The National Coalition for Assistive and Rehab Technology has
sent a report to state Medicaid directors urging caution in the
adoption of Medicare's new power mobility device fee schedule.
NCART says the report — “Adopting Medicare Power
Mobility Policies Will Impact the Provision of Appropriate Client
Services” — is an attempt to work proactively with
state programs as they implement the 64 new HCPCS codes for power
mobility. It includes background information, documentation and
data on the various Medicare PMD polices and how they are
related.
The report highlights two issues — pricing and coverage
policies — which the coalition believes could
“dramatically impact access to appropriate technology for
Medicaid recipients if caution is not used in adopting these
Medicare policies.”
Sent in December, the report was accompanied by a letter copied
to each state's governor. The letter explains that CMS' new fee
schedule, which took effect Nov. 15, is a discount off previous
power mobility pricing. “Even with the latest adjustments,
the fee schedule still represents a 10-30 percent decrease in
reimbursement when compared to the fee structure in effect prior to
Nov. 15,” NCART Executive Director Sharon Hildebrandt said in
the letter.
She also pointed out that suppliers who provide complex rehab
and assistive technology must employ trained specialists and are
burdened by costs, with 97 cents out of every dollar spent on
providing the equipment. “Any efforts to further reduce
pricing from the Medicare fee schedule will block access to
medically appropriate technology,” Hildebrandt wrote.
“The Medicare fee schedule must be viewed as the minimum
payment level by all state Medicaid programs. Moreover,” the
letter continued, “consideration should be given to
increasing reimbursement above the Medicare fee schedule should
your state be primarily rural in nature or other special
circumstances exist, such as additional processing
requirements.”
NCART also gave the state directors a recommended coverage
policy for power wheelchairs that removes the restrictive reference
to “in the home” used by the Medicare program.
