Medicares coverage rules for wheelchairs and other mobility devices force over 140,000 Americans into unnecessary isolation and lead to higher health care costs, according to a study released today by the Medicare Rights Center, a national consumer group.
The administrations interpretation of the Medicare law imprisons people in their homes, causing unnecessary pain and suffering, said Robert M. Hayes, an attorney who is president of the Medicare Rights Center. It is wrong and it is illegal.
Forcing Isolation: Medicare In the Home Coverage Standard for Wheelchairs, recommends that the Centers for Medicare and Medicaid Services (CMS) change its interpretation of the Medicare law that currently denies coverage of mobility devices, such as power wheelchairs, for use outside of ones home.
Under current policy, the administration will pay 80 percent of the cost of a power wheelchair for a person with Medicare who needs it to move from a bedroom to a kitchen, but not for a person who requires such assistance to leave home for medical care, shopping or even employment, the report found.
Changes in technology, medicine and law require coverage of equipment that allows a person with disabilities to participate in community activities, Mr. Hayes said.
The consumer group also recommends that CMS require case-by-case assessments and evaluations by specially trained professionals to guard against unnecessary expenses and ensure that people receive the proper equipment for their needs. Currently, doctors prescribe mobility devices and certify their medical necessity, but there is no requirement that they have training in rehabilitative medicine.
In December, the administration further tightened Medicare coverage of wheelchairs which has prompted widespread criticism from an array of consumer groups.
Mr. Hayes said he was hopeful that the President would support the studys key recommendations. Although CMS will not modernize its interpretation without White House approval, he said, President Bushs father was a strong supporter of the Americans with Disabilities Act. This President has said that he is too.
The ADA, common sense, and common decency cry out to change a policy that sentences people with disabilities to needless isolation.
The Medicare Rights Centers study Forcing Isolation: Medicare In the Home Coverage Standard for Wheelchairs, is available online.