RAMP Asks CMS to Clarify Requirements

Baltimore

A coalition of mobility stakeholders is asking CMS to shed light on documentation requirements for medical necessity before it implements new mobility coverage criteria.

According to statements issued last month by the Restore Access to Mobility Partnership, “one of the biggest flaws in the Medicare reimbursement process is a documentation policy that is too open to interpretation, resulting in DMERC claim processors increasingly insisting that physician chart notes are solely to be used to determine medical necessity.”

RAMP — whose members include the American Association for Homecare, Invacare Corp., The MED Group, Mobility Products Unlimited, Pride Mobility and Sunrise Medical — explained that “physicians will not, as a matter of practice, document the beneficiary’s medical condition with the level of specificity envisioned in the new coverage policy.”

The group added that “documentation requirements must be tied directly to the coverage policy and clearly outline the required information, who is responsible for providing the information and how the information must be documented.”

Instead, RAMP suggested CMS should base its requirements on an expanded Certificate of Medical Necessity, which is “far superior” to “vague and incomplete” physician notes.