CMS proposes to expand Medicare benefits for mobility devices
The proposed coverage of wheelchair power seat elevation equipment advances health equity, CMS says.
Photo: Lucy Lambriex/Getty Images
The Centers for Medicare and Medicaid Services has released a proposed National Coverage Determination on power seat elevation equipment on wheelchairs.
This is the first National Coverage Determination to expand Medicare coverage for power seat elevation equipment on Group 3 power wheelchairs to allow individuals to have an easier transfer from the wheelchair to other surfaces. Group 3 power wheelchairs are designed to meet the needs of people with severe disabilities such as stroke, Amyotrophic Lateral Sclerosis and late-stage Parkinson's or Multiple Sclerosis.
The proposed National Coverage Determination is open for a 30-day public comment period ending on March 17.
WHY THIS MATTERS
The National Coverage Determination proposal incorporates feedback from interested parties, particularly those who are focused on eliminating health disparities for people with disabilities, CMS said.
CMS encourages comments from all interested parties, but in particular, people with Medicare and their families, providers, clinicians, consumer advocates, healthcare professional associations and from individuals serving populations facing disparities in health and healthcare.
Additionally, CMS is specifically interested in gathering additional scientific literature that provides evidence surrounding the medical necessity for seat elevation systems through studies that include measurable characteristics related to the performance of transfers.
THE LARGER TREND
CMS follows a long-standing process established by Congress to determine whether a medical item or service can be covered nationally by Medicare, including when an item or service is reasonable and necessary for the diagnosis of and/or treatment of an illness or injury.
Today's proposed National Coverage Determination follows an evidence-based clinical analysis CMS initiated in August 2022 to examine whether the use of power seat elevation equipment on power wheelchairs both falls within a Medicare benefit category, and if yes, whether it is reasonable and necessary.
ON THE RECORD
"Millions of people with Medicare rely on medically necessary assistive devices to perform daily tasks that directly impact their quality of life," said CMS Administrator Chiquita Brooks-LaSure. "CMS remains committed to ensuring persons with disabilities are receiving available benefits that improve their health. Today's proposal promotes a first of its kind benefit expansion providing people with Medicare additional tools to improve their lives."
Twitter: @SusanJMorse
Email the writer: SMorse@himss.org
