The Derby City Chapter of the National Spinal Cord Injury Association Network- Serving Kentuckiana.
Message From the President
Dear Members & Friends-
At press time we have not received information regarding our speaker for the July 18 meeting. We will likely have a speaker, but if not, a video will be shown. Food and drink will be provided at the meeting.
August's meeting will be held at 6:30 at Frazier Rehab, 4th floor dining hall.
- David Allgood
Medicare IMPROVES ACCESS TO POWER WHEELCHAIRS AND SCOOTERS
From CMS Office of External Affairs, May 5, 2005
The Centers for Medicare and Medicaid Services (CMS) today announced new national coverage for mobility assistive equipment (MAE) including power wheelchairs and scooters. The new criteria, which are effective immediately, adopt a function-based determination of medical necessity. This determination looks at the ability of the beneficiary to accomplish mobility-related activities of daily living, such as toileting, grooming, and eating, with and without the use of mobility equipment such as a wheelchair. The national coverage determination (NCD) addresses the full range of MAE from simple canes and walkers to sophisticated power wheelchairs.
"The steps we are taking today are part of our efforts to ensure that seniors who need mobility help will get it promptly, and that we are paying appropriately for mobility assistive equipment," said CMS Administrator Mark B. McClellan, M.D., PhD. "The new Functional criteria reflect current medical practice and mean that beneficiaries will have the freedom to
live better, more mobile lives, without the rigid `bed or chair-confined' standard."
The new coverage criteria are part of a larger three-pronged Modern Mobility Initiative announced in April 2004 focused on improving coverage, payment and quality of suppliers of power wheelchairs and other mobility aides. In addition to developing new coverage criteria, CMS has developed new billing codes that will take effect January 1, 2006 , to reflect the variety of wheelchairs now on the market. CMS expects to issue new quality standards for suppliers in 2006.
"This coverage policy ensures that a beneficiary's functional status and individual circumstances are considered so that the most appropriate technology for each beneficiary's personal needs is covered," said Barry Straube, M.D., CMS's Acting Chief Medical Officer and Acting Director of the Office of Clinical Standards and Quality. "It is also consistent with the medical documentation of the functional needs of the patient that should be in medical records for our beneficiaries."
CMS plans to issue additional guidance in the near future to help physicians and treating practitioners better understand the new coverage criteria and CMS's expectations about proper documentation in the medical record. Because the new functional criteria more explicitly refer to standard clinical evaluative methods, CMS expects that the medical documentation generated during the patient evaluation will more accurately be reflected in the beneficiary's medical record. It is CMS's intent that this will make the power mobility device coverage process more straightforward.
