Q. I am paralyzed due to childhood polio and was bedridden for more than two weeks last month because my power chair (bought through Medicare) broke down and the vendor who sold it to me was so busy that they could not even look at it until 10 days later. They did say they could check it sooner if I brought it into their shop, but I don’t have my own transportation, and there is no way an inoperable wheelchair could travel by itself on a bus. When the problem was finally diagnosed, they advised me I would need to pay extra for expedited shipping of the part that was needed unless I wanted to wait another week for the repair.
I need some guidance about what to do the next time this occurs. Lying in bed all day and night made me realize how dependent I am on services out there in the “real world,” and it is depressing. If I was working outside the home right now, I wouldn’t be able to get to my job.
— Stranded, and hating it
A. The level of customer service you received should not be acceptable in any type of business, especially not in health care. The Centers for Medicare and Medicaid Services is responsible for all things Medicare. In reviewing the multiple documents posted on their website, the only reference I could find is from Medicare’s Supplier Quality Standards and Beneficiary Protections: “The equipment will be reliable and will work for the beneficiary without worry;” and “beneficiaries receive the equipment at their convenience, in a prompt manner and according to both the prescribing physician’s recommendations and the beneficiary’s assessed needs.” Requiring beneficiaries to deliver their power wheelchairs to a supplier’s location for repair is not consistent with Medicare requirements and should be part of any complaint.
You did the right thing by first calling the vendor who serviced your wheelchair. If you have a problem obtaining needed items or services, or if you are concerned about the quality of the supplies and services you are receiving, there are several additional ways that you can get help.
You should first contact your supplier with full details about your complaint and follow that up in writing. I recommend addressing it to the highest-ranking person on the organization’s management team. Names and addresses can usually be found on its website. Your supplier must provide regular business hours and after-hour access telephone numbers; must let you know they received your complaint, and are investigating it, within five calendar days; and must send you the result of your complaint and provide their response in writing within 14 calendar days.
Call 800-MEDICARE to get help or lodge a complaint. If you still need help, ask the Medicare representative to submit your complaint or inquiry to the competitive acquisition ombudsman. The CAO helps to ensure that your complaint is resolved.
Send copies of your detailed complaint letter to CMS and your congressional delegation; otherwise there will be no record of your complaint in subsequent CMS reports to Congress. That is important because Congress monitors the agency closely, requiring CMS to keep costs down on everything from prescriptions and orthotics to mobility devices. To accomplish that, Congress tasked CMS with establishing a competitive acquisition program, which began in 2011. The upshot of this program is that there are vendors, or contractors, that have been awarded exclusive rights to sell certain products within specific regions of the country.
The CAO is required to report to Congress about how the competitive acquisition program is working, but so far the only year reported on is 2011. CMS says they are currently compiling a report covering the years 2012 through 2014, but if recipients of poor service or inadequate equipment do not file formal complaints, the CMS reports may not be an accurate representation of how well that program is working. Perhaps of equal concern is the fact that most of these regional contracts will be advertised for rebidding in the next two years, and if there are no complaints on file, it increases the likelihood that the same companies will be serving those regions in the future.
• CMS Ombudsman, www.cms.gov/Center/Special-Topic/Ombudsman-Center.html
• Competitive Acquisition Ombudsman, go.cms.gov/1O6t3MK
• Medicare info, 800-Medicare; www.medicare.gov
• Please take a few minutes to help United Spinal learn about the extent of problems with Medicare wheelchair repairs by taking the United Spinal Association Medicare Beneficiary Wheelchair Repair Survey at this link: svy.mk/1MEO7W9.