Mobility Report

One of the nation’s largest disabilities groups, American Disabled for Attendant Programs Today or ADAPT, held a live demonstration yesterday in Chicago. According to WGN News, the protest was held in front of the headquarters of the American Medical Association (AMA).

ADAPT is known throughout the country for their demonstrations, but is also recognized for their legislative policy advocacy, grassroots education and mobilization efforts. This was very similar to the demonstration held in Washington, DC a while back that I had the privilege to witness. This particular protest however was held in part to demand better patient healthcare rights. The WGN news clip would suggest that physicians prematurely institutionalize seniors and people with disabilities rather than finding ways for people to live independently at home.

Watching this video clip though, brings me to a few relevant points of interest. Keeping people living at home independently not only enhances their quality of life, but also provides significant financial savings back to insurance and/or federal programs. Why?

• Changes in power wheelchair technology have made it possible for people with mobility impairments to pass through most doorways in their own home unassisted. The results of these changes give seniors and people living with disabilities the ability to rely less on a caregiver and the freedom to carry out their own activities of daily living;
• According to a report issued by the Alliance for Aging Research and Dr. Jack Guralnik with the National Institutes of Health, the total average annual costs of care for a person who remains independent for the year is $4,800. The total average cost of a person who lost independence during the year and needed help with daily activities is $36,000. The additional costs of medical and long term care each year due to lost independence is $26 Billion.
• National Center for Health Statistics reports that the average length of stay in a nursing home/institutional setting is 568 days.
• RRC, a renowned economics group conducted an outcome study of Medicare data which shows that by providing mobility equipment to senior citizens, Medicare actually saves enough to cover the cost of the equipment plus an average $10,887 over a two-year period. These benefits do not even include non-Medicare costs such as nursing home expenses.

Hats off to every organization fighting for disability rights across the country. The vitally active role we all play in educating the public today the better off our society will be tomorrow.

While the demonstration project in South Florida and Los Angeles should indeed help to reduce fraud and abuse, there are ways to make it even more effective.

CMS has publicly announced that its crackdown will unfold over a 30-90 day period, but wouldn’t that give the scam artists a window to accelerate electronic billing on the supplier numbers they already have?? Moreover, will it also give them time to relocate to other areas that are NOT part of the demonstration project? The program would be more effective if it was enacted immediately without giving these scam artists time to adjust. For example, CMS should consider making immediate site visits, and taking a more aggressive step of canceling supplier numbers suspected of being associated with shaky suppliers. Those businesses should be forced to prove they are legitimate.

Many company executives, including myself, have strongly advocated for years that mandatory accreditation for all suppliers would curtail fraud within the Medicare program. Our own reviews (which for the record are not nearly as sophisticated as the government investigations) have found "companies" billing the Medicare system for power mobility equipment while operating from addresses that were dry cleaners, vacant buildings, and garages. Congress has weighed in and has called for action. Last month, the Washington Post reported the third conviction from HHS’ special task force unit.

In most cases, senior citizens and people living with disabilities have been victims of these scams because they never received the products or services. Should the time ever come, most will not be able to receive a power wheelchair or scooter because government records show that they have already received one.

To be sure, if the fight against fraud is to be successful, the government must revise the system so that scam artists no longer have easy access to NSC billing numbers that open the door to Medicare reimbursements. CMS is now requiring accreditation in connection with the competitive bidding program, but that’s a process that will take years to be fully implemented.

What’s needed is mandatory accreditation for all suppliers before they can bill the Medicare program. This would force all suppliers to face a level of scrutiny that would weed out many of the fraudulent dealers and eliminate the longstanding pay and chase approach the government has used for years. Another benefit is that it would improve the credibility of the power wheelchair industry, and help ensure that Medicare beneficiaries receive quality service, as well as quality products. The days of criminals who pay doctors to write hundreds, if not thousands of phony power wheelchair prescriptions are numbered!

For almost five years now, I have been educating Congress on a number of ways to fight real fraud in the Medicare system. Some of those initiatives include mandatory third party accreditation, increased quality standards and increased, unannounced site visits. I am convinced that there was someone finally listening when I asked the question: how can a dry cleaner or empty building be billing the Medicare program? Can it really be that easy? Shouldn’t we be doing as much as we possibly can to a) protect our most frail population from these scam artists, b) protect the Medicare trust, and c) finally save the integrity of legitimate suppliers who are 100% committed to providing quality healthcare to Medicare beneficiaries?

The power mobility industry has been pushing for true, fraud measures for quite some time. It seems that for every step we take forward in gaining much deserved credibility, another scam artist makes the front page. Quite frankly…it’s time to put an end to this practice. In fact, the American Association for Homecare wrote an open letter to Congress entitled Greater Efforts Needed by Medicare to Combat Fraud applauding the recent efforts by CMS, but that more needed to be done.

Now, The Centers for Medicare and Medicaid Services (CMS) appears to be getting serious about fighting Medicare fraud associated with the power mobility benefit. The agency has recently shifted their focus from measures that restrict access to power wheelchairs and scooters to actually tracking down fraudulent suppliers and putting an end to costly scams that are costing the government millions of dollars.

In a July 2 press conference, Health and Human Services Secretary, Michael Leavitt announced an expansion of the Medicare Fraud Strike Force, a two-year effort designed to further protect Medicare beneficiaries from fraudulent suppliers. The power mobility industry applauds this new direction. Suppliers, manufacturers and Medicare beneficiaries still suffer from the series of regulatory changes — reimbursement cuts, new coding, competitive bidding and others — that were touted by CMS as tough action against fraud. But in most instances, the victims of these policies were legitimate suppliers and beneficiaries, not the scammers.

At least now, CMS has its sights on the right target: the fraudulent dealers. The demonstration project is aimed at South Florida and Los Angeles. Under the initiative, suppliers (about 2,700 in South Florida and 5,000 in LA) must reapply for their National Supplier Clearinghouse (NSC) supplier numbers; these numbers are required to bill the Medicare system. And, suppliers will need to be accredited and CMS will also conduct unannounced site visits.

This is attacking the problem at the source!

I’ll have Part II next time.

Doug and Susanna Harrison understood from the beginning that employees with a strong interest in the long-term health of their company would be motivated to protect the interests of their customers. For this reason every employee at The SCOOTER Store is an owner and every employee at The SCOOTER Store is treated as an equal. Through the company’s core values, the respect and care offered to each employee of The SCOOTER Store family is returned with great commitment and enthusiasm to our customers, the very foundation of our growth and success.

It is our job at The SCOOTER Store to match our product with customers who have a legitimate and verifiable need for them. In the spirit of the CompanY’s guiding principle ‘Always Do the Right Thing’, employees of The SCOOTER Store assume 100% of the responsibility for accurately determining the customer’s Medicare eligibility and completing the necessary paperwork. We take each customer through a 70-step screening and quality check process that includes phone interviews, coordinating with your doctor and visiting you at home. If you pass our extensive screening process, the power wheelchair you receive is yours to keep and we assume liability for Medicare reimbursement. This is our guarantee to our customers and our commitment to providing responsible Medicare screening.

Every month, The SCOOTER Store makes over 10,000 service and delivery calls to our customers’ homes.