New coalition for disabled to fight 'in the home'

Sunday, June 15, 2003

June 16, 2003

WASHINGTON - Frustrated by Medicare's narrow definition of "in the home" and other antiquated policies for the disabled, a new coalition of rehab providers is forming tomorrow to do battle against such restrictive statutory language.

The Independence Through Enhancement of Medicare and Medicaid (ITEM) coalition - now comprised of 65 consumer and provider groups such as the Paralyzed Veterans of America and the American Foundation for the Blind - wants CMS to relax restrictions that prevent reimbursement for DME used outside the home.

“ Medicare should look more broadly at facilitating people's ability to enjoy life in the community and in employment,” said Henry Claypool, a member of the coalition’s steering committee and co-director of another Medicare coalition with its eyes on reform, Advancing Independence: Modernizing Medicare and Medicaid. “We need to make sure people are not getting trapped in their homes."

While many believe that CMS is in a position to relax the restrictions and do more for people with compromised mobility, CMS disagrees, arguing that the statute itself - not CMS’s interpretation of the law - keeps Medicare from reaching more people.

" That is the law," said one CMS official. "It is not an issue that we are afraid of utilization rising or not. We're not trying to control utilization. We're just trying to be consistent with the statute."