The Centers for Medicare & Medicaid Services (CMS) made revisions last week to the power mobility device policy, with the most significant change removing the reference to “stand and pivot transfer” for Group 3 power wheelchairs.
The revised criterion pertaining to Group 3 power wheelchairs now states: “The patient’s mobility limitation is due to a neurological condition, myopathy or congenital skeletal deformity.”
Another change in the policy is an expansion of power wheelchairs that are eligible for Advance Determination of Medicare Coverage (ADMC). Single power option or multiple power option wheelchairs in Groups 2, 3, 4 and 5 are now eligible for ADMC “regardless of whether a power seating system will be provided at the time of initial issue.” This policy change will permit people with progressive neurological disease such as ALS or MS to have advanced determination for a power seating system needed in the future.
Visit www.tricenturion.com to read the revisions of the power mobility device policy.
AAHomecare Study Says Wheelchair Cuts Will Increase Government Costs by Billions of Dollars
The American Association for Homecare (AAHomecare) has released a detailed economic study concluding that cuts to the Medicare power mobility benefit scheduled to take effect on Nov. 15 will have a devastating impact on both the industry and beneficiaries who need wheelchairs. The study forecasts an exodus of at least 1,500 wheelchair suppliers and a net cost increase to the Medicare system of $2.7 to $5.9 billion over the next eight years.
The study indicates that Medicare?s direct expenditures on power mobility will decline, but notes the reimbursement cuts of 21 percent to 41 percent amount to price controls. The cuts to the mobility benefit will ultimately increase Medicare expenditures for hospitalization, physician services, and homecare services for beneficiaries who qualify for power wheelchairs but won’t acquire them because the cuts will “impose massive short-run shutdowns of supplier firms.”
Conducted by economist Clifford L. Fry, Ph.D., and his team at RRC, Inc, the study recommends that the Centers for Medicare & Medicaid Services (CMS) rely on market forces, and not price controls, for Medicare’s provision of products and services. “Price controls will impair the functioning of market forces and decrease access to power mobility,” the study claimed.
“This comprehensive study by Dr. Fry provides important information that will help CMS, Congress, and stakeholders to fully gauge the impact of the cuts to power mobility that are scheduled to take effect on Nov. 15,” said Tyler J. Wilson, AAHomecare’s President and CEO.
The study found that: