Repercussions of competitive bidding delay

WASHINGTON--An expected 9.5% reimbursement cut associated with delaying national competitive bidding will most likely create access issues for Medicare beneficiaries, say providers of standard and complex power wheelchairs. Mainly, the Jan. 1, 2009, cut would force them to whittle down, once again, the different types of wheelchairs they provide. “I used to be able to go in and offer 20 different chairs and then narrow them down based on a patient's lifestyle,” said Jody Wright, president of Rocky Mountain Medical Equipment in Englewood, Colo. “Now I'm going to have to go in with one to three chairs. It's anti-rehab.” Providers of standard power wheelchairs already limited their product selection in 2006, when CMS slashed reimbursement, on average, by 27%. While providers of complex power wheelchairs escaped those cuts for the most part, they point out they already operate on razor-thin margins, anywhere from 2% to 6%, making a 9.5% cut a “real killer.” Providers and therapists expect the changes to go over like a lead balloon with beneficiaries. “They're going to ask us, ‘Why can't I just get the chair that I got last time? It has always worked for me; it's just worn out,'” said Mary Alice Cafiero, an occupational therapist. “It makes our jobs harder.” Because of the cut, providers will also shop around for better prices from manufacturers. But manufacturers have already raised prices this year, sources pointed out. Additionally, providers will batch repair tickets, increasing the wait time for beneficiaries; and conduct fewer at-home visits, making it more difficult for less mobile beneficiaries to get service, sources say. They may even consider layoffs. “It's not going to be business as usual,” said Jim Greatorex, president of Black Bear Medical in Portland, Maine.