Mobility Stakeholders Await New Guidelines

Baltimore

As the comment period recently ended within Medicare’s National Coverage Determination process for wheelchairs, mobility stakeholders recommended that CMS delve further into details and speed up the process. The agency has named Sept. 12 as its target date for completion, but officials said they hope to finish the process early this year.

Any delay will have “the effect of perpetuating inappropriate wheelchair prescriptions and claims denials at the expense of Medicare beneficiaries,” said the ITEM (Independence Through Enhancement of Medicare and Medicaid) coalition, a group representing more than 70 disability organizations.

From mid-December until Jan. 14, interested parties submitted comments about a coverage proposal from the Interagency Wheelchair Work Group, a panel consisting of clinicians and other health professionals from several federal agencies.

The proposal includes criteria that would qualify Medicare beneficiaries for mobility-assist devices, from walkers to manual wheelchairs to scooters to power wheelchairs, and recommends removing current coverage policy language requiring beneficiaries to be “bed or chair confined.”

Although some commenters agreed with many of the group’s proposals, others pointed out what they felt were significant shortcomings.

For example, one physical therapist noted the document’s wording may be restrictive because it states that a mobility device must sufficiently restore “mobility-related activities of daily living.”

“With this wording, all of the clients I [have] dealt with who are severely brain-damaged and need the chair simply to be managed within their home … would not be eligible,” the therapist wrote. “… Christopher Reeve would not have been eligible for a wheelchair.”