Broad disability reforms sought

Gov. Mark Dayton and several prominent lawmakers say they intend to produce a broad package of reforms in the 2016 legislative session. […]

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Gov. Mark Dayton and several prominent lawmakers say they intend to produce a broad package of reforms in the 2016 legislative session. The comments were made after a Star Tribune series on life with disability in Minnesota, which described limits on jobs, housing and other life choices community members’ face. The articles described how Minnesota has fallen far behind other states in provides services for people with disabilities.

Documents reviewed by the Star Tribune show that Minnesota is among the most segregated states in the nation for working people with developmental disabilities such as Down syndrome and autism and that hundreds of people with disabilities are being sent, sometimes against their will, to state-licensed group homes where they live with strangers in settings far from their home communities. It also found that people of the items help wheelchair users avoid medical problems, some of which can be life-threatening.

Consumers, medical equipment providers and advocacy groups are sounding the alarm, contending that the change could make it more challenging or impossible for many Americans to find and purchase the equipment they need. For home medical equipment providers, the change raises the potential problem of financial losses. It also raises the difficult choice for providers of either dropping equipment lines or charging consumers more.

The change is the latest in a series of moves linked to the competitive bidding program. Competitive bidding is a Medicare program that was implemented to provide cost savings for CMS. But it has made it more difficult for some beneficiaries to obtain the medically necessary equipment and services needed for daily life. Competitive bidding has greatly affected the home medical equipment industry and consumers. Advocates are pushing for Congress to pass two measures, House Resolution 3229 and Senate File 2196, to stave off the wheelchair accessory competitive bidding proposal. The bills will provide a legislative technical correction to clarify that CMS cannot apply Medicare competitive bidding pricing to the complex rehabilitation wheelchair accessories. The legislation must pass by December 31.

Members of Congress are contending that the change would violate the intent of past federal actions and would reduce payment rates for 171 wheelchair accessory codes from 20 percent to more than 40 percent. Donald E. Clayback, executive director of the National Coalition for Assistive and Rehab Technologies (NCART), is among many advocates urging that consumers and home medical equipment providers contact their representatives. In a letter to members, Clayback said, “Our window of opportunity is getting CMS changes is getting smaller, but building on the positive developments (people) can make a difference.”

“This change will make it very difficult, or impossible, for millions of Americans to find the vital complex rehabilitation equipment they need. Since Medical equipment providers cannot sustain loss of revenue per accessory sold, they will either have to stop providing this equipment or charge you for the difference,” said People for Quality Care, an Iowa-based advocacy group.

The pending changes are the latest wrinkle in an ongoing controversy over competitive bidding. For many years Medicare contracted with many home medical equipment providers throughout the United States. Consumers could purchase equipment and goods from vendors in their home communities.

But in recent years Medicare has worked with providers through a competitive bidding process. Places where bidding took place were rolled out across the country over a period of years, and with different types of equipment and supplies. Low bidders receive contracts from Medicare.

Competitive bidding has been widely criticized for disrupting longstanding relationships between people with disabilities and their equipment and supply providers. In some cases, the new companies are much farther away. That makes life more challenging when equipment breaks, when power is disrupted or when other life-threatening events occur.

People for Quality Care contends that some chosen providers aren’t specialized home medical equipment service providers, nor do all carry the equipment they won bids to provide. “The Medicare-accepted low-bid equipment is the cheapest equipment available, which could lead to future malfunctions,” a People for Quality Care publication stated.

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