Stewing Over PWCs

Whether due to age, neuromuscular disorders, obesity or spinal cord injuries, there's no question that a growing number of consumers will continue to need power wheelchairs. The question that remains on the table, however, is how legislative and other factors might impact the market.

A difficult economy, health care reform, competitive bidding and elimination of the first-month purchase option are all ingredients in a mystery stew that providers and equipment-makers find hard to swallow. The bidding program is moving forward at a fast clip (although complex rehab has been excluded). In the contentious world of health care reform, a nix of the purchase option was included in both House and Senate proposals at press time. Any mention of funding cuts is enough to set the sector's teeth on edge.

According to Seth Johnson, vice president of government affairs for Pride Mobility Products Corp., Exeter, Pa., the Senate proposal preserves the purchase option for Group 3 and higher chairs but eliminates it for standard PWCs. The provision would front load rental payments so that 45 percent of the total would be received in the first 90 days.

But, says Johnson, “even with the front-loading of payments that still falls well short of the amount necessary to cover all the costs of providing a physician-prescribed power wheelchair.”

Based on the proposed legislation, elimination of the option would take effect in 2011, according to Johnson, and that gives the industry another year to advance an alternative.

The American Association for Homecare's Complex Rehab and Mobility Council (formerly RATC) has developed such a plan. Under the proposal, providers would have to refund Medicare the difference between the purchase amount and what would have been paid under a 13-month rental for beneficiaries whose medical need ends prior to the 13-month rental cap.

“While this alternative is not perfect, it does preserve the purchase option and provide an opportunity to manage through the change,” adds Johnson. “A straight elimination of the purchase option provides no such opportunity.”

Rapid City, S.D.-based provider Tim Pederson views elimination of the purchase option as a fundamental market changer for his business.