Bill Would Eliminate Mobility In-the-Home Restriction

Washington

Bipartisan legislation introduced in the Senate last month calls for lifting Medicare’s controversial “in-the-home” restriction for coverage of wheelchairs.

The Medicare Independent Living Act of 2006 (S. 3677), introduced by Sen. Jeff Bingaman, R-N.M., would eliminate the restriction and provide coverage for wheelchairs used outside of the home if it is determined that there is sufficient need due to the patient’s medical condition.

The current interpretation of Medicare’s in-the-home language covers devices that assist in activities of daily living such as eating, bathing, grooming, toileting and dressing, effectively restricting coverage to wheelchairs used inside a beneficiary’s home.

Specifically, the bill would amend section 1861(n) of the Social Security Act by adding that coverage would also be provided “in the case of mobility devices required by persons with expected long-term need, used in customary settings for the purposes of normal domestic, vocational and community activities.”

“Wheelchairs make it possible for otherwise homebound individuals to have the freedom and opportunity to get around outside their homes,” Bingaman said. “This bill allows people with disabilities to live independently in their community, and I hope my colleagues in the Senate support it.”

Rep. Rick Santorum, R-Pa., the sole Republican co-sponsor of the bill, said that he “will continue to advocate for an equitable Medicare payment policy for power wheelchairs that ensures patient access to these power mobility devices.”

The bill also has six other original co-sponsors — including Sens. Daniel Akaka, D-Hawaii; Tom Harkin, D-Iowa; James Jeffords, I-Vt.; John Kerry, D-Mass.; Joe Lieberman, D-Conn.; and Patty Murray, D-Wash. — and advocates are hopeful about gaining additional support for the measure and getting a companion bill in the House.

Last year, Bingaman was one of 34 senators and 70 representatives who signed a letter to HHS asking that the in-the-home restriction be modified through the regulatory process. But the government said that legislation would be required to make the appropriate changes, prompting Bingaman to author the new bill.

Seth Johnson, vice president, government affairs, for Exeter, Pa.-based Pride Mobility and chairman of the American Association for Homecare’s Rehab and Assistive Technology Council, said the legislation is “extremely positive for all Americans with disabilities or mobility impairments.”