Doug Harrison has lofty goals. When he joined the home health care industry in 1991, he wanted a business that changed people’s lives. His goal now is to ensure that all eligible Medicare beneficiaries receive the equipment they need to live independently.

“We wanted to start something that would add a real value to our customers and a real value to the community,” says Harrison, president and CEO of The Scooter Store, New Braunsfels, Tex.

In the early 1990s, Harrison and his wife, Susanna, were ready to make career changes. He was a petroleum engineer who had worked in the United States and abroad. She was teaching computer software.

Harrison enjoyed the technical side of engineering but felt he needed a different level of contact with people. The couple looked at various industries. When they saw news stories on the passage of the Americans with Disabilities Act in 1991 and its effect on people with disabilities, they knew they had found a business that fit. They purchased one of the first wheelchair-van rental franchises. Although they are no longer involved in that company, the experience lead them to create the first Scooter Store. They now have 27 stores in 16 states.

“From day one, our first business plan was focused on freedom,” Harrison says. “The current mission in our business is the same: providing mobility and freedom to people with limited mobility.”

Fighting for Freedom
Helping people by offering his products and services is what Harrison enjoys most. But like other providers of power mobility equipment—a category that include power wheelchairs and scooters—Harrison has had to face various reimbursement challenges and levels of regulatory scrutiny. Last year, the Health Care Financing Administration (HCFA) sent his company a development letter, which is a request for additional documentation on every claim that was in current submission.

“It was enough to shut us down,” Harrison says. “They would not pay us for any of [our reimbursement claims] until we furnished documentation on every claim.”

Harrison usually dealt with such trouble by contacting his local durable medical equipment regional carrier (DMERC). This time, however, was different. “We realized that a lot of the issues that we were facing personally were the same as those the industry faces and those had to be handled from the top down, not the bottom up,” he says.

Harrison got HCFA to retract the request by working with his congressional representatives and officials from the Department of Health and Human Services (HHS) and HCFA. During the process, government agency administrators and members of the HME industry encouraged Harrison to form a coalition that could present a unified voice. Believing the theory of power in numbers, Harrison staked his reputation and devoted his time to the formation of the Power Mobility Coalition (PMC), a nationwide group of power mobility equipment and service suppliers.

Friends Lend a Hand
Steve Azia, JD, and Valerie Eastwood, JD, helped Harrison make the final decision to form the PMC. Azia and Eastwood, who are attorneys with Duane, Morris & Heckscher in Washington and specialize in health care law, also serve as counsels to the coalition. They had been trying to encourage dealers to form this type of coalition for some time.

“There was an attitude that suppliers who provide [power mobility] equipment are guilty [of defrauding the government] because it appears to be some kind of targeted item,” Azia says. “Suppliers who were complying with the rules, going to the DMERC seminars, and trying to do all the right things were still being penalized with lack of payment, untimely payments, or audits that were done very carelessly.”

The effects of forming the coalition were almost immediate. The Office of Management and Budget (OMB) became willing to have open discussions. Coalition members were also able to meet with Timothy Hill, HCFA’s program integrity director in September.

The meeting with Hill was encouraging. “The coalition wants to work with the government in a positive way in order to ensure that those who play by the rules are able to provide appropriate service to the patients,” Azia says.

Harrison and the other coalition members emphasized to Hill that their primary goal is to ensure a constructive, ongoing relationship with HCFA and HHS and that the coalition is committed to work with them to ensure providers follow the rules of the Medicare program. PMC leaders also addressed areas of concern to their industry, including the government’s audit and investigation authority and the integrity of the certificate of medical necessity (CMN) process. In particular, the coalition is concerned with the Region D DMERC power operated vehicle policy, the Region B DMERC beneficiary questionnaire, and focused medical reviews conducted by the DMERCs.

Future plans include educating Medicare program administrators about the value power mobility providers offer to Medicare beneficiaries. “I am convinced that regarding the federal budget, we [the members of the power mobility industry] are revenue positive,” Harrison says. “When we put someone in a piece of power mobility equipment and that person [remains independent], we become revenue positive.”

It will take convincing HHS, OMB and HCFA officials to look at the big picture for them to see the long-term benefits of power wheelchairs and scooters and that is why the coalition is necessary, Harrison says.

Another industry hurdle is underuse of needed equipment. “There is a lot of new technology out there, and the products and services provided to patients across the country are very important for giving independence and freedom to these individuals,” Azia says.

To help power mobility users take advantage of equipment innovation, the PMC plans to educate both beneficiaries and Medicare administrators about new products. Unfortunately, provider-sponsored education through television, radio, or print advertising can raise red flags with Medicare. “Often Medicare gets very upset and says you are creating a false demand,” Harrison says. “I just don’t believe that. I believe we are educating beneficiaries about what is available.”

Completing the Group
The PMC has less than 10 members. However, each DMERC region is represented, which is a strong start for the organization. “I would like to have members in every state,” Harrison says. “Our goal is to find the honest, legitimate dealers and get together with a unified voice.”

Joining a group such as this has risks. “As one of the people originating and now chairing the coalition, I am nervous about putting my name and some of my credibility in a big pool with some people I don’t know very well,” Harrison says. Nevertheless, he is asking everyone else to take the same risk and is putting measures, such as standards for members, into place that will protect members and discourage the unethical providers from joining.

Competitors in the open market are peers and friends when it comes to reaching a common goal, Harrison says. Becoming a member of the PMC lets providers become a part of a group that cannot or will not get anything done without them.

The PMC wants to see a business environment that enables companies to understand and comply with the necessary regulations, Azia says. They should also be able to have the security of knowing that if they comply with these rules, they will avoid unnecessary scrutiny.

“Knowledge is power,” Harrison says. “With a unified voice, we can preserve this business and industry for all the dealers and the customers.”

Denise H. McClinton is a freelance writer for Dealer/Provider. For more information about the Power Mobility Coalition, contact Doug Harrison (830) 626-5802 or Steve Azia (202) 776-7826; smazia@duanemorris.com.