"Dear Colleague" Letter Seeks Delay of "First-Month" Implementation

A "Dear Colleague" letter being circulated on Capitol Hill urges members of Congress to support a delay of the elimination of the first-month purchase option for standard power wheelchairs.

Currently, the elimination is scheduled to be implemented on Jan. 1, 2011.

The letter is co-signed by Rep. Jim Langevin (D-R.I.) and Rep. Glenn "GT" Thompson (R-Pa.), and seeks additional co-signers.

"We urge you," Langevin and Thompson say in the letter, "to join us in requesting a one-year delay of the provision of the Affordable Care Act (ACA), which repeals the first-month purchase option on Jan. 1, 2011, to preserve access for wheelchair users under Medicare while maintaining the budgetary savings under the provision."

The letter goes on to state that the current schedule for implementation will impact wheelchair providers, and ultimately Medicare beneficiaries.

"The ACA repeals the first-month purchase option and requires a mandatory 13-month rental, regardless of the acuity of the condition or long-term need of the patient," the letter says. "Unfortunately, power wheelchair providers do not have the capital or lines of credit in the current economy to bear the burden of paying up-front costs to procure the proper wheelchairs from manufacturers.

"Without a one-year delay, this policy will create significant access and quality-of-care issues, as providers of this equipment either struggle to make the significant changes to their business model to adapt to a new payment model that has the costs front-loaded with reimbursements from Medicare spread over 13 months - or simply go out of business."

Langevin and Thompson conclude the letter by asking colleagues to show their support for the delay by Sept. 17.

Another letter supporting the delay will be sent by Langevin and Thompson to Henry Waxman (D-Calif.), chairman of the House Committee on Energy & Commerce; Joe Barton (R-Texas), ranking member of the House Committee on Energy & Commerce; Sander M. Levin (D-Mich.), acting chairman of the House Committee on Ways & Means; and Dave Camp (R-Mich.), ranking member of the House Committee on Ways & Means.

The letter to the two chairmen and two ranking members states, "Establishing a mandatory rental model, by eliminating the first-month purchase option, can only be accomplished over time and with financing available to purchase power wheelchairs in a manner that will not result in negative cash flow. Companies currently do not have the extensive capital or lines of credit necessary to purchase these items and wait 13 months to receive full payment."

A year-long delay, the letter adds, would "allow providers of power wheelchairs more time to secure credit and prepare for the implementations of this significant policy change."

Organizations supporting the year-delay include the American Association for Homecare (AAHomecare), the American Association of People with Disabilities, the Association of Programs for Rural Independent Living, the National Council on Independent Living, the National Spinal Cord Injury Association, and United Spinal Association.

Copies of the two letters are available on AAHomecare's Web site (aahomecare.org), and the organization is urging stakeholders to ask their members of Congress to support the delay.

To implement the delay in a budget-neutral manner, the Medicare consumer price index update to standard power wheelchairs would be reduced by 1 percent, according to the "Dear Colleague" letter.

About the Author

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

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