Power Play

At least for the short term, it appears that HME has escaped additional cuts from Congress.

The good news for manufacturers and providers of power wheelchairs is that they enter 2008 without further reduced reimbursements and with the first-month purchase option intact. The bad news is that industry attempts to get legislation passed that would alleviate the effects of competitive bidding have so far been unsuccessful, including getting complex rehab and assistive technology exempted from the program.

What will this year bring? Certainly a continuation of 2007's battles and challenges. But despite the uncertainty, most manufacturers seem confident that the market will eventually stabilize, and that strong providers will survive its changes.

It's Been a Tough Year

For manufacturers and providers of power wheelchairs, the biggest problem may simply be not knowing what's going to happen.

“It's been a down year in power, and it's all due to everybody being unsure of where the market's going to go because of competitive bidding and all of the changes that they keep putting on us,” sums up Les Brandeis, director of sales for Merits Health Products.

DuWayne Kramer, president of Leisure-Lift, shares that sentiment. The market is “still in kind of a state of uproar,” he says, “with providers not knowing exactly what CMS will do next. They are reviewing their business to see what's most effective and most profitable.”

Another big problem for providers is documentation requirements. In 2006, CMS' issued a new power mobility rule that replaced the power mobility CMN with a face-to-face exam and a doctor's prescription. Under new documentation requirements, providers are responsible for gathering patient records that prove medical necessity for the equipment.

“It's very difficult to get all of the documentation required from the physicians,” says Mark Sullivan, vice president of rehab for Invacare. Physicians are resistant, he says. “They just don't like it. They just want to write a prescription and be done, so a provider has to keep going back to get [what they need], and even if you get as much as you're going to get it doesn't make you feel comfortable in terms of a post-payment audit.”