Eliminate it from LCD, NCART asks Medicaid
WASHINGTON - Power mobility pricing wasn't the only issue that NCART wanted state Medicaid directors to look at twice before adopting. In a late-December letter, the organization also asked directors to leave out references to the in-the-home restriction from their coverage policies.
While Medicare restricts coverage to equipment that's needed for use in the home only, Medicaid doesn't have to, thanks to the Olmstead decision, the letter states. The 1999 U.S. Supreme Court decision requires states and local governments to keep people with disabilities in their least restrictive environments.
"NCART agrees that in order for products to meet the definition of DME they must be appropriate for use in the home," the letter reads. "This is very different from covering only what is needed to move about inside one's home."
NCART recommends that state Medicaid directors adopt a modified version of Medicare's local coverage determination (LCD) that eliminates the in-the-home restriction.
Last year, NCART lobbied for bills in the House of Representatives and Senate that would have eliminated the restriction. Supporters seek to have the bills reintroduced this year.