CMS Power Wheelchair LMRP “Clarifications” Denounced By Trade Groups
This article was originally published in The Gray Sheet
Executive Summary
CMS' interpretation of the term "non-ambulatory" in a recent clarification of local coverage policies for power wheelchairs will significantly restrict beneficiary coverage and access to the DME devices, industry groups argue
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CMS Administrator McClellan Likely To Lend Ear To Power Wheelchair Issue
CMS may allow power wheelchair medical necessity determinations to be made on a case-by-case basis - a step that would preclude it from developing unpopular "non-ambulatory" patient coverage definitions
CMS Administrator McClellan Likely To Lend Ear To Power Wheelchair Issue
CMS may allow power wheelchair medical necessity determinations to be made on a case-by-case basis - a step that would preclude it from developing unpopular "non-ambulatory" patient coverage definitions
Power wheelchair user criteria
CMS Acting Administrator Dennis Smith pledges to provide House Appropriations/HHS Subcommittee with "series of updates" concerning appropriate use of clinical assessments to guide power wheelchair reimbursement. During a March 10 hearing, Subcommittee Chair Ralph Regula (R-Ohio) cited instances of certain DME regional carriers "routinely denying" power wheelchair coverage for patients with "limited mobility." In extreme cases, "just a little bit of mobility takes you out of the running for a power wheelchair." Smith responded: "Maybe we're behind the rumor curve a bit in terms of people interpreting what our rules are for us. But we are working hard to say we haven't really changed the rules. There really does need to be a clinical evaluation of that individual. To really do this requires a thorough assessment of what's best for them." The agency has come under fire since clarifying its wheelchair policy last December in an effort to curb fraud (1"The Gray Sheet" Jan. 5, 2004, p. 3)...