Spinal Cord Injury and Paralysis Community

The following is a press release from the National Council on Independent Living (NCIL). NCIL is a national disability advocacy organization which advocates for the rights and needs of people with all types of disabilities, utilizing its members in the independent living movement to create positive change and continually stave off many of the shortsighted policies that threaten the ability of all of us to live independently throughout our lives. I am a proud NCIL member of several years' standing, and will continue to support them as long as their mission remains as positive as it has been and will continue to be.

That is my disclaimer, but know that I agree with the concerns they express, the actions they are recommending and the rest of what follows:

FROM NCIL:
Action Alert: Medicare Demonstration Project to Impact Access to Mobility Products

On September 1, 2012 Medicare implemented a prior authorization demonstration project for power mobility devices (power wheelchairs and scooters) that will impact access to prescribed mobility products for consumers who live in California, Florida, Illinois, Michigan, New York, North Carolina, and Texas.

It is important for you to know that if you have a need for a mobility device based on your doctor’s exam; the process to obtain the product changed significantly on September 1 under this Medicare-developed demonstration program. Lengthy delays or denials in securing mobility independence will largely be due to paperwork issues between Medicare and the doctor’s office, which now must be addressed up front, prior to receiving your power wheelchair. Currently this back and forth process is something Medicare, your doctor, and equipment provider work through following the delivery of the equipment. That all changed on September 1, 2012.

NCIL does not believe government bureaucracy and administrative issues should hold up your access to a prescribed mobility device. We are encouraging our members to take action and express your concern regarding this serious issue, and report how this program has negatively impacted you. Here is what you can do:

• Call 1-800-MEDICAR(E)
• Call your Senators and Representative at (202) 224-3121.
• Write a letter to the editor of your local newspaper.

Let them know the following:

• If this delay has led to an inability to get around your home or work, or to participate in the community
• It is not right to refuse prescribed support to a person based on subjective review of a doctor’s documentation to further support their prescription
• If the delay has led to a lengthier stay in a hospital or nursing facility while waiting for this paperwork issue to be resolved

NCIL and other consumer organizations continue to express concerns with the impact of this project on seniors and individuals with disabilities. The more people who learn about this unfair process, the more the President, Medicare, and our elected officials will realize that changes are necessary. Please help us fix this short-sighted government project before more harm is done. Take action now!

© 2012 Michael Collins |

Categories: Civil Rights, Technology, Independent Living, Healthcare, Community Engagement, Quality of Life

Leslieann1968: I am a quadriplegic, C-4/C-5 and live in Texas. My insurance through my employer paid for my first power chair. I just got my second power chair, this time through Medicare, my supplemental insurance provider and DARS about4 months ago. From the time that my perscription was first written, it took approximately 13 months to finally get my new chair. Every time that I would ask my equipment provider how long it would take or how much longer, he always told me that he was waiting on approval or paperwork. So if I am understanding your article correctly, it may take even longer? This is pure governmental stupidity. Our elected officials that are supposed to be working for us, have NO concept of how we live. Not one of them have to deal with any of the red tape and hoops that we must jump through in order for us to live our lives. Thanks for the information, Mike!

~ Leslie
zuzu: It's a safe bet that when the government decides to have a "demonstration" project it's going to be helpful to the patients or doctors. The unfortunate part is this just the beginning of delays and difficulties that come with the new Affordable Care Act and health care plan. The government health care that's provided to you has to reduce what they pay out to you in as many ways as possible, whether that's by delaying payment, cutting out fraud, making qualifications more limited, or saddest of all making the process so tedious and difficult that people and doctors just give up or die during the process. It may seem rude, but it's a system that works. Here in NC they boast about a free state caregiver respite program available through each county senior resources office. It excites lots of people with the offer of the chance to have a break every week, for free. But when they call to inquire they are told that they can't even be put on the waiting list because that list has over 200 people on it, and those people will have to wait over 2 years to even be considered as a match for respite help, and all they'll be offered it 2-4 hours a week because of the demand. Most families, like ours, get the call offering to be put on an active list for matching with a volunteer several years after their loved one has passed away. The government doesn't want Medicare to pay for your power chairs, and if Medicare doesn't approve and pay, neither will your supplemental insurance. The government wants your doctor to get really tired of the complete harassment of the paperwork they have to do to help you qualify for the chair, and the constant calls and email and copies and angry communications with you the patient so that they either charge for doing that or refuse completely to be involved in prescribing chairs for people who need them (either by passing it off to another medical provider, or just saying "No you don't need a power chair." Doctor's Medicare payments are being cut quite a lot in this new health care plan so they aren't going to have much financial incentive to take the time and sheer harassment involved helping people get power chairs when it takes FOURTEEN MONTHS of back and forth bickering. When a doctor WHO HAS ATTENDED YEARS MEDICAL SCHOOL TO LEARN WHAT HE KNOWS, has decided, with ALL KINDS OF MEDICAL TESTS AND DOCUMENTATION that a person is in need of a power chair to move their body from one place to another, then the MEDICARE INSURANCE PROVIDER WHO WAS AND IS PAID PREMIUMS BY THE PATIENT TO ABIDE BY THEIR CONTRACT should GIVE THEM THE CHAIR. Pronto. I realize that most people who deal with CRPF have been on the side of the Affordable Care Act and the new health care plan, but I'm really afraid that you are going to be very disappointed by what you find happens as a result of its implementation. Leslie is right and her 14 month ordeal is going to get longer and more tedious, and she's a pro and knows what to do. Saddest of all are families of the newly injured who have no clue as to what to do or where to start that are going to have to deal with this ridiculousness while they are trying to make medical decisions (that may be limited also based on age, health, location, longevity), cope with the emotional issues of a devastating family event and the financial issues surrounding it all. This is just the beginning, so voice your opinions to elected officials because IT IS WRONG, but know that this is part of a health care plan that so many said they wanted because it "fixed a broken system".
Michael Collins: Those Medicare power wheelchair dermonstrations were originally proposed and implemented prior to the Affordable Care Act, and many voices protested loudly at the time. Unfortunately that has led to the current expansion to other states, for all of the reasons and with the consequences you describe so well. I hope you have shared your opinion with your elected officials, as we can always hope that someone in power will eventually realize that this misguided attempt to save a few dollars is actually a huge loss of potential productivity and even human lives. Similar oversubscribed but underfunded programs like the respite care relief you described simply raise hope and expectations while preventing people from moving on to a better life. Good stuff for a meaty discussion, so thanks!
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