WASHINGTON — While intense behind-the-scenes health care reform negotiations continued throughout the weekend, rehab providers pondered a congressional committee proposal to preserve the first-month purchase option for power wheelchairs.
Current provisions in both the House and Senate reform bills would eliminate the option for standard PWCs. But the American Association for Homecare reported last week that a Senate alternative would instead set updated reimbursement rates for standard PWC base codes in 2011 through 2014 "at the Consumer Price Index-Urban (CPI-U) less 3.5 percent. So if the CPI-U were 2 percent in 2011, the update for standard power wheelchair base codes would be negative 1.5 percent for that year."
According to the Congressional Budget Office, the payment adjustments would save the Medicare program $800 million over 10 years, the same amount the CBO has said Medicare would save if the purchase option were eliminated.
Is it too little too late, particularly at this critical juncture in the push for health reform? Seth Johnson, vice president of government affairs for Pride Mobility Products Corp, Exeter, Pa., agreed there are a lot of unknowns, but he believes the "phased-in rate reduction" spread out over time is a much better option than eliminating the purchase option altogether.
"At this point, there is no guarantee the alternative will be included in the health care reform bill," said Johnson. "But it's much easier to plan for a 3.5 percent reduction and hopefully much less than that with the CPI when you spread it out over four years. The Senate Finance Committee has indicated they support including this in the final bill, and we have been advised to secure as much support as possible from the House of Representatives."
Wayne Grau, vice president, supplier relations and government affairs for The MED Group, Lubbock, Texas, believes the provision has a "good chance" of passing due to committee backing and support from Senate and House Democrats.
"This is a budget-neutral alternative to eliminating the first-month purchase option," said Grau. "The provision protects seniors and Americans with disabilities by ensuring that an industry still exists to provide them with the mobility equipment they need. With that being said, we need providers to contact their senators and representatives and ask them to speak to both the House and Senate leadership about this issue."
As events of the past week attest, speed is a factor, and Grau believes the majority party would like to get a reform vote completed before the president's State of the Union Address, which is typically in late January or early February.
"The other issue is the upcoming special election in Massachusetts, which is very tight right now, and if the Republicans were to win and get the senator seated before the health care vote, it would eliminate the filibuster-proof majority in the Senate," said Grau. "This is why it is important that providers contact their [legislators] today."
Despite the time constraints, Georgie Blackburn, vice president, government relations and legislative affairs, for Blackburn's, Tarentum, Pa., is confident that the new remedy could finally cement retention of the purchase option for standard PWCs.
"Legislators recognize the ramifications of removing the option, such as provider inability to finance a 13-month payment period, which would result in a lack of beneficiary access to product," explained Blackburn. "For those that depend on power mobility for a functional lifestyle, the consequences [of removing the purchase option] would be catastrophic."
Ultimately, whether the motivation is to save money or preserve beneficiary access, rehab provider Tim Pederson said the time could finally be right to cinch the deal.
Congress is "not so much interested in continuing the first-month purchase as a policy initiative as they are looking for cost-savings," said Pederson, CEO of WestMed Rehab, Rapid City, S.D., and chair of AAHomecare's Complex Rehab and Mobility Council. "This plan gives them the cost-savings that they want, so there should be no objection to it."
