ITEM Coalition Lauds Introduction of Legislation to Fix Medicare's "In the Home" Restriction on Mobility Devices

[Washington D.C.] Today, the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition commends Senators Bingaman (D-NM) and Santorum (R-PA) for introducing important legislation to modify Medicare’s antiquated “in the home” restriction on mobility devices.

The “Medicare Independent Living Act of 2006” (S. 3677) would significantly increase community access for Medicare beneficiaries with mobility impairments by providing them with mobility devices appropriate not only for daily activities inside their homes, but outside of their homes as well.  

“The introduction of this legislation represents a tremendous step toward bringing an outdated Medicare benefit in line with the true abilities and goals of people with mobility impairments,” stated Lee Page of the Paralyzed Veterans of America and ITEM Coalition Steering Committee.

The statutory “in the home” language, (originally meant to define durable medical equipment (DME) as devices that were provided outside of a hospital or skilled nursing facility and, therefore, warranted separate reimbursement under Medicare Part B), is currently interpreted by CMS to restrict coverage to only those mobility devices that are reasonable and necessary in the patient’s home.  However, many individuals are able to function without a mobility device inside their homes but need a device for community activities such as attending work, school, religious services, physician appointments and grocery shopping.

“The ‘in the home’ restriction has long acted as an artificial barrier to appropriate wheelchair access by narrowly confining Medicare coverage criteria to in-home activities,” stated Alaine Perry of the United Spinal Association and ITEM Coalition Steering Committee. “But the sponsors of this legislation recognize that a person’s need for mobility does not end at the front door.”  

Senators Bingaman and Santorum are clearly committed to this issue.  In July, 2005, the Senators spearheaded a bipartisan Congressional sign-on letter to the Secretary of Health and Human Services (HHS) asking that the Department modify the “in the home” restriction to improve community access for people with disabilities.  Despite the signatures of 34 Senators on the letter, as well as 70 signatures from House Members on a similar letter sponsored by Congressman Bass (R-NH) and Langevin (D-RI), the HHS Secretary responded by stating that the agency is confined by statutory language.   As a result, the Senators are now moving forward with a legislative fix.

“The efforts of Senators Bingaman and Santorum on this issue have been extraordinary,” stated Peter Thomas, an ITEM Coalition Steering Committee Member.  “With over 6 million Medicare beneficiaries under the age of 65, many of whom have mobility impairments, this legislation will provide access to some of the basic tools required for independent, community living,” Thomas continued. “We look forward to working with the bill’s sponsors to ensure its passage.”

The ITEM Coalition was formed in 2003, and its 74 member organizations include a diverse set of disability groups, aging organizations, 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 improve coverage of assistive devices, technologies and related services for people with disabilities of all ages.  For more information on the ITEM Coalition, please visit www.itemcoalition.org. 

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