Under the new coverage policy to take effect November 15th, only persons with
a neuromuscular or neurological condition who cannot perform a stand, pivot,
and transfer test will be eligible for a higher-performing wheelchair. Those
who can perform the test will be forced into other technologies, many of which
lack critical features needed by people battling diseases such as ALS, multiple
sclerosis, and cerebral palsy.
Also threatening access
is the proposed fee schedule which cuts reimbursements for higher-performing
chairs by an average of 30 percent. For some chairs, the reimbursement
will not even cover the suppliers’ acquisition cost.
The proposed fee schedule further ignores the service costs associated
with fitting and configuring a complex device to be used by a severely
disabled person. We believe this fee schedule is certain to put many
suppliers of complex rehab equipment out of business and further
hinder access to equipment needed by the disabled.
Experts in the rehabilitation industry, including clinicians and equipment
suppliers, are urging CMS to rescind and modify this coding and fee schedule
before they take effect and hurt disabled Americans.
“Without these higher-performing chairs, many beneficiaries will lose
much of the independence and mobility they currently have and either be forced
into nursing homes or require the assistance of another person for activities
they can currently do independently,” said Rita Hostak, NCART president.
The National Coalition
for Assistive and Rehab Technology (NCART) is asking CMS to:
• Postpone the November 15, 2006 PMD Fee Schedule and Local Coverage Determination
(LCD) in order to resolve all identified issues.
• Establish a new
Fee Schedule using a rational methodology, accurate product classifications
and pricing data.
• Recognize the
service component inherent in providing higher-performing wheelchairs
to persons with disabilities
• Make necessary changes to the
Local Coverage Determination to eliminate the stand, pivot, transfer
requirement and allow for recognition of the progressive nature
of some disabilities. ![]()
Sharon Hildebrandt
works for The National Coalition for Assistive and Rehab Technology
(NCART) www.ncartcoalition.org
