For the record: Jeffords goes to bat for PWC providers

Sunday, February 20, 2005

February 21, 2005

WASHINGTON - Sen. Charles Grassley, R-Iowa, isn’t the only Washington powerbroker voicing very public concerns about issues near and dear to the HME industry.
On Jan. 20, during confirmation hearings for new DHHS Secretary Michael Leavitt, Sen. James Jeffords, I-Vt., posed the following question to Leavitt in writing:
Over the last few years, the Centers for Medicare and Medicaid Services (CMS) has been consumed with the reducing the use of power wheel chairs by the programs’ beneficiaries.  In 2003, then Administrator Scully announced a “10-point initiative to substantially curb abuse of the Medicare program by unscrupulous providers of power wheelchairs”; and last year Dr. McClellan announced a new, “three-pronged approach focused on coverage, payment and quality of suppliers of power wheelchairs”. 
I am aware that there has been tremendous growth in the reimbursement of these chairs and that CMS has significant concerns about abuse of this benefit.  Clearly the agency must guard against fraud and abuse.  I have heard from beneficiaries, vendors and health care providers in Vermont who are concerned that these efforts may limit access for those with legitimate needs.  I want to alert you to the importance of this equipment to beneficiaries, especially rural-based beneficiaries,. 
CMS’ current interpretation ignores the very real medical and community living needs of those with disabilities and, as such, it lacks legitimacy in the clinical community.  The new national coverage policy for power wheelchairs must provide prescribing physicians and beneficiaries with objective criteria for deciding when a manual or power wheelchair is medically necessary, making it possible to carry the policy out in a fair and consistent manner (a feature which is sorely lacking in the current policy). 
I would like a commitment from you that as the CMS moves toward a national coverage decision, that it be based on current best practices in medical and patient care.