Under new rules due to take effect Nov. 15, the Department of Health and Human Services would reimburse wheelchair users for less of the cost of purchasing a power wheelchair.

"People who are on Medicaid and Medicare will have to pay more for their power wheelchairs, and we're already nickel-and-dimed to death. It's not like we have a lot of money at our disposal. And power wheelchairs are our freedom," said Barbara Toomer of the Disability Rights Action Center. "I wouldn't be able to move without a power chair."

The new rules would cut reimbursement by as much as 41 percent for individuals covered by Medicare, according to groups opposed to the changes. Several senators and House members have written letters to HHS Secretary Mike Leavitt, asking that he postpone the new reimbursement rule and reconsider the changes.

"I don't want to do anything to complicate matters for people who depend on wheelchairs," Hatch said in a statement released by his office. "CMS worked with clinicians and providers to try to find the right balance - ensure access to high-quality wheelchairs while cracking down on well-documented abuse and fraud in the industry. I'm working with the Senate Finance Committee, CMS, and our Utah providers to determine how to implement this new policy fairly."

Jay Broadbent, owner of Alpine Home Medical in Salt Lake City, said the reimbursement rates were cut so severely it would make it impossible for his company to continue to supply wheelchairs.

"It was severely hacked is what they did," he said. "They cut the reimbursement so hard that, as a medical equipment dealer, we're looking at it and saying, 'You know what? We can't afford to buy them and turn around and sell them that low.' So we're debating if we even want to stay in that business."

But Ellen Griffith-Cohen, spokeswoman for the Centers for Medicare and Medicaid Services, said the changes were made when it became clear that the government was overpaying for the wheelchairs.

In 2004, the HHS inspector general found that the reimbursement rate Medicare used for an overwhelming number of its power wheelchairs was more than twice the wholesale cost in some cases.

So CMS developed 61 new codes with reimbursement rates that more accurately reflected the actual retail price of the chair, said Griffith-Cohen. That means Medicare may now pay $3,500 for a chair that it had paid nearly $5,300 for in the past.

That also helps the Medicare beneficiary, she said. A beneficiary pays one-fifth of the cost for the device, so "when Medicare pays too much for a wheelchair, the beneficiary pays too much for the wheelchair."

Between 1999 and 2003, the amount Medicare spent on motorized wheelchairs grew from $289 million to $1.2 billion, according to the inspector general, who also cited numerous examples of fraud and abuse in the program.

But Broadbent said it will be the patients who lose because CMS made the changes without considering who now might not be able to get a wheelchair.

Broadbent and others have asked Leavitt to take another look at the reimbursement rate and are pressing Hatch, a member of the Senate Finance Committee, which oversees Medicare issues, to intervene.