Rep. James Langevin, D-R.I., and 12 other House members have introduced H.R. 3184. The proposed legislation would eliminate

WASHINGTON — Rep. James Langevin, D-R.I., and 12 other
House members have introduced the Medicare Independent Living Act of 2009 (H.R. 3184).
The proposed legislation would eliminate Medicare's "in the home"
requirement for DME including power mobility devices.

Langevin introduced a similar measure in 2007, but no action was
taken on the bill.

According to Langevin, the statutory in-the-home language was
originally meant to define DME as devices that were provided
outside of a hospital or skilled nursing facility, warranting
separate reimbursement under Medicare Part B rather than Part A.
Over time, however, CMS has interpreted that language as
restricting coverage of mobility devices only to when a beneficiary
has a medical need in the home.

That has made it difficult for "a significant number" of
Medicare beneficiaries to qualify for the appropriate power
wheelchair or other PMD, according to the bill.

In a 2005 interview with HomeCare, Langevin — the
first quadriplegic elected to Congress — said he felt CMS had
missed opportunities to clarify the issue both in its new national
coverage determination on mobility and its interim final rule on
power mobility devices issued that year. He subsequently
co-authored a letter to then-HHS Secretary Michael Leavitt —
signed by nearly 70 other congressmen — asking CMS to modify
its in-the-home coverage restriction.

"There are people with great talents and skills who are stuck in
their house as opposed to serving in Congress with me or being out
there in the community realizing their potential and contributing
their gifts and talents," Langevin said at the time. "It's a waste
of talent and resources that we could use in the workforce."

But CMS officials said the new policy was not the proper place
to tackle the change and that the issue would be better addressed
through legislation.

If Langevin's recent measure becomes law, power wheelchairs and
other mobility devices would be covered by Medicare if they are
used "for the purpose of normal domestic, vocational or community
activities," even if the equipment would not be used primarily in
the home.

"The need to have access to one's physical environment through
the use of an appropriate wheelchair or other mobility device, both
inside and outside of the home, is critical to living
independently, functioning in society and attaining a meaningful
quality of life," according to the bill.

The proposed legislation notes there are approximately 2.2
million wheelchair users in the U.S., with a significant portion of
those users qualified for Medicare coverage either based on
disability status or age.

H.R. 3184 has been referred to the House Energy and Commerce and
Ways and Means committees.

Read the full text of the bill.