New CMS Guidelines
The new CMS guidelines will severely restrict access to appropriate power mobility devices.
The new CMS guidelines will severely restrict access to appropriate power mobility devices and threaten to undo years of progress made by the ADA.
“The mission of the ITEM Coalition (Independence Through Enhancement of Medicare and Medicaid) is to raise awareness and build support for policies that will improve access to assistive devices, technologies and services for people of all ages with disabilities and chronic conditions.”
The ITEM Coalition’s current mission is to overturn the changes that CMS (the Centers for Medicare and Medicaid Services) has made to its already less-than-generous mobility device benefit. The Medicare mobility device benefit will only provide wheelchairs and scooters for use inside the home and, more specifically, only if it will help beneficiaries to eat, bathe, dress or groom. The new guidelines, effective November 15, 2006, are even more restrictive and are set to put a huge dent in the sixteen years of progress the ADA has made.
The old CMS guidelines allowed a beneficiary to use their power mobility device outside of the home, as long as it was also needed inside the home. The new guidelines will not only not allow the mobility devices provided by Medicare to be used outside the home, but they may even prevent the beneficiary from getting from room to room inside their home, as these “junk wheelchairs,” as most people consider them, will not navigate a small obstacle such as a doorjamb. These new, more restrictive guidelines will prevent people from returning to work or school, getting to their place of worship or even running daily errands.
The new billing and coding guidelines for power mobility devices are not based on functionality or the needs of the beneficiary. They are based on outdated standards that require a person to be completely non-ambulatory in order to receive a proper mobility device and will force countless others into power chairs that do not meet their needs, lessen their level of function and may, in some cases, cause their conditions to worsen. This is all in an effort to avoid fraud and abuse.
What all these new guidelines boil down to is simple: Unless the government changes these guidelines drastically, Medicare beneficiaries will never again receive the power mobility devices that they and their doctors deem appropriate for their needs. Rather, they will be stuck with the second-rate, inappropriate mobility devices that a stranger at Medicare has deemed appropriate and will reimburse a rehab equipment company of their choice for.
Contact your state and federal representatives to lend your voice to the growing concern over these new policies.
