Medicare Stakeholders React to New PMD Fee Schedules

Mobility and rehab manufacturers and providers decried the newly released Centers for Medicare & Medicaid Services (CMS) fee schedules for power mobility devices (PMD), and warned that such allowables would endanger consumer access to much-needed equipment.

Industry reaction was swift following the Oct. 2 announcement, which had been expected following the newly revised local coverage determination (LCD) for PMD and the new Nov. 15, 2006, implementation date, both revealed Sept. 20.

Manufacturers and industry organizations were quick to express grave concern that the new fee schedules showed cutback percentages as high as 41 percent. And efforts to share the news swiftly spread.

The RAMP Coalition, an industry organization dedicated to protecting consumer access to mobility equipment, quoted Andrew Imparato, president/CEO of the American Association of People with Disabilities, as saying about the new fee schedules, "The Medicare mobility benefit as we knew it is gone. CMS has chipped away at the benefit over the last three years, and this latest stop ensures that people living with disabilities will get little help from Medicare when they need a power wheelchair to remain independent and out of institutions."

Imparato called the situation "intolerable" and the fee schedules meant "dismantling an important Medicare benefit for senior citizens and people living with disabilities."

Barbara Crane, co-coordinator of the Clinician Task Force, said, "Because of the recent changes, people with severe disabilities will no longer have access to the wheelchairs they need to address their daily mobility needs. Clinically, it is standard professional practice to address all mobility needs for typical daily activities; essentially, these cuts will sentence people to live their lives in institutions, or they will be forced to hire caretakers. The costs of caretakers and institutionalization will ultimately far outdistance the price of a wheelchair."

Added Laura Cohen, Clinician Task Force co-coordinator: "We cannot allow CMS to let these vast policy changes stand."

Provider networking groups have moved quickly to inform members, mobilize forces and make legislators and the general public fully aware of the crisis.

The MED Group (www.medgroup.com) posted a "PMD Alert" on its Web site that called the reductions "extreme" and predicted that if the reductions take place, they will have "a dramatic negative impact on the equipment and services available to people with disabilities." In a "call to action" letter also posted on the site, The MED Group's Senior VP of Networks, Don Clayback, added that the harmful repercussions "Not for (just) Medicare beneficiaries, but for everyone. And while this is obvious to rehab people, I guarantee it is not obvious to those outside the industry. That group includes clinicians, consumers, CMS and Congress."

Along with its PMD Alert, The MED Group has posted a list of action items, with helpful links and downloads so providers can access documentation, sample letters and press releases related to the fee schedules.

The VGM Group (www.vgm.com) via its Web site said it would be working with other organizations — including the National Coalition for Assistive & Rehab Technology (NCART) and the Rehab & Assistive Technology Council (RATC) — "to voice strong concerns with the level of these cuts in reimbursement for PMDs. It is clear that many of these new fee schedule amounts are totally unreasonable and must be corrected."

Go to www.cms.hhs.gov/DMEPOSFeeSched/ to download the PMD fee schedule.

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