New Medicare rules will make it hard to get wheelchairs
November 27, 2006
If you need a wheelchair and you're on Medicare, good luck.
Shameful new reimbursement rules that went into effect Nov. 15 are making it more difficult for people with disabilities to acquire the wheelchairs they need.
The Centers for Medicare and Medicaid Services enacted a complicated set of new payment regulations that is resulting in Medicare paying about 30 percent less of the price of wheelchairs than it had previously.
This means that those who have the most severe disabilities will feel the sting the most.
Obtaining a wheelchair through Medicare was hardly a sweet deal to begin with. The program covered a maximum of 80 percent of the cost of a wheelchair. That might sound like a lot, but I'm sitting in a wheelchair that cost $16,000. So if I depended on Medicare to help me pay for it, I would have had to come up with at least $3,200. Under the new rules, I would have to pay a whole lot more.
In 2003, the Centers for Medicare and Medicaid Services launched Operation Wheeler Dealer, a campaign to crackdown on alleged fraud by dealers who sell wheelchairs and bill Medicare. But the campaign has consistently been used as an excuse to make backdoor cuts into Medicare. In the end, this allows the system to shirk its obligation to help low-income people with disabilities purchase wheelchairs.
Under Operation Wheeler Dealer, the agency implemented harsh new restrictions on who would be considered disabled enough to qualify for wheelchair purchase assistance. This eliminated anyone who could function at all without a wheelchair inside his or her home.
It also cut reimbursements because the agency says that between 1995 and 2003, Medicare expenditures for power wheelchairs increased from $43 million to $1.2 billion. This may be true, but it does not automatically mean fraud.
Over the years, with a growing elderly population, demand for wheelchairs has grown. And as the stigma against people with disabilities has lessened, more and more folks have insisted upon living full and active lives. That's a good thing.
Wheelchair dealers are complaining that the new reimbursement rates could force many of them either to go out of business or to deny their chairs to people who pay through Medicare. But these companies deserve little sympathy.
Many wheelchair manufacturers and dealers take advantage of their market, charging prices that make you gasp from sticker shock. They know very well that we can't live without what they sell. So, in the spirit of shrewd capitalism, they really make us pay.
Living with a disability is extraordinarily expensive. Few people can get by without government assistance. But the government seems bent on devising sneaky ways to make that assistance harder to obtain.
Mike Ervin is a Chicago-based writer and a disability-rights activist with ADAPT. He is also producer of "The Strength Coach," a nationally syndicated radio talk show. He can be reached at firstname.lastname@example.org.