Power of the Option

Power wheelchair providers face an overwhelming challenge on Jan. 1, 2011, that will lead to significant access and quality-of-care issues for the patients they serve. Health care reform legislation passed in the spring contains a provision that dramatically changes the way businesses are reimbursed for providing power wheelchairs to Medicare beneficiaries. Delaying that policy is the best option to allow providers to prepare for the change and preserve access to wheelchairs.

Medicare beneficiaries who have been prescribed a power wheelchair currently have the choice of purchasing the equipment in the month it is first prescribed or renting it for 13 months, at which time ownership transfers to the beneficiary. Given the chronic, long-term conditions of power wheelchair consumers, the vast majority of Medicare beneficiaries elect to purchase their power wheelchair in the first month.

Power wheelchairs save Medicare millions of dollars a year by helping seniors and people with disabilities to remain independent and in their homes. The purchase of a wheelchair by a beneficiary who would otherwise rent the chair for 13 months also saves Medicare money in terms of total payments, with the one-time purchase by Medicare costing less than 13 rental payments.

Most beneficiaries who elect to purchase indeed end up needing the wheelchair for beyond the 13 months. Medicare only loses money in those infrequent cases where the beneficiary purchases the chair and where the ultimate need is for some relatively short period of time.

But Section 3136 in the Affordable Care Act, the health care reform law, eliminates the purchase option for most power wheelchairs.

The situation is critical. The new policy creates a cash-flow nightmare for both large and small providers. Capital or lines of credit to provide the equipment in this current economy is difficult to come by. Providers cannot afford to bear the burden of paying the up-front costs to procure the appropriate wheelchairs. According to AAHomecare's analysis, the elimination of the first-month purchase option could slice cash-on-hand by as much as 40 percent in the first year.