 ITEM Coalition Members and Friends:
Senators Bingaman (D-NM), Santorum (R-PA), Murray (D-WA), Collins (R-ME), Akaka (D-HI), Jeffords (I-VT), Lieberman (D-CT), Kerry (D-MA), Harkin (D-IA), and Kennedy (D-MA) have introduced the Medicare Independent Living Act of 2006 (S. 3677) – bipartisan legislation to fix Medicare's "in the home" restriction on mobility devices. Thank you to everyone who has worked so hard to get this legislation introduced! Please find below a summary of the legislation as well as an ITEM Coalition press release issued this morning. Additionally, below, please find Senator Bingaman's statement in the Congressional Record upon introduction of this bill. We are encouraging individuals to call their Senators and ask them to become cosponsors of this important legislation. Or, if your Senator is one of the original cosponsors listed above, please be sure to thank them for supporting this bill. Your Senators can be reached toll-free via the capitol switchboard at 1-877-224-0041. Additionally, we encourage organizations to send letters of support to Senators Bingaman and Santorum. Please let me know if you have any questions and, as always, thank you for your advocacy! Emily Niederman Statements on Introduced Bills and Joint Resolutions By Mr. Bingaman (For Himself, Mr. Santorum, Mrs. Murray, Mr. Akaka, Mr. Jeffords, Mr. Kerry, Mr. Harkin, and Mr. Lieberman): S. 3677. A bill to amend title XVIII on the Social Security Act to eliminate the in the home restriction for Medicare coverage of mobility devices for individuals with expected long-term needs; to the Committee on Finance. Mr. Bingaman. Mr. President, I rise today to introduce the Medicare Independent Living Act of 2006 with Senators SANTORUM, MURRAY, COLLINS, AKAKA, JEFFORDS, KERRY, HARKIN, KENNEDY, and LIEBERMAN. This legislation would eliminate Medicare's "in the home" restriction for the coverage of mobility devices, including wheelchairs and scooters, for those with disabilities and expected long-term needs. This includes people with multiple sclerosis, paraglegia, osteoarthritis, and cerebrovascular disease that includes acute stroke and conditions like aneurysms. As currently interpreted by the Centers for Medicare and Medicaid Services, CMS, the "in the home" restriction prevents beneficiaries from obtaining wheelchairs that are necessary for use outside the home. This precludes beneficiaries who need a wheelchair to access work, the community at-large, his or her place of worship, school, physician's offices, or pharmacies. On July 13, 2005, 34 senators wrote Secretary Leavitt asking the Department of Health and Human Services, or HHS, to modify the "in the home" requirement so as to "improve community access for Medicare beneficiaries with mobility impairments." Unfortunately, CMS continues to impose the "in the home" restriction on Medicare beneficiaries in need of mobility devices. The result is that people who may not need a wheelchair to get around their house but do need one to get around their communities, such as to a job, church, or the grocery store, can't get Medicare to pay for one. As the Medicare Rights Center in a report entitled "Forced Isolation: Medicare's 'In The home' Coverage Standards for Wheelchairs" in March 2004 notes, "This effectively disqualifies you from leaving your home without the assistance of others." Furthermore, in a Kansas City Star article dated July 3, 2005, Mike Oxford with the National Council on Independent Living noted, "You look at mobility assistance as a way to liberate yourself." He added that the restriction "is just backward." In fact, policies such as these are not only backward but directly contradict numerous initiatives aimed at increasing community integration of people with disabilities, including the Americans with Disabilities Act, the Ticket-to-Work Program, the New Freedom Initiative, and the Olmstead Supreme Court decision. According to the Medicare Rights Center update dated March 23, 2006, "This results in arbitrary denials. People with apartments too small for a power wheelchair are denied a device that could also get them down the street. Those in more spacious quarters get coverage, allowing them to scoot from room to room and to the grocery store. People who summon all their willpower and strength to hobble around a small apartment get no help for talks that are beyond them and their front door." In New Mexico, I have heard this complaint about the law repeatedly from our State's most vulnerable disabled and senior citizens. People argue the provision is being misinterpreted by the administration and results in Medicare beneficiaries being trapped in their home. The ITEM Coalition adds in a letter to CMS on this issue in November 25, 2005, "There continues to be no clinical basis for the 'in the home' restriction and by asking treating practitioners to document medical need only within the home setting, CMS is severely restricting patients from receiving the most appropriate devices to meet their mobility needs." Therefore, our bipartisan legislation would clarify that this restriction does not apply to mobility devices, including wheelchairs, for people with disabilities in the Medicare Program. The language change is fairly simple and simply clarifies that the "in the home" restriction for durable medical equipment does not apply in the case of mobility devices needed by Medicare beneficiaries with expected long- term needs for use "in customary settings such as normal domestic, vocational, and community activities." This legislation is certainly not intended to discourage CMS from dedicating its resources to reducing waste, fraud, and abuse in the Medicare system, as those efforts are critical to ensuring that Medicare remains financially viable and strong in the future. However, it should be noted that neither Medicaid nor the Department of Veterans Affairs impose such "in the home" restrictions on mobility devices. As Senator BROWNBACK said to the Kansas City Star, it is important to lift the restriction "to reflect our goal of ensuring that Americans with disabilities are able to live independent, healthy, and productive lives." I thank Senators Santorum, Murray, Collins, Akaka, Jeffords, Kerry, Harkin, Kennedy, and Lieberman for cosponsoring this important legislation, and attached is a fact sheet that I request to be printed in the RECORD. I would also ask unanimous consent to have printed in the RECORD copies of the letter to the administration and the response that was received by Capitol Hill.
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