ATLANTA--A comment on equipment warranties made during a CMS Open Door Forum last week prompted two top manufacturers to clarify their positions, with one reiterating the call to defeat President Bush's budget proposal for a 13-month rental cap on power wheelchairs.

The issue erupted when a provider called in to the Wednesday forum and informed CMS officials that Elyria, Ohio-based Invacare and Sunrise Medical of Longmont, Colo., both "have said on capped rentals, once ownership has transferred, there is no warranty."

The comment struck a sensitive chord; in addition to the wheelchair proposal, the president 's 2008 budget also proposes slashing the current 36-month oxygen rental cap to 13 months. The question of who would service and maintain equipment after the rental period ends--with or without a warranty--is quickly becoming a hot-button issue.

Sunrise responded that its policies remain in place and indeed, its concentrator warranty has been the same since 2005. "Sunrise has not made any recent changes to our warranty parameters, including those associated with capped rental items, as a result of the latest regulatory policy," said Genevieve Dubuc, vice president of marketing, North America.

However, she noted that recent regulatory developments are causing many manufacturers to re-evaluate their warranty policies. "This process will most likely take some time as there are numerous factors manufacturers need to consider when evaluating warranties," Dubuc added.

Invacare officials said they had not really come up with a policy regarding capped rental power chairs and the transference of ownership.

"Today, power chairs aren't rented," said Mark Sullivan, vice president and category manager, rehab products. "The warranty belongs to the consumer. The warranty is covered. Warranty repairs get taken care of by the provider with the manufacturer typically reimbursing for the parts warranty and the provider typically taking care of the labor."

Sullivan said he was not sure how that would change if the PWC capped rental proposal went into effect. "We haven't thought it through that far yet," he said. "We are more focused on defeating the policy because it would be devastating for the market."

Since power chairs are configured for specific patients, they are not prime candidates for recycling to another patient, he said. "On the one hand, [CMS is] saying that you need an [occupational therapist/physical therapist] evaluation, you need a large amount of physician documentation, you need to be assessed by an [assistive technology supplier] and yet they think they can turn around and rent the same chair.

"As far as the warranty issue," Sullivan continued, "it's hard to get your head around that because there are so many problems with this proposal."

Cara Bachenheimer, vice president of government relations for Invacare, had an encouraging word about the proposal. "We haven't seen a whole lot of receptivity on the Hill," she said.

The question of servicing PWCs if, say, a beneficiary has moved to a different state also surfaced during the Open Door session. Historically, Medicare has provided "minute information on billing for repairs," said Bachenheimer.

"Medicare has always paid for parts and labor not under a manufacturer warranty," she said. But the codes are sparse, and many providers simply absorb the cost of repairs rather than going through the cost and hassle of submitting a claim to Medicare.

With reimbursement tightening, service is likely to become even more problematic.

"A consumer's chair breaks down and the provider says, 'I can't make any money on service and I didn't sell the chair, so why would I [fix it]?'" said Sullivan. "They often do fix it because they're nice people, but occasionally that happens."

Typically, said Sullivan, the provider who sold the power chair would work with Invacare in finding another provider to fix the chair. Or, if the original provider had purchased Invacare's 5-Star Service Program, a service technician would actually travel to the site and make a warrantied repair, Sullivan said.

The future for repairs could look a little different if Invacare has its way. "We've been working with [the American Association for Homecare] to put together a comprehensive list ... of replacement parts for CPAPs, wheelchairs and oxygen concentrators so there will be a coding system and reimbursement for these items," Bachenheimer said.