CMS readies face-to-face requirement for PWCs

Sunday, July 11, 2004

July 12, 2004

WASHINGTON -  Details for a new Medicare regulation that requires doctors to perform a face-to-face evaluation of a patient before prescribing a power wheelchair should be released any day now, say industry watchers.
The Medicare Prescription Drug Act, which President Bush signed into law in December, 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. For example: what documentation is required to prove that the examination has take place; what is the allowable timeframe between the face to face and when the doctor prescribes the chair; what is required of a beneficiary who for whatever reason can’t make it in to his doctor’s office.
Exactly what the regulations will look like is anyone’s guess. CMS has played its cards pretty close to the vest on this issue. “We’re not anticipating  that it will be a problem, provided CMS is rational,” said Cara Bachenheimer, Invacare’s vice president of government relations.
The face-to-face requirement went into effect Dec. 8, but it appears the DMERCs have delayed enforcing it until CMS releases regulations. Once CMS releases the regulations, industry watchers don’t expect the DMERCs to enforce them retroactively.