AAHomecare to Congress: Delay Elimination of First-Month Purchase Option

In a letter to Congress, the American Association for Homecare (AAHomecare) expressed concerned that mobility and rehab providers will find it difficult or impossible to purchase power chairs for their Medicare clients, then wait 13 months to be fully reimbursed.

The elimination of the first-month purchase option for standard power chairs is due to go into effect on Jan. 1, 2011 - too soon to ensure a smooth transition from the current policy, AAHomecare added.

In a letter sent last week to Senate Finance Committee Chairman Max Baucus (D-Mont.) and Sen. Charles Grassley (R-Iowa), the committee's ranking member, AAHomecare President Tyler J. Wilson urged a one-year delay in the implementation of the new policy, a move that the Congressional Budget Office indicated would cost less than $50 million.

In the letter, Wilson noted, "Many providers are currently unable to secure the capital/credit necessary to cover the up-front cost of acquiring the power wheelchair while waiting 13 months to receive full payment." He added that banks are "unwilling to loan money due to the unpredictability of the Medicare program and the risk associated with 13 months of billing."

If the transition to the new policy occurs too quickly, it "will put this largely small-business segment of the healthcare sector out of business, considering the current national economic environment where even medium and large providers care unable to secure necessary lines of credit," Wilson said.

Providers unable to secure lines of credit will need to stop providing power chairs, Wilson said, "resulting in a loss of jobs, economic revenue and beneficiary access to a physician-prescribed power wheelchair, which is especially concerning in rural and underserved areas."

In supporting a one-year delay in implementation, Wilson noted that the "timelines, guidelines and documentation requirements for the provision of a power wheelchair are significantly different from those required for other capped rental equipment." Because of those differences, Wilson says more guidance and more implementation time is required to ensure the transition does not end up limiting beneficiary access.

A memo from AAHomecare to members added, "Offsetting, or paying for that delay, would require a one-percent reduction in the Medicare update to standard power wheelchairs."

To read the full letter, go to aahomecare.org.

The first-month purchase option for standard power chairs was eliminated via passage of the Affordable Care Act in March.

About the Author

Laurie Watanabe is the editor of Mobility Management. She can be reached at lwatanabe@1105media.com.

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