Medicare program creates roadblock for Skokie company
Jonathan Miller (right), president of In Step Mobility in Skokie, is facing a critical dilemma making his product available under a new Medicare program. Employee Alejandro Amilpa tests out a U-Step II walker at the shop. | Curtis Lehmkuhl~Sun-Times Media
Updated: December 23, 2012 6:04AM
SKOKIE — Jonathan Miller created awalker more than 20 years ago to help his mother, but once he developed that product into a Skokie business, it became indispensable for many with neurological diseases.
But now, Miller said, a new Medicare Competitive Bid program is making it more difficult for people to get the product that helps them become more mobile.
Since Medicare instituted the program in nine national markets last year, In-Step Mobility has had difficulty in making its product available. The company has tried to work with the medical stores awarded Medicare contracts directly, but has discovered a roadblock.
“The major problem is that contract winners submitted bids for providing our walker at our wholesale price, so the stores lose money on our product, once they add in our operating costs,” Miller said.
Suppliers are avoiding ordering the walker despite its obligation to do so — a problem, Miller said, created by Medicare not following its own rules.
Medicare could not be reached for comment.
The Medicare competitive bid program requires “bona fide bids” — bids that are reasonable in covering product cost, operating cost and profit.
“Distributors submitting non-bona fide bids are to be disqualified, and Medicare is to check the reasonability of the bids submitted,” Miller said.
That that has not been happening, and has made it more difficult for patients to acquire the walker, Miller said.
Miller said the U-Step II walker, the latest version of In-Step Mobility’s primary product, provides more stability than standard walkers. It has helped certain patients become more mobile just as it did Miller’s own mother.
Some doctors see a more stable walker as crucial for their patients so they, too, share concern about future availability of the U-Step II.
Dr. Monique L. Giroux, director of movement disorder outpatient services at the Cleveland Clinic Foundation, said standard walkers are “not appropriate” for many patients with Parkinson’s disease.
“A light walker ... increases the chance of retropulsion or the tendency to fall backwards,” Giroux said. “This is especially critical in Parkinson’s disease.”
Giroux said many patients have stated their quality of life has dramatically improved with greater activity levels after using the walker.
The potential result of these walkers not being available to Medicare beneficiaries could put In-Step Mobility out of business or downgrade the scope of its business, Miller said.
The second round of bidding is scheduled to cover most of the country next year, including Illinois.
Miller has been reaching out to Medicare, legislators and others to voice his concerns, but there has as yet been no resolution, he said. According to the HomeCare E-newsletter, the Centers for Medicare & Medicaid Services state it doesn’t see a problem with beneficiaries getting the walker under its new program.
But Miller has experienced otherwise in the first nine markets that have implemented the Medicare Competitive Bidding program.
His company may be one of the first to be impacted by the program in this way, but he predicts it will not be the last. As the program spreads, he said, there will be other companies producing important medical accessories facing the same dilemma.
“I think this is a problem waiting to happen for other companies if it isn’t fixed,” Miller said. “It is impacting our business, but more importantly it is impacting people who use our product to significantly improve their lives in critical ways.”