supply power wheelchairs, reducing beneficiary access, industry sources say. "I know the providers who I've spoken to in South Dakota are not willing to rent power wheelchairs," said Tim Pederson, CEO of WestMed Rehab in Rapid City, S.D., and chairman of RATC. "It would mean paying for wheelchairs up front and waiting longer to get paid. We're not getting paid adequately, anyway. We take no pleasure in the idea of no longer serving those clients, but it's a bad deal. The economics would no longer play out." Additionally, based on information received from the SADMERC, the industry argues that nearly 100% of beneficiaries who need power wheelchairs purchase them upfront. "People purchase complex power wheelchairs on day one because they know they'll need them for a long time," said Sharon Hildebrandt, executive director of NCART. "Also, the chairs can't be used by anyone else." Some wonder how much longer the rehab industry "can dodge the bullet." Attempts to implement the provision go back two years. That's why Pedersen spoke about the importance of protecting the first-month purchase option at a July 26 event in Rapid City celebrating the 17th anniversary of the Americans with Disabilities Act. Similar events took place nationwide. "(Rep. Stephanie Herseth Sandlin, D-S.D.), our representative, can expect a lot of feedback after that event," he said.