Harrison on a Complex Rehab Carveout: "We Think All Power Mobility Should Be Exempt"

Asked during a Jan. 23 Mobility Management interview if he fundamentally opposes the exclusion of high-end rehab products from competitive bidding, Scooter Store founder Doug Harrison offered a Sophie's Choice-like metaphor.

"I have three kids," he said as a comparison. "If someone said, 'But which one do (you) love the least?' There's no answer to that; I love them all."

Harrison uses that comparison to express, he says, that he acknowledges a difference between so-called "consumer power" and complex rehab -- but that doesn't mean he favors a carveout for rehab without a twin carveout for consumer power.

"So is there differentiation in the product? Of course; it's absurd for anybody to think that we don't think there's differentiation in the product," Harrison said. "We think all power mobility should be exempt from this current, so-called national competitive bidding because the product's underutilized and the process as rolled out is pretty Draconian."

Harrison added that he dislikes the term "consumer power."

"I'm fundamentally opposed to a lot of the high-end rehab groups that would try to demean the definition of geriatric mobility by saying, 'It's just a strength-and-stamina thing,'" he said. "They love to call geriatric mobility 'consumer power' because it sounds like something that maybe people just want, but they really don't need.

"If someone needs mobility to get around their house, and the next best option is a nursing home, to say, 'Well, that's just strength and stamina -- they didn't need a ventilator, so they're not really disabled' is intensely insulting to a huge number of disabled seniors that face giving up their home and going into long-term care because they can't take care of themselves inside of their own home anymore."

But does Harrison acknowledge the difference in equipment needs, for example, between a young child with Duchenne muscular dystrophy and a senior who's had a hip replacement surgery? Or for the sake of competitive bidding, does he believe that all seating and mobility equipment should be given the same weight?

"I think they all have a lot in similar and clearly they have a whole lot that's different as well," he said. "Both of them right now, for geriatric mobility and complex rehab products, pediatric or adult, are being substantially underutilized for Medicare. Since we went through the last four years of Operation Wheeler Dealer and recoding and repricing, the entire industry, all mobility products to Medicare beneficiaries, is being grossly underutilized in all categories. Medicare's own estimate of appropriate utilization shows that today's utilization is grossly less, 30 to 40 percent less than what Medicare's own estimate of what beneficiary access and utilization ought to be."

And that, Harrison said, is at the heart of his concern over carving rehab out of the competitive bidding program while leaving consumer power products to be bid.

"So if both groups are being hurt, which they are, do you all want to differentiate between the two and say, 'Well, bid this one and not that one?'" he asked. "Those are both bad answers. If you say, 'Yeah, but if you had to bid one or the other, which would you bid?' There's not a winning answer to that."
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