Scooter Ads Targeting Seniors Misleading, Say Doctors, Gov't

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Hoveround commercial
AP / YouTube.comA screenshot from a Hoveround commercial. Lawmakers say ads by the Scooter Store and Hoveround have led to hundreds of millions of dollars in unnecessary spending by Medicare.
By MATTHEW PERRONE

WASHINGTON -- TV ads show smiling seniors enjoying an "active" lifestyle on a motorized scooter, taking in the sights at the Grand Canyon, fishing on a pier and high-fiving their grandchildren at a baseball game.

The commercials, which promise freedom and independence to people with limited mobility, have driven the nearly $1 billion U.S. market for power wheelchairs and scooters. But the spots by the industry's two leading companies, The Scooter Store and Hoveround, also have drawn scrutiny from critics who say they convince some seniors that they need a scooter to get around when many don't.

Members of Congress say the ads lead to hundreds of millions of dollars in unnecessary spending by Medicare, which is only supposed to pay for scooters as a medical necessity when seniors are unable to use a cane, walker or regular wheelchair. Government inspectors say up to 80 percent of the scooters and power wheelchairs Medicare buys go to people who don't meet the requirements. And doctors say more than money is at stake: Seniors who use scooters unnecessarily can become sedentary, which can exacerbate obesity and other disorders.

"Patients have been brainwashed by The Scooter Store," says Dr. Barbara Messinger-Rapport, director of geriatric medicine at the Cleveland Clinic. "What they're implying is that you can use these scooters to leave the house, to socialize, to get to bingo."

The scooter controversy, which has escalated with a raid by federal authorities on The Scooter's Store's New Braunfels, Texas, headquarters last month, underscores the influence TV ads can have on medical decisions. Like their peers in the drug industry, scooter companies say direct-to-consumer advertising educates patients about their medical options. But critics argue that the scooter spots are little more than sales pitches that cause patients to pressure doctors to prescribe unnecessary equipment.


The Scooter Store and Hoveround, both privately held companies that together make up about 70 percent of the U.S. market for scooters, spent more than $180 million on TV, radio and print advertising in 2011, up 20 percent from 2008, according to advertising tracker Kantar Media. Their ads often include language that the scooters can be paid for by Medicare or other insurance: "Nine out of ten people got them for little or no cost," states one Hoveround ad.

Hoveround didn't respond to a half-dozen requests for comment. The Scooter Store, the nation's biggest seller of scooters, said that most people who contact the company after seeing the ads do not ultimately receive a scooter.



"The fact that 87 percent of the persons who seek power mobility products from The Scooter Store under their Medicare benefits are disqualified by the company's screening process is powerful evidence of the company's commitment to ensuring that only legitimate claims are submitted to Medicare," the company said in a statement. The Scooter Store has been operating with a streamlined staff in recent days, following massive layoffs in the wake of the raid by federal agents.

Insurance executives say doctors who don't understand when Medicare is supposed to pay for scooters are partly to blame for unnecessary purchases.

Scooters -- which are larger than power wheelchairs and often include a handlebar for steering -- are covered by Medicare if they are prescribed by a doctor who has completed an evaluation showing that a patient is unable to function at home without a device.

The doctor fills out a lengthy prescription form and sends it to a scooter supplier that delivers the device to the patient and then submits the paperwork to Medicare for payment. Medicare pays about 80 percent of that cost, which can range from $1,500 to $3,500. The remainder is often picked up by supplemental insurance or the government-funded Medicaid program for low-income and disabled Americans.

The process can help immobile seniors get equipment that improves their lives. Ernest Tornabell of Boynton Beach, Fla., received a scooter from Pride, a smaller manufacturer, through Medicare about six years ago. Tornabell, 73, suffers from obesity, diabetes and lung disease and says he used to never leave his house. Now, using the scooter he can walk his dog, go to the grocery store and run other errands.

"I couldn't really get out and do anything before. Now I have a lot more mobility," said Tornabell, whose doctor recommended that he get the device.

Uninformed Physicians

But Dr. Stephen Peake, medical director for the insurer Blue Cross Blue Shield in Tennessee, says doctors can often be as uninformed about the appropriate role of scooters as patients.

