Mass offers financial rewards for quick wheelchair fixes

The rules, which went into effect earlier this month, are Massachusetts’s latest attempt to address a national lack of investment in repair operations among the biggest companies in the wheelchair industry. This summer, a bill written to address the widespread problem of slow repair times stalled out in the state legislature. As the industry has consolidated around two large providers, infuriating delays for even basic repairs have become the norm.
“The people who are doing the repairs do need to put more effort into this service,” said Rich Levasseur, a wheelchair user from Tewksbury who spoke at a virtual public hearing Monday about the new regulations. “People can’t be without a repair for months at a time. It’s cruel and inhumane.”
Wheelchair users are applauding new state regulations that address painfully long wait times for wheelchair repairs but worry the initiatives don’t go far enough to ensure people will no longer be immobilized for weeks or months as they await urgent fixes.
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The initiatives from MassHealth, the state’s Medicaid administrator, include a $1,000 bonus payment for wheelchair providers that complete repairs for MassHealth members within 12 days. Eighty percent of that money must be reinvested into repair operations, including maintaining stock, staffing, and offering expanded hours. Providers will be required to share with the state quarterly data on repairs and how the money is used. That data will be made available to the public, state health officials said.
The reforms collectively add an estimated $4 million a year to MassHealth costs, money available through increases included in the most recent state budget.
Monday’s hearings, drew about two dozen advocates, wheelchair users, and at least one representative from the wheelchair industry. Advocates and wheelchair users ere tentatively optimistic. They praised the state’s action to address a longstanding, national problem, but worried a lack of penalties gave the industry insufficient incentives to improve their operations.
Rick Glassman, director of advocacy at the Disability Law Center, an advocacy organization that has made wheelchair repair problems one of its top priorities, said there was nothing keeping the wheelchair industry from seeking the incentive payment only for simple repairs, leaving people with more complicated maintenance in limbo.
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“We could have $1,000 payments given for simple and convenient repairs while other users are stranded at home,“ he said at the hearing, “where those people are still getting the same poor level of customer service they’ve already experienced.”
He described MassHealth’s new regulations as “carrots that need to be balanced with enforcement or sticks.”
State health officials noted MassHealth isn’t a regulatory agency, and financial incentives, not penalties, are its most powerful tool to encourage change in the industry. The incentive payments are designed to ensure the wheelchair industry commits the money and resources necessary to keep up with demand for repairs, said Leslie Darcy, chief of long term services and supports for the state’s Executive Office for Health and Human Services.
“To actually show improvement and to improve the member experience is going to require investment, both an investment in dollars and an investment in time,” she said.
The regulations also permit coverage of some routine maintenance, which users now have to pay for out-of-pocket, a move that could identify wear and tear on parts before they fail. In addition, MassHealth has made it possible for repair providers to coordinate transportation for wheelchair users through the state’s paratransit service to get them to and from repair facilities.
The regulations launched prior to public hearings because of the urgency of the problem, state officials said, but they could be revised based on feedback. Speakers during Monday’s hearings noted 12 days was still a long wait for repairs. State officials described the timeline as a starting point, with the goal of shortening that wait over time.
This year’s proposed legislation would have required two-year warranties for all new wheelchairs sold and would have allowed chair users to pursue action against the wheelchair industry through the attorney general’s office for work that took too long. The durable medical equipment industry group, National Coalition for Assistive and Rehab Technology, spent close to $100,000 in lobbying in 2022 and 2023 on, “matters relevant to the wheelchair industry,” state records show. The bill passed the state Senate but failed to move out of the House.
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State health officials said they would closely review quarterly data from the wheelchair industry to determine the effectiveness of the incentive payments and would communicate with legislators about the results.
“If this isn’t moving the needle the way that we hope that it will, we will be back at the table,” Darcy said.
The wheelchair market is dominated nationally by two private equity-owned firms, National Seating & Mobility and Numotion. The industry was valued at $63 billion in 2023. About 64 percent of all wheelchairs break down over a six month period, a 2023 report found. National Seating & Mobility declined to comment, and Numotion did not respond to a request for comment.
Jason Laughlin can be reached at jason.laughlin@globe.com. Follow him @jasmlaughlin.