Congress wants in-the-home changed

Sunday, June 26, 2005

WASHINGTON -- Sixty-one members of Congress called on CMS to modify the in-the-home restriction through the regulatory process, and if they cannot, to say why not as soon as possible.

The request was made in a June 11th letter to Michael O. Leavitt, secretary of the Department of Health and Human Services.

"We are concerned that CMS's current interpretation of the "in the home" requirement may continue to act as an inappropriate restriction in meeting the real-life mobility needs of Medicare beneficiaries with physical disabilities and mobility impairments," the members wrote.

In the wake of the recent National Coverage Determination for power mobility devices, voices within the HME industry bemoaned the fact that CMS did not address in-the-home restriction in the NCD. The restriction keeps Medicare from paying for a power wheelchair unless it's intended for use inside the home.

CMS said the NCD was not the appropriate vehicle for addressing in-the-home. But the 61 congressional signatories, led by Rep. Charlie Bass, R-N.H, and Rep. Jim Langevin, D-R.I., are asking CMS to modify it, or else.

"If your agency concludes that the "in the home" requirement cannot be addressed through the regulatory process, we request that you respond with such information as quickly as possible, so that Congress may begin examining legislative alternatives," the letter states.

The letter is evidence of a groundswell of awareness about the issue on Capitol Hill, and a clarion call for change within the Medicare program.

"CMS should have policies that enable seniors and people with disabilities to participate in society as much as possible," said Cara Bachenheimer, Invacare's vice president of government relations. "They should not impose artificial restrictions that essentially confine beneficiaries to their homes."