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Power Wheelchair Suppliers Spar With CMS Over New Regs

This article was originally published in The Gray Sheet

Executive Summary

Suppliers of power mobility equipment say CMS' new interim final rule on the devices creates a system that is more complicated than the one it replaces and should not be implemented until next April

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New power wheelchair rule is official

As of April 1, beneficiaries must meet face-to-face with a healthcare practitioner to receive a prescription for a power mobility device. The rule replaces CMS' former "bed-or-chair confined" criterion. According to CMS, the practitioner must also submit documentation from the beneficiary's medical history as evidence of the need for the device. The final rule differs from the interim final rule in that it gives a practitioner 45 days, rather than 30 days, to submit documentation to an equipment supplier after conducting the interview. During a September forum on the CMS decision, suppliers complained that the new prescription method was more complicated than the system it replaces (1"The Gray Sheet" Sept. 19, 2005, p. 9). The final rule also provides an add-on payment to practitioners for the work involved in compiling and transmitting the required documentation to the DME supplier...

New power wheelchair rule is official

As of April 1, beneficiaries must meet face-to-face with a healthcare practitioner to receive a prescription for a power mobility device. The rule replaces CMS' former "bed-or-chair confined" criterion. According to CMS, the practitioner must also submit documentation from the beneficiary's medical history as evidence of the need for the device. The final rule differs from the interim final rule in that it gives a practitioner 45 days, rather than 30 days, to submit documentation to an equipment supplier after conducting the interview. During a September forum on the CMS decision, suppliers complained that the new prescription method was more complicated than the system it replaces (1"The Gray Sheet" Sept. 19, 2005, p. 9). The final rule also provides an add-on payment to practitioners for the work involved in compiling and transmitting the required documentation to the DME supplier...

Wheelchair group files suit against CMS

:The Power Mobility Coalition, a group of industry suppliers and manufacturers, filed a temporary injunction against CMS Oct. 13 in an attempt to stop the agency from implementing its interim final rule on power mobility devices. On Oct. 14, CMS announced it was postponing local coverage determinations on new codes for wheelchair reimbursement. The agency did not postpone implementation of the rule, which becomes effective Oct. 25. The coalition has said the rule would establish a method of prescription that is more subjective and prone to error than the current certificate of medical necessity-based system (1"The Gray Sheet" Sept. 19, 2005, p. 9)...

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