"I talk to a lot of physicians about this subject ... and after our discussions, they don't understand that you can't get a power mobility device so mom can go to the park with the family," Peake said in testimony before the Senate Committee on Aging last year.

One reason for the confusion? Doctors say scooter companies are just as aggressive with health professionals as they are in marketing to their patients.

Dr. Jerome Epplin of Litchfield, Ill., who also testified before the Senate, estimates that only about one of every 10 patients who ask him for a scooter actually needs one. But he said that sales representatives from some scooter companies put pressure on him by accompanying patients to his office. The effect is coercive, he says.

"It can be intimidating," Epplin says. "I see it as an inappropriate attempt to influence my clinical judgment when I'm evaluating a patient."

Allegations of Medicare fraud within the industry go back nearly a decade.

In 2005, the U.S. Justice Department sued The Scooter Store, alleging that its advertising enticed seniors to obtain power scooters paid for by Medicare, and the company then sold patients more expensive scooters that they did not want or need. The Scooter Store settled that case in 2007 for $4 million.

As part of the settlement, The Scooter Store was operating under an agreement that made the company subject to periodic government reviews between 2007 and last year. In 2011, the latest review available, government auditors estimated that The Scooter Store received between $47 million and $88 million in improper payments for scooters.

The Scooter Store took no action to repay the money until February 2012, when the Health and Human Services' inspector general threatened to bar the company from doing business with Medicare, which accounts for about 75 percent of its revenue, according to its congressional testimony.



The company said the government's estimate was flawed and that it was willing to repay $19.5 million in overpayments. The company has paid about $5.7 million. The rest is scheduled for repayment by 2017.

Medicare said in a January letter that it accepted the fee based on The Scooter Store's own assessment of what it owed, but that the agreement "does not absolve The Scooter Store from any further liability."

In recent months, Sen. Richard Blumenthal, D-Conn., and other members of the Senate Aging Committee have pushed Medicare to recover the millions of dollars spent on unnecessary scooters each year. Those purchases totaled about $500 million in 2011, the latest year available, according to a report by the Department of Health and Human Services' inspector general.

Reducing 'Wasteful Spending'

Medicare, which says that it doesn't have control over how companies market the scooters, launched a pilot program designed to reduce wasteful spending on scooters.

Under the program, government contractors in seven states review patients' medical documentation to make sure they need a wheelchair or scooter before approving payments for a device. The program is being tested in a small number of states -- including Florida, California and New York -- because the government must pay contractors extra to review additional paperwork.

The program has been criticized by The Scooter Store's executives, who say that contractors are too strict in their reviews, rejecting payments for power chairs that are genuinely needed.

The reduced payments are hurting the company, which was founded in 1991. The Scooter Store has spent nearly $1 million lobbying Congress over the last two years, almost exclusively focused on the Medicare review program. And the company laid off about 370 employees in the past year, blaming the reduced payments it's been getting from Medicare.

Then, last week, The Scooter Store notified most of its remaining 1,800 employees that their jobs were being eliminated. The company said in a statement to the Associated Press that it is operating with a workforce of 300 employees -- down from the 2,500 workforce it had at its peak -- while trying to restructure its operations.

The mass layoffs followed a raid in February by about 150 agents from the FBI, the Department of Justice and the Texas attorney general's Medicaid fraud unit. Authorities searched the company's headquarters.

Federal authorities have declined to speak about the raid, but scooter industry critics in Congress praised the action.

"This raid is a welcome step toward cracking down on waste and fraud in Medicare," said Blumenthal, the Connecticut senator. "I have urged action to stop abusive overpayments for such devices -- costing taxpayers hundreds of millions of dollars and preying on seniors with deceptive sales pitches."
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AP writer Juan Lozano contributed to this report from Houston.


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13 Comments

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clarita995

if they're so concerned about WASTE AND FRAUD in medicaid--get the illegals OFF THE ROSTER and end the duplication of services as with WIC--medicals etc to get in the program--do they do this bs to get their foodstamps ?
same for funding planned parenthood CLINICS--they are a profit making corp and don't need federal dimes
etc
plenty of WASTE OUT THERE STARTING WITH THEIR LAZY@zzzed employees and up to their illegals and ALL LEGIT ENTRANTS/
AMERICANS FIRST.

