January 24, 2005

Medicare & Wheelchairs

The Washington Post reported that CMS has reconsidered its criteria for covering motorized wheelchairs. According to the writer, Cindy Skrzycki:

The Medicare program recently introduced three major regulatory initiatives to tighten up eligibility, reduce payments and assure the legitimacy of the providers.

Then you have to read through almost the entire long article about the history of this to find out what the initiatives are. I've excerpted them for you here:

Reacting to the pressure, CMS said it was reverting to its original qualifications criteria and was talking with industry and contractors' medical directors about their concerns. It convened a wheelchair working group last summer, and its recommendations have become part of a major reform effort underway within the agency.

It anticipates changing to a "functional" definition to determine who gets a chair -- in other words, can a person do daily activities without one? It also proposes requiring physicians to have face-to-face contact with patients before a prescription for a chair is written. The agency wants to change coding for the chairs to more accurately represent how much the government should be billed. And it plans to install more checks to make sure suppliers are legitimate.

How will this affect you?