Rob Brant

We are continually disappointed by negativity in the press toward medical equipment providers, which is based on a fundamental misunderstanding of what we do. A recent article in the Miami Herald said the following: "For decades, Medicare has set generous rates of reimbursement for renting or buying medical equipment. For example, the program pays $4,023 for a powered wheelchair that can be purchased online for $2,174."

That statement, and others like it, does not provide a proper or fair comparison. We must educate members of the press, so they know that Medicare's reimbursement rates are not generous, and are not even guaranteed. In addition to the equipment costs, we offer significant services and extended responsibility for the equipment—such as repairs, maintenance, and warranties.

In the example of a power wheelchair, the Miami Herald did not take into account that the posted reimbursement rate for Florida is less than $4,000, but Medicare, by law, only pays 80% of that, or $3,200. If a patient has Medicaid as a secondary insurance, the provider cannot collect any co-payment.

The typical cost to bill Medicare is 6% ($240), which lowers revenue to $2,960. Power wheelchairs are shipped unassembled in a large box on a pallet, and weigh approximately 200 pounds. The cost to ship such an item to a residential address typically runs about $200. That lowers the revenue to $2,760. The item would then have to be assembled by a certified technician, or a RESNA-certified, licensed ATS technician. The cost for a trained individual to drive to the patient's residence and assemble the unit for proper use would run about another $225, bringing the revenue down to $2,535. When Medicare cuts the reimbursement in January by 9.5%, that will reduce it another $380, bringing the total revenue down to $2,155. This is comparatively $19 less than what can be purchased online for $2,174.

After making that comparison, it should also be noted that Medicare only pays for a motorized wheelchair if it is medically necessary, and the patient must qualify. It is not a convenience item. Patients must be properly measured, and their home must be assessed to make sure that the motorized wheelchair has clearance to move through hallways and doors. Medicare wants to make sure that the unit will be used and won't just collect dust at the front door.

How are patients who cannot move about their residence without a motorized wheelchair going to perform the necessary assessments of their home to qualify for the motorized wheelchair—without the HME company or licensed ATS? Right now, Congress and the press do not understand these nuances, and we must again start the education process.

Rob Brant is president of the Accredited Medical Equipment Providers of America Inc, Miami. He can be reached via e-mail: .