AAHomecare Will Seek Clarifications to Wheelchair Coverage Criteria

Main Category: Caregivers / Homecare
Article Date: 11 Feb 2005 - 10:00 PDT

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The American Association for Homecare (AAHomecare) welcomed draft Medicare coverage policy for power wheelchairs but expressed continuing concerns about potential affects on patient access to medically necessary mobility equipment.

Specifically, the Rehab and Assistive Technology Council (RATC) at AAHomecare will seek clarification about proposed documentation and evaluation requirements and the in-the-home restriction, which is used for determining patient eligibility based on functional improvements in the home.

Kay Cox, President and CEO of AAHomecare, stated, "We appreciate progress on wheelchair coverage and coding issues, especially the move away from the 'bed or chair confined' requirement which can prevent some patients from getting the equipment they need."

CMS said the proposed coverage criteria would rely on clinical guidance for evaluating whether a patient needs a mobility device and if so, what type of device is needed. The new approach would replace the standard that relied on whether a patient was non-ambulatory, or "bed or chair confined." The analysis begins with whether the patient has a limitation in mobility that prevents the performing one or more mobility-related activities of daily living in the home. The evaluation includes consideration of whether or not an assistive device, whether a cane, power wheelchair, or anything in between, would improve the beneficiary's ability to function within the home.

The agency plans to publish the final national coverage determination (NCD) in March and to provide guidance on how to use and document the new criteria.

Comments on the proposed national coverage determination will be accepted until March 7, 2005. CMS also plans to hold an open door forum from 1:00 to 4:00 p.m. ET on February 24 on the NCD.

Homecare delivers tremendous value for Americans' healthcare dollar. AAHomecare is the only national association that represents every line of service in the homecare community, including home health and home medical equipment providers, respiratory and infusion therapy, telemedicine, rehab and assistive technology, and hospice. With more than 3,000 member locations, AAHomecare advances quality healthcare services where patients prefer them - at home.

Michael Reinemer - michaelr@aahomecare.org
Vice President, Communications
American Association for Homecare
625 Slaters Lane, Suite 200
Alexandria, VA 22314-1171
703-535-1881
http://www.aahomecare.org

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