March 30 2013 at 11:21 AM Report abuse rate up rate down Reply
clarita995

misleading ads ????ever see the crappola from AARP ?
read huffpooP ?

March 30 2013 at 11:15 AM Report abuse rate up rate down Reply
Albert Gazalooch

If not for these scooters, 500 pound black women wouldn't be able to shop at Walmart!

March 29 2013 at 10:30 PM Report abuse +1 rate up rate down Reply
1 reply to Albert Gazalooch's comment
clarita995

why so many MORBIDLY OBESE today ? i don't recall seeing folks sooooooo overweight back when either.

March 30 2013 at 11:16 AM Report abuse rate up rate down Reply
ElliottMagalnick

Medicare rules dictate that a 3-wheeled or 4-wheeled scooter is available for a patient with a neuro muscular disease such as MS, or Muscular Dystrophy, Parkinson's, rheumatoid arthritis, etc and if not in that category then they are not eligible for a scooter. Scooters cost half of what power wheelchairs with a joy stick used by one hand cost but the eligibility requirements for a power wheelchair are not as stringent as for a scooter so places like Scooter Store trade up to power drives from scooters and then they can bill Medicare and get paid. The article quoted Scooter Store as saying that 87% of inquiries are rejected for scooters which may very well be true but they never mentioned that they moved the clients up to more expensive equipment.

March 29 2013 at 8:44 PM Report abuse rate up rate down Reply
ElliottMagalnick

Yes

March 29 2013 at 8:39 PM Report abuse rate up rate down Reply
mdennish

I cannot believe how many elderly people complain about medicare rates and then they try to bilk medicare out of money such as procuring a scooter they do not need.

March 29 2013 at 6:36 PM Report abuse -1 rate up rate down Reply
jj2301

These things are new-age cigarettes. They create and perpetuate their own class of dependents, at the expense of taxpayers. This scam is making millions for businesses, while doctors too weak to say 'no' write prescriptions for devices lazy people don't need - and we all get to pay for it.

There needs to be serious scrutiny of *any* medical claim that specifically calls for a power wheelchair. These devices engender obesity other disorders related to sedentary living.

As bakethis said, we need to stop giving money to noncitizens as well; all the fraud, waste and abuse needs to stop.

March 29 2013 at 5:15 PM Report abuse rate up rate down Reply
Missy Youtoo

Why isn't the government overseeing the claims to prevent payment from going out in the first place? Incompetent government employees is the reason. How do these people continue to remain employed in government and were not fired for failure to scrutinize claims? Firing the incompetents and there would be less fraud taxpayers end up paying for to the claimants.

March 29 2013 at 4:45 PM Report abuse +1 rate up rate down Reply
1 reply to Missy Youtoo's comment
mdennish

If all incompetent government workers were fired . The remaining 10% would have to work 24/7 to get things accomplished.

March 29 2013 at 6:37 PM Report abuse rate up rate down Reply
bakethis

Medicare launched a pilot program designed to reduce wasteful spending on scooters. An amendment was added to the "keep the government in business" bill that is giving illegals free medical care under Medicaid. I'd rather see a few old people tooling around in scooters than the tremendous amount of money that is wasted supplying taxpayer supported benefits to non citizens. The clown in the White House just keep tearing us down.

March 29 2013 at 2:06 PM Report abuse +1 rate up rate down Reply
dssmalik

I must be missing something.
Government inspectors say up to 80 percent of the scooters and power wheelchairs Medicare buys go to people who don't meet the requirements.
Then why is medicare paying for them?

March 29 2013 at 1:37 PM Report abuse rate up rate down Reply
1 reply to dssmalik's comment
Albert Gazalooch

Because there's no money in the budget to fight Medicare abuse! You can thank the Republican sequester for that!

March 29 2013 at 10:31 PM Report abuse -1 rate up rate down Reply
1 reply to Albert Gazalooch's comment
clarita995

glad you expose diMwitted lies and INABILITY to even go outside and OFF the dem_plantation
as
the sequestor IS DIM OWNED AND OPERATED.
change YOUR NEWS SOURCE and be AMAZED with the TRUTH.

March 30 2013 at 11:14 AM Report abuse +1 rate up rate down