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March 3, 2004
Contact: Emily Niederman
(202) 349-4260
ITEM COALITION COMMENDS SENATOR GRASSLEY’S LETTER TO CMS ON POWER MOBILITY
POLICY CLARIFICATION
Coalition Submits Comments to CMS Listening Session on Medicare Power Mobility
Benefit
[Washington, DC] – The ITEM Coalition commends Senate Finance Chairman
Charles E. Grassley (R-IA) for his letter to Acting CMS Administrator Dennis
Smith requesting further justification of the criteria and procedures used
to create the recently published “Policy Clarification” on Medicare coverage
of power wheelchairs and power-operated vehicles (“POVs” or “scooters”).
“We praise Senator Grassley for his call to CMS to provide a clear statement
of the standards and process used to develop the Policy Clarification,”
said Henry Claypool of Advancing Independence, a member of the ITEM Coalition
Steering Committee. “Though it represents a significant change from prior
wheelchair coverage policy, the Clarification was put together behind closed
doors, without input from the public or other stakeholders.”
The change in policy, part of an effort by CMS and the HHS Office of Inspector
General (“OIG”) to combat fraud in Medicare’s power mobility benefit, overshoots
the mark by imposing new restrictions on coverage of both manual and power
wheelchairs, as well as POVs. Senator Grassley’s letter, which was sent
on February 24, 2004, emphasized the importance of balancing the objective
of combating fraud with the interests of beneficiaries to have access to
the technologies they need.
“Senator Grassley is right on target,” said Lee Page of Paralyzed Veterans
of America, another member of the ITEM Coalition Steering Committee. “Everyone
supports efforts to eliminate fraud in Medicare, but those efforts should
not jeopardize the health and welfare of beneficiaries by preventing them
from accessing needed mobility devices.”
Senator Grassley will oversee confirmation hearings this week for President
Bush’s nomination to the post of Administrator for the Centers for Medicare
and Medicaid Services (CMS), Mark McClellan, M.D., Ph.D. The Coalition
expects that Dr. McClellan will be asked to address the issues raised in
Senator Grassley’s letter at the confirmation hearing.
Also today, the ITEM Coalition will submit written comments and provide oral testimony at CMS’ “Special Open Door Forum Listening Session,” which focuses on the agency’s efforts to stop fraud in the power mobility benefit. Members of the Coalition’s Steering Committee will raise concerns regarding the Policy Clarification’s effect on beneficiaries’ access to mobility devices. The ITEM Coalition’s written comments will be available at www.ITEMCoalition.org.
In a letter to HHS Secretary Tommy G. Thompson sent on January 23, 2004,
the ITEM Coalition Steering Committee identified several concerns about
the effect of the Policy Clarification on beneficiaries’ access to mobility
devices and requested a meeting to discuss the issue. The letter to Secretary
Thompson highlighted the obstacles to access raised by the Policy Clarification’s
statement that if a patient is able to walk either without any assistance
or with the assistance of an ambulatory aid, such as a walker, a power
wheelchair will be denied as not medically necessary.
“The language sets a bright line rule that threatens the health and mobility
of the many Americans who can rely on walkers or canes for traveling a
short distance, but require power mobility devices to be able to live healthy,
safe lives,” the ITEM Coalition Steering Committee letter to Secretary
Thompson stated. The letter also expressed concerns with the process used
to implement the Policy Clarification, which was not released in a draft
form or made available for notice and comment before it was finalized.
The Coalition Steering Committee urged Secretary Thompson to “rescind the
wheelchair policy clarification and, in the alternative, issue a proposed
policy that seeks public comment.” A copy of the letter is available at
http://www.itemcoalition.org/press/thompson_ltr.html.
The ITEM Coalition (“Independence Through Enhancement of Medicare and Medicaid”) is a consumer-led coalition formed in 2003. Its over 70 member organizations include a diverse set of disability organizations, aging organizations, other consumer groups, labor organizations, voluntary health associations, and non-profit provider associations. The ITEM Coalition’s purpose is to raise awareness and build support for policies that will improve access to assistive devices, technologies and related services for people of all ages with disabilities and chronic conditions. For more information on the ITEM Coalition, please go to www.ITEMCoalition.org.
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