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PDF Version (75 KB)
March 12, 2004 The Honorable Tommy G. Thompson
Secretary
Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Re: Power Wheelchairs and POVs – Medicare Coverage Policy Clarification
Dear Secretary Thompson:
On January 23, 2004, we sent you a letter on behalf of a national, consumer-led
coalition known as the “ITEM” Coalition, which is an acronym for Independence
Through Enhancement of Medicare and Medicaid. The ITEM Coalition has over
70 member organizations, which have joined together 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.
In our earlier letter, we raised concerns over the implementation of “Power
Wheelchairs and POVs – Policy Clarification and Medical Review Strategy”
(the “Policy Clarification”) issued in December, 2003 and urged you to
rescind the Policy Clarification and, in the alternative, issue a proposed
policy that seeks public comment. Despite our subsequent telephone contacts
to schedule a meeting, we received no response from your office.
Since we sent you the January 23 letter, CMS has held a “Listening Session”
on this issue on March 3, 2004, in which members of the ITEM Coalition
Steering Committee participated. The Coalition’s Steering Committee also
submitted written comments to CMS, which are provided as an attachment
to this letter. Unfortunately, many consumers and consumer advocates participated
in the Listening Session by conference call and were not selected to speak,
including those who had registered. In addition, the Listening Session,
which was only scheduled for two hours, was held in Baltimore, making it
difficult for users of mobility devices who are active on this issue in
D.C. to attend in person, and no comparable session has been scheduled
in Washington.
An open process is essential to ensuring that policy changes in Medicare
benefits do not harm beneficiaries and deny them access to critically needed
items and services for which they are eligible. The continued limitation
on participation in the process of developing the Policy Clarification,
as exemplified in the Listening Session, raises grave concerns. Critical
stakeholders – beneficiaries, physicians, therapists and rehabilitation
specialists – have not been adequately heard in this process.
CMS has acknowledged that the Policy Clarification has been misinterpreted
by a number of parties. In our view, this is due to the fact that the new
policy is seriously flawed and out of step with current medical practice,
resulting in widespread confusion. Simply attempting to further clarify
a bad policy is no solution.
We therefore renew our request to meet with you at your earliest convenience.
Please contact Henry Claypool at 202-349-4260 to schedule a convenient
date and time.
Thank you for your initiative to reduce fraudulent claims under the Medicare
power wheelchair benefit. Every dollar saved on fraudulent activity can
be devoted to meeting the existing and future assistive device needs of
beneficiaries with disabilities and chronic conditions.
Sincerely,
Henry Claypool
Advancing Independence: Modernizing Medicare and Medicaid
ITEM Coalition Steering Committee Member
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Peter W. Thomas
Consortium for Citizens with Disabilities
Health Task Force
ITEM Coalition Steering Committee Member
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Paul W. Schroeder
American Foundation for the Blind
ITEM Coalition Steering Committee Member
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Lee Page
Paralyzed Veterans of America
ITEM Coalition Steering Committee Member
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Cc: Mark B. McClellan, Administrator, CMS
Dara Corrigan, Acting Principal Deputy Inspector General, HHS
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ITEM Coalition Comments on Power Mobility to Special Open Door Forum
ITEM Coalition Commends Senator Grassley's Letter to CMS on Power Mobility Policy Clarification
Letter from Senator Grassley to CMS on Power Mobility Policy Clarification
(PDF Version)
ITEM Coalition Writes to HHS About Medicare Clarification on Power Mobility
(1/23/04)
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