Good News Soon for Power Wheelchair Sector?

ATLANTA — In the first glimmer of hope for mobility providers in a long while, a bill to delay elimination of the first-month purchase option for power wheelchairs could come through as early as this week.

Mandated by the Affordable Care Act, the first-month purchase option for Group 2 PWCs is scheduled to be eliminated as of Jan. 1, 2011. Rather than getting reimbursed up front, providers would have to wait 13 months before receiving Medicare's full payment for the power chairs. (The mandate does not apply to providers serving the Round 1 competitive bidding areas.)

Stakeholders have been working to stave off the elimination but were not able to move forward with a bill until the Congressional Budget Office issued a score for the delay. That score — $50 million for a 12-month delay — has been released.

"Now that we have the CBO score, the purchase option delay is being put into legislative language and we are looking to have that introduced maybe as early as [this week]," said Pride Mobility Products' Seth Johnson, vice president, government affairs, adding that the legislation will be introduced in the Senate.

Johnson said both the Senate Finance and the House Ways and Means committees have expressed support for a 12-month implementation delay.

"They recognize that when they drafted the [health reform] bill, there was significant time for the industry and CMS to adjust to this change," Johnson said, pointing out that providers will have to change their business model and CMS will need to put together significant guidance on the change. "But the reality is that by the time the bill was signed, there was [less than a year]."

Oddly, the lagging economy has aided in hanging onto the purchase option a while longer.

"Many providers are unable to secure the financing to cover the upfront cost of the power wheelchairs," Johnson explained. "Banks are unwilling to loan money, credit is so tight. And you cannot use a Medicare receivable as collateral. So we really need additional time to allow for the economy to continue to recover. Hopefully, assuming we get the delay, banks next year will be lending money again, and the transition to this model will be easier."

Johnson also said consumer groups are very concerned about the access issue. The National Council on Independent Living, the United Spinal Association and the National Spinal Cord Injury Association have already weighed in on the issue with letters to key congressional committees. They recognize, he said, that "providers don't have the financial wherewithal to adjust to his change."