Fwd: [disability-civil-rights] New Medicare power wheelchair policy

[Guest guest]

Hi all...very important news....please read. Medicare is changing their policy on those of us who use wheelchairs and walkers on short distances. Call you Senators and Congresspersons and tell them that it needs to be changed.

Headline News 18 Dec 2003

DMERCs Issue Power Wheelchair Policy Clarification

BALTIMORE--Following the 10-point initiative called Operation Wheeler

Dealer by the Centers for Medicare and Medicaid Services/Office of

Inspector General to curb fraud and abuse of the Medicare power

wheelchair benefit, last week the four DMERCs announced a

clarification of the local medical review policy for power

wheelchairs and the adoption of "a consistent approach" to medical

review of power wheelchair claims.

.... [snip] ...

In bulletins issued from all four DMERC regions, the following

clarification was given: "If a patient can only bear weight to

transfer from a bed to a chair or wheelchair, the patient is

considered nonambulatory. However, if the patient is able to walk

either without any assistance or with the assistance of an ambulatory

aid, such as a walker, the power wheelchair is denied as not

medically necessary. If the patient is nonambulatory and qualifies

for a wheelchair, a power wheelchair is covered only if the patient

is unable to self-propel a manual wheelchair within their home.

Medicare coverage of durable medical equipment is limited to items

that are necessary for use within the home. Although a power

wheelchair may be useful to allow the beneficiary to move extended

distances, especially outside the home, Medicare statute and national

policy do not currently provide coverage solely for those uses."

.... [snip] ....

"It's much more than a clarification; it's actually a change in

policy," responded Sharon Hildebrant, executive director of the Rehab

and Assistive Technology Council at andria, Va.-based American

Association for Homecare. Such strict interpretation and medical

review would drastically change a national policy that, until now,

has based medical need on a patient's ability to perform daily living

activities within the home.

.... [snip] ...

http://snipurl.com/3hzf

Robin s

Radrobins@...

My comment: This will cost Medicare 10 times more in hip surgeries (and other ER visits) and rehabilitation costs

http://snipurl.com/3hzf

Headline News 18 Dec 2003

DMERCs Issue Power Wheelchair Policy Clarification

BALTIMORE--Following the 10-point initiative called Operation Wheeler

Dealer by the Centers for Medicare and Medicaid Services/Office of

Inspector General to curb fraud and abuse of the Medicare power

wheelchair benefit, last week the four DMERCs announced a

clarification of the local medical review policy for power

wheelchairs and the adoption of "a consistent approach" to medical

review of power wheelchair claims.

.... [snip] ...

In bulletins issued from all four DMERC regions, the following

clarification was given: "If a patient can only bear weight to

transfer from a bed to a chair or wheelchair, the patient is

considered nonambulatory. However, if the patient is able to walk

either without any assistance or with the assistance of an ambulatory

aid, such as a walker, the power wheelchair is denied as not

medically necessary. If the patient is nonambulatory and qualifies

for a wheelchair, a power wheelchair is covered only if the patient

is unable to self-propel a manual wheelchair within their home.

Medicare coverage of durable medical equipment is limited to items

that are necessary for use within the home. Although a power

wheelchair may be useful to allow the beneficiary to move extended

distances, especially outside the home, Medicare statute and national

policy do not currently provide coverage solely for those uses."

.... [snip] ....

"It's much more than a clarification; it's actually a change in

policy," responded Sharon Hildebrant, executive director of the Rehab

and Assistive Technology Council at andria, Va.-based American

Association for Homecare. Such strict interpretation and medical

review would drastically change a national policy that, until now,

has based medical need on a patient's ability to perform daily living

activities within the home.

.... [snip] ...

http://snipurl.com/3hzf

Robin s

Radrobins@...