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DEPARTMENT OF HEALTH &. HUMAN SERVICES Office of Inspetor General ( t

"'''''.10 Memorandum 

Date


From


Subject' 

MAY 7 

Richard P. Kusserow 

Inspector Genera


OIG Management Advisory Report: "Pricing of Seat Lift
 Devices " OEI-02-90-02090 

Gail R. Wilensky, Ph.


Administrator 

Heal th Care Financing Administration


This management advisory report provides the Health Care


Financing Administration (HCFA) with current availability and


pricing information on seat lift mechanisms. 

BACKGROUND 

The Office of Inspector General (OIG) February 1989 report,

"Medicare Coverage of Seat Lift Chairs" (OAI-02-88-00100), concluded that: "There are strong indications that seat lift chairs (SLC) do not qualify as durable medical equipment (DME) under the Medicare program. The OIG recommended that the HCFA 

reconsider whether SLCs , in fact, meet the Medicare


definition of DME.


The HCFA agreed with the recommendation and drafted a notice 

for the Federal Register to exclude coverage of SLCs. The HCFA 

planned to continue covering seat lift mechanisms that are 

independent of a complete chair. Concern was expressed wi thin 

the Office of the Secretary that options other than exclusion 

were not considered by HCFA , including continuing to cover the

seat lift portion of the SLC under existing guidelines. 

this context, it was noted that there was no available data to 

provide estimates of costs associated with the manufacture and 

sale of the seat lift portion of the SLe. Additionally, little 

was known about the pricing and availability of seat lifts. As 

a result, HCFA asked the OIG to obtain information concerning 

the availability and cost of seat lifts. 
. 

Page 2 - Gail R. Wilensky, Ph.


FINDINGS 

Seat Lift Devices Are Marketed In Two Basic Forms


Independent or Free-Standinq Seat Lifts


At least four independent or free-standing seat lift devices 

are marketed in the united States. They are neither complete 

SLCs nor patient lifts similar to Hoyer lifts. These devices are free-standing and/or portable and can be placed upon a chair or bench inside and outside the home. They are the: "Assisto-seat " "Easy-Riser " "Automatic Lifter Seat " and 

"Pneumatic Lifter Seat. 

The "Pneumatic Lifter Seat" operates by using compressed air; the other devices are spring operated. The main features and pricing of these devices are summarized below. 

ASS ISTO-SEAT EAY-RISER AUTOMATIC PNEUMTIC 

LIFTER SEAT LIFTER SEAT 

ser

eight ettings 150 to 

. 220 lbs. 

80 to 

300 lbs. 150 to 

250 lbs. 112 to 

300 lbs. 

ize: 

14 " x16 " x4" 16 in. 16 in. 16. 5 in. 

, W

eight 7 lbs. square

4 . 5 lbs. square

5 lbs. square

3 . 5 in. 

etail rice $148. 50 to 

$159 

$129 to 

$169 

$129. 99 to 

$149. $250. 

arketing

pproach catalogueand 

Surgical 

Not yet 

production 

Catalogue

Direct 

Purchase 

Catalogue

Direct 

Purchase 

Suppl iers 
Page 3 - Gail R. Wilensky, Ph. D.


Seat Lift Chairs


There are several manufacturers of SLCs marketing them under


names such as "Cushion-Lift Chair, " "Action-Lift Chair " "Lift
 o 'Matic " and "Easy-Lift. All of these chairs operate 

electrically, handle body weights up to 400 pounds , and
 function in one of two ways:


elevation of just the seati and


elevation of the entire chair. 

The SLCs which operate by the elevation of the entire chair


(chair lifts) are currently more heavily marketed than the
 standard SLC. They are also more expensive. All of these 

models are reimbursed by the Medicare program when all coverage


requirements are met.


Medicare Carriers 
 ay Only For Seat Lift Chairs


Medicare carriers are not aware of any current allowed charges


for any seat lift devices other than SLCs. Carriers cover 

electrically or hydraulically operated patient lift devices 

which are different than SLCs and are used primarily for 

immobilized or otherwise nonambulatory persons. Some carriers 

are currently reimbursing both types of SLC (seat lift/chair

lift) without justification for the more expensive chair lift. 

These SLCs are billed at rates of about $300 to $500 more than 

standard SLCs and inflate the prevailing rates for Code 620. 

Current reasonable charge rates for purchase and rental of SLCs 

and related items follow. Code E0620 is for Seat Lift Chairs 

E0621 is for Slings or Seat Patient Lifts, E0625 is for Patient 

Lift-Kartops, E0630 is for Patient Lifts - Hydraulic , and E0635 is for Patient Lifts - Electric: 

PURCHASE RENTAL 

CODE HIGH LOW HIGH LOW E0620 $1, 487 * $689. $157. $81. 87 E0621 91. 22 $ 56. $ 9. 12** $ 9. 00** E0625 NONE NONE NONE NONE E0630 $ 982. $737. $ 89. $71.35 E0635 685. $692. $157. $75. 

All rates will be reduced 15% effective 04/01/90.

Only two of carriers in the sample paid a rental rate. 
r 1 

Page 4 - Gail R. Wilensky, Ph. D. 

The Veterans Administration Does Not Usually Provide Seat Lift


Chairs 

Contracting officers for the Department of Veterans Affairs'


(VA) Federal Supply Schedules confirmed that SLCs of the type 

used by Medicare beneficiaries are not contracted for nor 

supplied to VA centers around the country. The VA generally 

provides veterans with a variety of patient lifts--usually 

hydraulically or electrically operated--when they have lost the 

use of their lower limbs. It may be possible for a local VA 

center to provide a device such as a SLC on an individual

basis , if it is determined a medical necessity. 

CONCLUSIONS 

This management advisory report is being provided


for HCFA' s use in developing its regulations on SLCs and


seat lifts. We have no formal recommendations.


HCFA COMMENTS


During the exit conference on this report , HCFA staff asked for 

more information on the manufacturer of the "Pneumatic Lifter 

Seat. This information was provided informally. No other 

significant comments or suggestions were made. 

Please call me if you have any questions , or your staff may 

contact Barry Steeley at FTS 646-3138.