House Members Fight In-the-Home Restriction

WASHINGTON–Two congressmen are urging their fellow House
members to sign a letter to HHS Secretary Michael Leavitt
requesting that he modify Medicare’s in-the-home requirement for
coverage of mobility equipment.

Reps. Charlie Bass, R-N.H., and Jim Langevin, D-R.I., began
circulating the letter on behalf of the ITEM (Independence Through
Enhancement of Medicare and Medicaid) Coalition on Thursday in
response to CMS’ new mobility coverage guidelines.

The consumer-led organization is one of many disability advocate
groups and mobility stakeholders disappointed that the new policy
did not remove the in-the-home restriction–language that limits
coverage to those who have medical need for mobility-assist devices
in the home, excluding those who need the equipment only for work
or another use outside of the home.

In an attached letter explaining the policy to their colleagues,
Reps. Bass and Langevin noted that perpetuation of the in-the-home
restriction “runs counter to important goals established in the
administration’s New Freedom Initiative and legislation such as the
Ticket to Work program, which seeks to return people with
disabilities back into the workforce and into communities. This
sends a mixed message by denying individuals with disabilities the
basic tools they need to achieve maximum function and
independence.”

The letter to Leavitt includes the following paragraph:

“In order to ensure that the ‘in the home’ requirement does not
act as a barrier to community participation for Medicare
beneficiaries with disabilities and mobility impairments, we ask
that you modify this requirement through the regulatory process.
Additionally, if your agency concludes that the ‘in the home’
requirement cannot be addressed through the regulatory process, we
request that you respond with such information as quickly as
possible so that Congress may begin examining legislative
alternatives.”

ITEM spokeswoman Emily Niederman said she is optimistic the
letter will gather a significant number of House signatures. The
organization is also working on a similar letter to be circulated
in the Senate. “[Eliminating the in-the-home requirement] is
something that should have been done a long time ago,” she said.
“It’s so outdated.”

A CMS decision memorandum said the mobility NCD would not be the
appropriate place to change the restriction, which comes from the
Medicare statute.

For more on the NCD, access the May 9 HomeCare Monday by
clicking
here.