Power Chair Medicare Benefit Threatened

Power wheelchair users urged to speak up to preserve first-month purchase option

by Quest Staff on July 10, 2009 - 9:32am

People who receive a power wheelchair through Medicare may lose the option to buy the chair immediately, under a proposed change to Medicare rules being considered by committees dealing with healthcare reform in the U.S. House of Representatives.

The proposed rule change would eliminate the first-month purchase option for power wheelchairs provided by Medicare, requiring all Medicare beneficiaries to wait 13 months before owning their chairs.

This extended period before ownership could lead to two problems for consumers, warns Annie Kennedy, MDA’s vice president of advocacy. It could result in fewer power wheelchair options being available to consumers from authorized providers, and in consumers losing access to their uniquely customized power chairs if they have to go into the hospital or other care facility during the 13 months before ownership.

MDA’s Advocacy program urges interested Medicare consumers to contact their representatives about the proposed rule change.

Consumers prefer owning to renting

Under current regulations, people who obtain a power wheelchair through Medicare have the option of buying the chair any time during the first month after it’s provided by a Medicare-authorized provider. If they chose to purchase during the first month, Medicare reimburses the provider at government-approved rates for the chair’s cost.

If Medicare beneficiaries don’t choose to buy the chair during the first month, then Medicare rents the chair for them from the provider for 13 months. The first day after the 13th rental month, title to the chair is conveyed to the beneficiary. During the 13-month rental period, the chair belongs to the provider.

More than 90 percent of Medicare beneficiaries choose the first-month purchase option because the chairs are highly customized for the users’ unique needs, and beneficiaries don’t want to risk losing them if they enter the hospital or other professional care facility during the 13-month rental period.

A Medicare beneficiary’s prescription for a rental wheelchair is temporarily “discontinued” while he or she is in such a facility, and the chair reverts back to the provider, who can pick it up and rent it to someone else. When the beneficiary leaves the care facility and needs another chair, his/her original rental chair may be no longer available.

Providers want to recoup their investment

Providers purchase all the chairs they sell upfront – an expensive investment. They’re accustomed to receiving full payment during the first month for about 90 percent of the Medicare-authorized power chairs they provide. If legislation removes the first-month purchase option, providers instead will receive their payments over 13 months for these chairs.

As a result, providers in many cases may be financially unable to maintain inventories of wheelchairs with a variable range of capabilities, says Kennedy. This means wheelchair users may find it difficult to obtain chairs that meet their specific needs.

‘Take 5’ and speak up

Kennedy urges everyone who could be affected by this aspect of the health reform package to contact their members of Congress and tell them it’s imperative to retain the first-month purchase option for wheelchairs as part of Medicare benefits.

Interested consumers can “Take 5” – five minutes -- and reach out to their local representatives by using MDA’s online advocacy tools at www.mda.org/advocacy, or by calling the U.S. Capitol switchboard at (202) 224-3121.

For more on this, see the MDA Advocacy Alert.

Your rating: None Average: 5 (1 vote)
MDA cannot respond to questions asked in the comments field. For help with questions, contact your local MDA office or clinic or email publications@mdausa.org. See comment policy