CMS yanks restrictive LMRP on scooters

Wednesday, March 31, 2004

WASHINGTON - A change in local medical review policy that would have restricted coverage for scooters sparked jitters throughout the industry early last month before the changes were overturned by CMS.

“Given the level of attention focused on power wheelchairs at this point, if the DMERCs are going to issue a new policy they need to do it in a more considerate, rolled out way than just putting it up on the web before folks have had the chance to talk about it,” Tim Hill, CMS’s chief financial officer told HME News.

In contention was a change in the coverage guidelines for scooters from needed “in the residence” to “bed or chair confined.” The other revision changed the coverage guidelines for power wheelchairs from “totally, usually nonambulatory” to “totally nonambulatory.”

The DMERCs were instructed to rescind the LMRP changes less than a week after they were made for conflicting with national policy guidelines and for failing to provide notice or a comment period, said a CMS spokesperson.

“Any return to established due process is a welcome one,” said Dr. Paul Metzger, medical director at the Scooter Store. “Now, if they’ll apply that same long-standing process to the DMERC [power wheelchair coverage] ‘clarification’ … they’ll at least begin to rectify the debilitated living situation for thousands of the nation’s beneficiaries.”