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Senators ask CMS to reconsider ‘in-the-home' requirement 

Senators ask CMS to reconsider ‘in-the-home' requirement 

Sen. HassanWASHINGTON – Sens. Maggie Hassan, D-N.H., Marsha Blackburn, R-Tenn., Bob Casey, D-Pa., and Tammy Duckworth, D-Ill., are asking CMS to conduct a full review of its national coverage determination (NCD) for mobility assistive equipment for Medicare beneficiaries, including its interpretation of the “in-the-home" requirement. 

Current Medicare coverage limitations on equipment used outside the home can limit a beneficiary’s access to mobility equipment and their communities, the senators say in a letter to the agency. 

“In the 2005 National Coverage Determination and subsequent guidance, CMS has determined that coverage of MAE is reasonable and necessary only for activities of daily living occurring within the home,” the letter states. “This interpretation can lead to coverage denials for wheelchair users and cause delays in obtaining appropriate equipment. These delays can result in health injuries and secondary health conditions, increasing costs for the program and taxpayers.” 

The senators commended CMS’s recent decision to cover seat elevation technology in power wheelchairs, but they say more can be done to ensure that beneficiaries have access to mobility assistive equipment. 


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