Improve Wheelchair Coverage for Medicare Recipients

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What is the problem? 

Adults insured through Medicare are not receiving the proper manual wheelchairs, wheelchair cushions, and other related equipment that they need due to the  competitive bidding program.  

The facts: 

On September 11, 2017 Congressman Lee M. Zeldin of New York State’s 1st district introduced his proposed bill titled “H.R.3730 - To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative manual wheelchairs and accessories” to the 115th Congress.

This amendment aims to remove complex manual wheelchairs and equipment from the competitive bidding portion of Medicare in order to provide Medicare recipients with the medical equipment that they need. 

Following the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, suppliers in various areas of the country submit bids for regional contracts with Medicare to be a supplier of specific equipment (i.e. wheelchairs). Medicare then selects the few suppliers based upon the price and quality of the equipment offered and the company’s reputability. The selected suppliers are then part of the competitive bidding program and Medicare recipients are restricted to obtaining their Durable Medical Equipment (DME) from these few companies in their designated regions.

The biggest problem with competitive bidding is that many Medicare recipients and their health care providers are forced to select DME from a small list of pre-approved suppliers. These suppliers often do not carry the equipment that Medicare recipients require and these individuals are then forced to either pay for the equipment out of pocket themselves, or they have to settle for an alternative product that does not meet their needs as well. Local DME retailers that have not won the few competitive bidding contracts (i.e. local pharmacies) are also negatively impacted by the competitive bidding program as they edged out of business as they lose customers with the inability to sell DME.

Why does it matter?

The goal in amending title XVIII of the Social Security Act is to broaden the number of wheelchair vendors covered under Medicare to ensure that all Medicare recipients receive the most appropriate equipment to meet their individual needs. 

If clients covered under Medicare are unable to get the necessary equipment due to the suppliers in their region not providing it, the lack of needs met could lead to a decline in function. This decline could result in a diminished quality of life for these individuals and lead to an increased need of further rehabilitative services, thus costing both the recipient and taxpayers more money.

How can you help?

Contact your local Congressional Representative and tell them to vote YES for H.R.3730 - To amend title XVIII of the Social Security Act to provide for the non-application of Medicare competitive acquisition rates to complex rehabilitative manual wheelchairs and accessories! 

Help our citizens get the wheelchairs and equipment that they deserve! 

 

 



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