CMS delays release of revised power chair CMN

Sunday, January 2, 2005

January 3, 2005

WASHINGTON - CMS started 2005 by breaking a 2004 resolution to issue a revised CMN for power wheelchairs by year’s end.
Despite pressure from the HME industry and its allies on Capitol Hill to complete the work in 2004, CMS announced Dec. 30 that it now intends to have the updated document out by mid January, said Seth Johnson, director of government affairs for Pride Mobility Products.
In its effort to clarify or craft new coverage criteria for wheelchairs, CMS apparently has had to put other projects on hold, say industry watchers.
Also delayed until mid January: a revised policy for power operated vehicles (scooters); and a final rule requiring doctors to evaluate patients face-to-face before prescribing a power wheelchair. CMS also intended to release this information by the end of 2004.
“Hopefully, whatever they were going to put out will be revised and better for the industry, but because we haven’t had a chance to see what they were going to put out, it is hard to answer that question,” Johnson said.
The Medicare Prescription Drug Act, which President Bush signed into law in December 2003, mandated the face-to-face evaluation as a way to reduce fraud and unnecessary utilization. The law didn’t, however, spell out particulars about the face-to-face meeting.
With its POV revision, industry watchers expect CMS to broaden the list of doctors who can prescribe scooters. Currently, that list is limited to  neurologists, orthopedics, rheumatologists and doctors of physical medicine.
For over a year, the current CMN has created confusion among rehab providers. While Medicare’s coverage policy requires that beneficiary be bed- or chair-defined in order to qualify for a power wheelchair, the CMN simply asks whether the beneficiary needs a power wheelchair to move about the home. By revising the CMN, providers hope CMS eliminates that confusion and eliminate or broaden the definition of bed-or-chair confined.