DMERCs Implement Grace Period for Power Mobility Rule

BALTIMORE–The DMERCs announced last week that there will be a
grace period for the implementation of a rule that does away with
the power mobility certificate of medical necessity.

The interim final rule for power mobility devices, which took
effect Oct. 25, replaces the power mobility CMN with a face-to-face
exam and a doctor’s prescription. Providers also are now
responsible for gathering records that prove a patient’s medical
necessity for power mobility before delivering the device (see
HomeCare
Monday, Aug. 29).

In a notice issued last week, the DMERCs said that following
discussions with CMS, they will honor PMD orders signed and dated
by the treating physician before Oct. 25 and will not subject the
claim to the requirements of the new rule if it is subjected to a
manual medical review. Instead, the prior documentation
requirements will be applied:

–there must be a dispensing order for the PMD from the
physician that is obtained by the supplier prior to delivery of the
device;
–there must be a detailed written order for the PMD which is
signed and dated by the treating physician and received by the
supplier prior to billing the device;
–there must be documentation in the patient’s medical record that
the coverage criteria for the PMD have been met; and
–all of this documentation must be available to the DMERC on
request.

Meanwhile, the National Coalition for Assistive and Rehab
Technology announced that it is not supporting a proposed amendment
to the Senate’s budget bill from Sen. Arlen Specter, R-Pa., to
rescind the IFR and delay its implementation until April 2006 (see
HomeCare
Monday, Oct. 31).

While much of the industry supports the move to provide more
time for education on the change, “most rehab companies have close
relationships with their physicians and have been working with them
since [the National Coverage Determination] came out in May,”
according to NCART Executive Director Sharon Hildebrandt. “We feel
[delaying the rule] would lead to more confusion. It’s just not a
priority for us.”

In addition, the organization said it opposes the 1.5 percent
reduction in power wheelchair reimbursement incorporated into the
amendment as a way to pay for the delay.

To view the notice on the IFR grace period,
click here.