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Medicare Policies Are Inconsistent with Cost-Effective Aging-at-Home Strategies
Date:12/13/2012

ts competition in geographic areas. In many jurisdictions, businesses have stopped providing power wheelchairs to Medicare beneficiaries or gone out of business because a low-ball bidding process has caused unrealistic reimbursement rates for the products provided.

In addition, the Centers for Medicare and Medicaid Services (CMS)—despite years of criticism—has not fixed the process for documenting a patient's medical need for a power wheelchair. Decisions are still made inconsistently, with each region essentially adopting its own guidelines even after a prior authorization process has been implemented. The providers of power wheelchairs are also subjected to excessive and costly audits that disrupt their businesses.

"It is very frustrating for the providers of power wheelchairs that CMS has made it more difficult for them to get power wheelchairs to Medicare beneficiaries," says Tyler Wilson, CEO and president of the American Association for Homecare.  "Studies show considerable cost savings from allowing beneficiaries to stay independent in their homes."

Seniors and people living with disabilities say it is their preference to stay in their homes rather than be placed in nursing homes and care facilities.

Wilson noted that the Affordable Care Act was supposed to make the government smarter with its healthcare spending, but he said the CMS power wheelchair policies are instead squandering tax-payer money on nursing homes fees and emergency room visits when a better implementation of the Medicare power wheelchair benefit could be helping to bring down those costs.

In fact, the Bowles-Simpson presidential commission on federal budget reform supported home and community care programs, calculating that if more such programs were implemented Medicaid could save up to $12 billion over the next eight years.

A study published in

SOURCE American Association for Homecare
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