Sunday, April 27, 2014

What can you do to help fix Funding for DME.

The item coalition, as well as NRRTS, RESNA, NCART, and countless other groups and manufacturers have been fighting a battle for the mobility challenged community. For years, it has been up to our industry to police itself, and there have always been a few bad apples that have ruined our system, reducing our credibility and have forced CMS to take action. As a long time supplier, I remember the signs “FREE LIFT CHAIR”, which providers abused until Medicare blocked the code, and made it difficult for consumers to get these items.

Over the past few years, since powered wheelchairs have become fashionable and attractive; suppliers had found a loop hole which could be very lucrative. We have all seen the people who receive powered wheelchairs, but can still walk. We have also recently witnessed many providers becoming indicted for billing for this equipment and never providing it to their patients.

I have repeated over the years, to my congressman, to organizations, consumers, and professionals; that the only solution is to rid the industry of its bad apples. The problem stems from the manufacturers, who see increased demand of their equipment through outlets who do not offer service, customization, or any choice to the consumer. If manufacturers demanded their suppliers were credentialed, and provided adequate service with the capacity to follow up the product; our industry would be very professional and respectable. Instead today, suppliers are looked at as people you cannot trust; and only in it for the money.

There is a genuine concern about the competitive bidding program that Medicare is initiating. As a supplier my concern is that to put something out for bid in an industry which is already providing (in many cases) substandard equipment; the allowable for equipment will plummet. Competitive bidding means that in a community all providers bid their lowest price they can provide a service for. Since many suppliers are providing non-US equipment, the price ceiling would most likely be set for these lower imported products.

The obvious concern here is that when reducing costs so much, what happens to the service. What many individuals do not understand is that most equipment that is provided (by responsible providers) requires an assessment from the provider, with a team consisting of a physician, therapist, and family to provide the best solution for the patient. When you set a capped amount on equipment, both the choice of equipment and the specialty of customizing, and fitting a mobility product will disappear.

What most people don’t know, is that most physicians and therapists are not familiar with equipment and depend on the supplier they are working with to recommend the most appropriate equipment. In reality the equipment that is being prescribed, is left up to the supplier to choose. When you reduce the funding, and reduce the choices, you will lose the specialty providers; and have only a delivery system. Would you rather a delivery person drop off your equipment, or a specialist who can instruct, train, adjust, modify and make suggestions to you?

The competitive bidding issue still has a long battle ahead, as there are too many uncertainties; like if you award a company a particular demographic; and they turn out to be a bad provider; what is the recourse. When you award one provider the work for an entire area, you will certainly force many of the other providers out of business. So how do you replace a provider that fails to perform?

The larger picture may be that by providing cheaper products that will be outsourced to non US countries, our Gross National Product declines. To spend billions of US dollars on healthcare for most of that revenue to be sent outside the US , is not good for our country. Even worse, is the amount of unemployed, skilled workers from local equipment suppliers, and from national manufacturers.

Now is the time to get involved, voice your concerns to legislators; tell them of the importance of local providers who can supply, fit, repair and customize products. Nothing in this world is free, when you see these ads for free power wheelchairs, no cost to you, qualifying people who can still walk- turn them in to Medicare. We cannot be blind and turn away as this problem is not going away; and when you need Medicare benefits they are not going to be there.

This article was provided by Carey Britton, seating and mobility specialist for Active Mobility Center. He can be reached at 954-946-5793 or at cbritton@wheelchairguys.com

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