An Issue of Access

The situation is not exactly what HME providers projected during the last quarter of 2003 when they responded to HomeCare's annual survey on purchase intentions for the New Year. Then, there seemed to be no obstacles to growth in the power mobility market. Indeed, 48.9 percent of surveyed providers said power wheelchairs would be the fastest-growing product for their companies. And 17.8 percent were banking on power wheelchairs to account for their largest percentage of revenue growth in 2004.

But then, along came the government's “Operation Wheeler Dealer” and a clarification notice involving Medicare-covered power wheelchair and scooter claims. In the few months since, the unexpected turn of events has led the industry to a fight for beneficiary access — and business. New Braunfels, Texas-based The Scooter Store, the nation's largest provider of power wheelchairs and scooters, laid off 200 employees, blaming the move on the clarification notice. As payments in some areas slow, smaller providers are mulling their options.

Seeking relief, manufacturers, providers and industry organizations are clamoring for audiences with government entities. And just about everyone is asking, “What's the future for the power mobility industry and its beneficiaries?”

“It's hard to say what effect this will have on the mobility market. There's a lot of [concern] right now,” says Cara Bachenheimer, vice president of government relations for Invacare, Elyria, Ohio.

“The mobility market is in for a change,” predicts Sandra Hoskins, owner of American Medical Equipment Company in Houston.

“Power wheelchairs are profitable, there's no doubt about that,” states D. Rexford Maxey, president of Penn York Medical Supplies, Binghamton, N.Y. Nevertheless, he says, “we've had the discussion that we need to look at other things.”

FRAUD TAKES A TOLL

Circumstances changed almost overnight for HME dealers when the Centers for Medicare and Medicaid Services, in conjunction with Health and Human Services' Office of Inspector General, issued a 10-point initiative designed to curb fraud and abuse in the power mobility market. The nationwide crackdown came after reports surfaced of “rampant fraud and abuse” in the Houston area. Medicare paid for more than 31,000 claims for power wheelchairs in Texas in 2002, compared to 3,000 in 2001.