I thought you might be interested in reading the article below which appeared on the front page of the Saginaw News today, Aug. 22, 2011. As you all know, the Thieme family and Amigo are friends of the NAPH family. They have loaned Amigos to us for our conventions for many years at no cost. Also Regenia Huffman from the Akron NAPH Chapter was the lucky winner of the NAPH Amigo raffle to receive a new Amigo which was donated by Amigo Mobility!
Al Thieme, the founder of Amigo Mobility International, sits on an Amigo model RD in the company's showroom at 6693 Dixie Highway in Bridgeport Township.
Medicare-funded power wheelchairs create headache for Amigo Mobility
Published: Monday, August 22, 2011, 8:47 AM Updated: Monday, August 22, 2011, 10:46 AMBy Kathryn Lynch-Morin | The Saginaw News
BRIDGEPORT TWP. — Al Thieme manufactures and sells three-wheeled electric scooters called “Amigos” from the Bridgeport Township business he founded more than 40 years ago.
Seniors and the disabled who need help with mobility find them a handy way to get around grocery stores and shopping centers.
Thieme says he could sell a lot more of his machines to people who need them, but Amigo Mobility International is caught up in a larger problem involving Medicare.
Each year, he says, hundreds of people call his company after they thought they had purchased a power-operated vehicle or scooter made by Amigo. Instead, they got a four-wheeled, power wheelchair from another company.
The wheelchairs, people complain, are bigger, less comfortable and harder to use. And although the wheelchairs can cost up to 10 times the price of an Amigo, they are fully paid for by Medicare and supplemental insurance. Amigo International’s scooters are partly covered.
“When a person is offered a more expensive product for free, they feel like they have to take it,” Thieme said. “But people who can use POVs (power-operated vehicles) shouldn’t be getting power wheelchairs.”
A new study released by the Office of the Inspector General shows hundreds of millions of Medicare dollars are wasted each year on medically unnecessary power wheelchairs.
More than 61 percent of Medicare-funded power wheelchairs were either medically unnecessary or lacked sufficient documentation to determine medical necessity during the first half of 2007 alone, the Inspector General’s report said.
One power wheelchair supplier, the Texas-based Scooter Store, in 2007 was fined $4 million and agreed to give up more than $13 million in pending Medicare claims for fraudulently billing the government and private health care insurers for power wheelchairs.
“The Scooter Store sold the beneficiaries expensive power wheelchairs that they did not want, need, and/or could not use,” The Department of Justice wrote in 2007.
The problem isn’t new. Back in the 1990s, suppliers started airing commercials for free or nearly-free power wheelchairs through Medicare. From 1999 to 2003, Medicare payments for power wheelchairs increased 350 percent, to $1.2 billion annually from $259 million.
Amigo, which Thieme invented in the late 1960s after a family member with multiple sclerosis needed help with mobility, couldn’t keep up with the expensive advertising. It forced the company to turn its focus on selling electric scooters to grocery stores and other shopping centers.
Serving people with mobility limitations once made up nearly 100 percent of Amigo’s business. Now, it accounts for 4 percent, Thieme said.
“It’s been very disappointing for me to see people put in motorized wheelchairs when they are not severely disabled,” Thieme said from the floor of his manufacturing facility, 6693 Dixie Highway.
Thieme admits his business is doing OK, but he says it could be doing a lot better if Medicare reimbursements were fair across the board.
Medicare and its beneficiaries pay more than $4,000 for standard power wheelchairs. Power operated vehicles or scooters sell for an average of about $1,200, but suppliers like Amigo are only reimbursed $935.03 by Medicare.
According to Medicare coverage guidelines, motorized wheelchairs should be prescribed as a last resort and are best for people with severe disabilities, as they require only slight motions of the hand to maneuver and have seats locked in place.
Medicare guidelines say scooters, or power-operated vehicles, should be considered before a power wheelchair is prescribed. They are best suited for people who have mobility limitations but require help in order to participate in activities of daily living.
Scooters or power-operated vehicles require the driver to steer with both arms and have seats that swivel 360-degrees to allow people access to sinks, counters and other areas.
Once a person receives a Medicare-funded power wheelchair, they become ineligible for other mobility aids, such as less expensive power-operated vehicles or manual wheelchairs.
That leaves many people trying to sell their power wheelchairs and to pay out of pocket for a scooter they would rather have.
Jennifer Thieme Kehres, marketing manager of Amigo Mobility International, points to the records the company keeps of customers who’ve called Amigo looking for help after receiving power wheelchairs they didn’t want or couldn’t use:
• A 65-year-old woman who got an $8,000 power wheelchair paid for by Medicare said it couldn’t fit through her door.
• Another customer, an 85-year-old Flint woman, told Amigo a power wheelchair was delivered to her assisted living home even though she hadn’t had the chance to try one out. She said she couldn’t try another type of power wheelchair or power-operated vehicle because the type she had was what her doctor had ordered. The woman asked to see the prescription: It was from a doctor she hadn’t seen in two years.
“It’s heartbreaking when you hear how frustrated these customers are,” Kehres said. “They’re stuck and often afraid of losing their coverage or having their chair taken away all together.”
By law, Medicare pays for durable medical equipment based on a fee schedule that was derived from historical costs, with payment rates updated for inflation, said Ellen Griffith, spokeswoman for the Center for Medicare and Medicaid Services.
She said payment rates for power wheelchairs and for power-operated vehicles vary depending on the specific features and any needed modifications to accommodate a patient's specific clinical conditions.
Griffith said Medicare is phasing in a competitive bidding program for durable medical equipment such as power wheelchairs and power-operated vehicles in an effort to bring market forces to bear on pricing.
“Of course, because the program would bring payment rates for the equipment subject to the bidding program in closer alignment with the market, it has met with persistent opposition from the industry,” Griffith said.