Mobility at a Crossroad

Ask providers and manufacturers working in the mobility sector of the home medical equipment industry what it's like these days and you'll hear words such as “challenging,” “uneasy,” “chaotic” and “confusing.” Indeed, it is all those things.

In the past year, the power mobility market has been faced with a continuing and stepped-up fraud investigation by CMS; a new National Coverage Determination for mobility; the issuance, then the delay, of an Interim Final Rule; and new power mobility codes that were released last February, revised months later with the addition of more — then withdrawn entirely and are now being reworked.

President Bush added a new worry to the list with a proposal in his FY 2007 budget that would eliminate the first-month purchase option for power wheelchairs. And a Valentine's Day fact sheet from CMS asked physicians and other providers to hold off on submitting some PWC claims until April 1.

“With all the changes hitting this industry, it's amazing that anyone can keep up with it all,” says Jerry Keiderling, vice president of VGM's U.S. Rehab in Waterloo, Iowa.

Such fast-flying changes have thrust the power mobility sector into the greatest state of flux it's ever been in, stakeholders say. But perhaps the real question isn't where this sector of the marketplace has been or where it is — but where it's going.

TURNING POINT

From Dan Meuser's vantage point, the industry is at a crossroad. The president of Exeter, Pa.-based Pride USA says there are two paths the industry could choose — but only one will lead to success.

“The undesirable road is dark, full of potholes and bears no directional signage. This direction will reduce quality of care, quality of products and a reasonably consistent process,” Meuser predicts.

“Here, reimbursement levels and utilization will be controlled by ‘technical denials’, ‘gotcha’ audits (that may often come as a big surprise to the unsuspecting reputable provider), and untenable fee schedule cuts. Fraud will randomly rear its ugly head for the media's pleasure, and the exceeding displeasure of the professionals of our industry and CMS.”

But as with every crossroad, there is another path.