CMS to update LCD

Sunday, October 16, 2005

WASHINGTON - CMS also announced on Friday that it will revise the draft local coverage determination for power mobility devices so policies "accurately reflect" the national coverage determination coverage criteria.

The agency also announced it would continue to solicit and review comments on all aspects of the draft LCD. Comments will be considered in developing new determinations.

The comment period for the draft LCD was due to end Oct. 31, with an implementation date of Jan. 1.

The announcement comes on the heels of meetings held by the DMERCs on Tuesday (regions B and D in Indianapolis) and Wednesday (regions A and C in Columbia, S.C.). The goal of the meetings was to allow the rehab industry to voice concerns on the propose LCD.

A requirement that a RESNA-certified practitioner evaluate patients who need certain power wheelchairs raised the ire of those attending, including Nancy Lansing, director of marketing for Connecticut Rehab in West Hartford, Conn.

"It's above and beyond CMS's purpose," said Lansing, who attended the Columbia meeting. "Licensure is the responsibility of the individual states."

The draft LCD states that "specific use or high activity specific use" power wheelchairs and scooters require patients to have a face-to-face exam with an Assistive Technology Practitioner (ATP) to meet coverage criteria.

Like Lansing, others questioned the legality of the requirement, not to mention whether there are enough ATPs to conduct the examinations required.

"How do providers phase into this requirement when there isn't a sufficient amount of qualified ATPs?" asked Cara Bachenheimer, vice president of government relations for Invacare, who attended both meetings.

Lansing estimates there are only a handful of ATPs in Connecticut that perform wheelchair evaluations.

Another requirement that raised concerns: If power operated vehicles and power wheelchairs are used in the home, payment will be based on the allowance for the least costly medical appropriate alternative.