Advocates for Seniors and Disabled Americans Call on CMS to Revise the Rules

9/11/2006 11:25:00 AM

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To: City Desk, Health Reporter

Contact: Michael K. Frisby 202-625-4328 or Alicia Ingram 404-493-1724, both of Frisby & Associates

WASHINGTON, Sept. 11 /U.S. Newswire/ -- Clinicians and advocates for people with disabilities today sharply criticized new Medicare procedures that will force beneficiaries living with mobility impairments, many of whom are senior citizens, to receive power wheelchairs and scooters unable to meet their medical needs.

Advocates called on the Centers for Medicare and Medicaid Services (CMS) to delay the scheduled Oct. 1 implementation, charging that individuals with mobility impairments, including senior citizens and people living with disabilities, will become "prisoners in their homes" because of the new policy that operationalizes the coverage, coding and pricing changes that CMS has recently made to the Medicare power mobility benefit. They want the policy revised.

"Medicare is seeking to save money on the mobility benefit at the expense of senior citizens and people of all ages with disabilities," said Barbara Crane, PhD, PT, ATP, and co- coordinator of the Clinician Task Force. "Clinically, it is standard professional practice to address all mobility needs for typical daily activities; we aim for individuals to be as mobile as possible. This policy conflicts with accepted medical practice, and will confine people to their homes and in some cases to a single room in their homes."

Under the procedures scheduled for implementation on Oct. 1, Medicare coverage for power wheelchairs and scooters will be restricted to inexpensive, low-powered models leaving people with degenerative diseases such as multiple sclerosis, Parkinson's disease or post polio syndrome in the position of no longer qualifying for an appropriate level power chair that also plans for their future medical needs. This shortsighted approach will unnecessarily cost the taxpayers more in the future when patients have additional medical and mobility needs.

Currently, Medicare pays for power mobility equipment only if it is required to help a beneficiary perform essential daily activities inside their home, such as eating, dressing or using the bathroom. However, the coverage policy previously allowed beneficiaries to receive a power wheelchair also capable of outdoor use, so many individuals were active in their communities and could go to the store, shopping or to the bank.

"After Oct. 1, many beneficiaries will receive wheelchairs that don't meet their needs," said Henry Claypool, an advocate from the Independence Care System. "It makes no sense that Medicare should pay for a wheelchair that won't maneuver over the threshold of a sliding glass door. At a minimum, Medicare must facilitate people leaving their homes in emergency situations instead of making them prisoners in their homes."

Andrew Imparato, president and CEO of the American Association of People with Disabilities, agreed, saying, "It is outrageous that Medicare will seek to cut costs by victimizing people who most need their assistance. These changes will impact the thousands of people who will need power wheelchairs and scooters now and in the coming weeks, months and years. As Baby Boomers grow older, there will be an increased need to meet their mobility needs, but Medicare won't be there for them."

Technically, the new standard will require that a Medicare beneficiary be unable to stand and pivot to get into the seat of a power wheelchair or scooter to be eligible for the best of the inexpensive, low-powered models that CMS will cover after Oct. 1.

"It is unfortunate that new CMS guidelines are not intended to meet the functional needs of Medicare beneficiaries," said Laura Cohen, PhD, PT, ATP, a co-coordinator of the Clinician Task Force. "They are based on cost-cutting standards that require individuals to be completely non-ambulatory to receive an appropriate mobility device. These rules will undoubtedly force many beneficiaries into inappropriate and low-functioning mobility devices. And that is not in the best medical interest of these individuals or fiscally responsible to taxpayers."

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