Comments Sought for CMS Wheelchair Coverage Policy
January, 2005

From the ITEM Coalition

On Wednesday, December 15, 2004, the Centers for Medicare and Medicaid Services (CMS) announced that it has decided to open a National Coverage Determination (NCD) process for Medicare's wheelchair benefit. (CMS' press release regarding this initiative is on the CMS website), The following day, CMS released the Interagency Wheelchair Work Group's (IWWG) recommended changes to Medicare's wheelchair benefit. (The recommendations can be found at the Medicare Coverage Database website.)

The opening of the NCD process allows for a 30-day comment period, and the agency is specifically interested in comments on the IWWG's recommendations. The agency has 6 months to prepare a draft document or "decision memorandum." After that is released, there will be another 30-day comment period and the agency then has 60 days to release a final NCD.

CMS' announcement to begin the NCD process signals a more formal, time-limited procedure in which it will review Medicare's wheelchair coverage policy. But it also signals an additional delay in CMS' handling of this issue. People invested in this issue, and specifically those in attendance at the June 14th CMS Open Door forum were given the impression that CMS would be releasing its own draft guidance in early October.

The ITEM Coalition feels the IWWG's recommendations are very promising in that they specifically seek to replace the "bed or chair confined" standard with functionally- based criteria. Unfortunately though, the recommendations fail to suggest changes in the agency's interpretation of the "in the home" restriction.

The "in the home" restriction severely impedes the health and independence of people with disabilities as it essentially confines people to the four walls of their homes and does not take into account the need for beneficiaries to access their communities. The ITEM Coalition has circulated a press release regarding CMS' recent announcement and it can be found on the ITEM Coalition's website .

The ITEM Coalition strongly encourages all advocates to submit comments to CMS regarding the IWWG's recommendations and the agency's failure to address the "in the home" restriction. Comments can be submitted at the internet address below. Please contact the ITEM Coalition at 202- 349-4260 with any questions or visit the ITEM Coalition's website.

To submit comments visit see The Medicare Coverage Database

| Benefits | Info | Join | Other Sites | News | Feedback | Calendar | Home |