Senator to seek relief
WASHINGTON - Efforts to change CMS's interpretation of the in-the-home restriction were resuscitated recently, when a senator from New Mexico e-mailed his colleagues notifying them of his intent to seek legislative relief.
Sen. Jeff Bingaman, D-N.M., has written a draft bill that would make it easier for qualified Medicare beneficiaries to get power mobility devices, even if they plan to use them outside the home. He's currently shopping the bill to Republican senators, particularly those on the powerful Finance Committee.
"He wants to make the bill bipartisan," said Emily Niederman, spokeswoman for the ITEM Coalition, a Washington-based consumer-advocacy group that's working with Bingaman to get a bill introduced. "This is a big deal."
The industry's struggle to lift the in-the-home restriction was last pushed to the forefront in August 2005. At that time, about 30 senators and about 60 representatives sent letters to Michael Leavitt, the secretary of the Department of Health and Human Services, demanding that the restriction be lifted--or else.
Because CMS has stood by its interpretation, legislators now have no other option but to try and force the agency's hand through legislation, said Seth Johnson, chairman of AAHomecare's rehab council and vice president of government affairs for Pride Mobility.
"This is clearly an effort we support," he said.
The industry, along with the ITEM Coalition, has long considered the in-the-home restriction archaic and not in the best interest of beneficiaries who often need power mobility devices inside and outside the home to maintain full independence. They also argue the restriction contradicts the administration's New Freedom Initiative and the "Ticket to Work" program.
But Medicare has always been reluctant to lift the in-the-home restriction, because it fears a spike in utilization. Bingaman's bill, however, wouldn't apply to all home medical equipment, industry sources said.
"One of CMS's concerns is that their costs would skyrocket," said Sharon Hildebrandt, executive director of NCART, "but (Bingaman's) legislation, as I understand it, would remove the restriction for mobility equipment only."
While the industry acknowledges that lifting the in-the-home restriction would cost "some money," it wouldn't be a "huge number," said Cara Bachenheimer, vice president of government relations for Invacare.
Sen. Chuck Grassley, R-Iowa, has sent Bingaman's draft bill to the Congressional Budget Office (CBO) to determine its potential cost or "score," Niederman said.
"The ideal situation is that people who aren't getting the devices they need would get them, so, absolutely, more wheelchairs would be prescribed," she said. "But we don't think the benefit would be opened up completely. (This legislation) would apply to long-term users of wheelchairs not short-term users. We hope that brings the score down."