US Rehab/VGM Supports Concise Industry Message

Contact Your House Members NOW!

The following Dear Colleague letter is time sensitive! All signatures are due by NOON on Wednesday, December 14.

VGM encourages providers to forward the letter below to their members of Congress and/or call your members of Congress to ask that they cosign the letter to put a stop to the new three year demonstration project. Recently, CMS announced a new three year demonstration project that will go into effect January 1, 2012 in the following states (CA, FL, IL, NY, TX, MI, and NC). While this affects seven states, we know these projects rarely go away and are usually expanded. It is important that you contact your members of Congress and make them aware of this issue!


Dear Colleague:

            Please join us on this bipartisan letter to the Centers for Medicare and Medicaid Services (CMS) to ensure seniors and those with disabilities have access to power mobility devices (PMD).

Recently, CMS announced a new three year demonstration project that will go into effect January 1, 2012. This project requires an initial 100% prepayment review of all power wheelchair claims in the seven largest Medicare beneficiary states: CA, FL, IL, NY, TX, MI, NC. The demonstration project is being initiated as an attempt to address fraud and improper payments, but instead has unintended consequences that hamper the operations of the PMD industry. As a result of this demonstration project, the industry will be forced to find additional working capital to survive, thereby threatening business operations and seniors.

This letter encourages CMS to halt the implementation of the demonstration project and instead, implement a formal notice and comment for rulemaking process on this topic. This ensures that stakeholders have the ability to provide input, and avoid any unintended consequences such as massive layoffs and halted operations that would unduly harm seniors and people with disabilities who rely on power mobility devices.

If your boss would like to cosign this letter, please contact Rep. Henry Cuellar’s Senior Legislative Assistant, Claudia Urrabazo at; or Rep. Lamar Smith’s Legislative Assistant, Shannon Moore at Deadline extended: noon on Wednesday, December 14, 2011.



/s                                                                     /s

Henry Cuellar, Ph.D.                                   Lamar Smith

Member of Congress                                 Member of Congress

Letter is below:

December 12, 2011

Marilyn Tavenner

Principal Deputy Administrator of Centers for Medicare and Medicaid Services

Centers for Medicare & Medicaid Services

7500 Security Boulevard

Baltimore MD 21244-1850

Dear Administrator Marilyn Tavenner:

Thank you for your hard work ensuring that Medicare, Medicaid and health services are afforded and administered to the population. We are writing to express our concerns over the Medicare Prepay Review and Prior Authorization Demonstration Project for Power Mobility Devices (PMDs).  

On November 15, 2011, the Centers for Medicare and Medicaid Services (CMS) announced a three-year demonstration project that will conduct 100% prepay review for all new PMD claims in seven of the largest Medicare reimbursed states, beginning January 1, 2012. We applaud the agency’s efforts to reduce waste, fraud and abuse; however, we have many concerns with enacting a demonstration project of this size with minimal notice to the affected stakeholders.  Such a project could result in significant job losses and jeopardize seniors’ access to this important Medicare benefit.

As you are aware, Congress and CMS has significantly reduced pricing for PMDs and increased program integrity requirements for Medicare suppliers (e.g. accreditation, surety bonds, quality standards) over the past three years.  Specifically, on January 1, 2011, CMS enacted Round One of the Medicare Durable Medical Equipment Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding program, which includes power wheelchairs.  Also on January 1, 2011, Congress mandated that all Medicare Group 2 standard power wheelchairs be converted to a 13-month rental item requiring businesses to obtain substantial outside capital as a result of the transition.  Including a demonstration project to the requirements already in place could harm seniors that depend on durable medical equipment to live independently in their own homes. Additionally, taking a one-size-fits-all approach adds burdensome regulations to good-standing providers and threatens jobs.

We encourage you to halt the prepay review demonstration project due to the potential threats to businesses, jobs and seniors’ access to care.  Furthermore, we recommend that you work with all stakeholders, including physicians, beneficiaries, and suppliers to develop a program that restores access to these invaluable products and services without impacting legitimate businesses.  Any efforts should include a formal notice and comment period.  Thank you for your attention to this important matter.


__________________________                                __________________________

Henry Cuellar, Ph.D.                                                  Lamar Smith