Medicare Compliance & Reimbursement

CMS tries to sneak in drastic changes through backdoor policy-making.

The durable medical equipment industry is gearing up to fight restrictive new changes to Medicare's coverage policy for pricey power wheelchairs.

A newly formed organization, the Restore Access to Mobility Partnership (RAMP), has launched "a grassroots campaign across the country," says spokesperson Alicia Ingram. RAMP, which consists of industry trade associations, wheelchair manufacturers and wheelchair providers, is joining forces with organizations for seniors and the disabled, ranging from the Gray Panthers to the American Association of People with Disabilities.

RAMP's foremost objective is to persuade the Centers for Medicare & Medicaid Services to rescind the so-called "clarification" to wheelchair coverage that the DME regional carriers issued in December, says Cara Bachenheimer with Elyria, OH-based Invacare Corp. - one of the RAMP members. It's not a clarification, but rather a wholesale change in policy, insists attorney Steve Azia with Washington, DC-based Eastwood & Azia, who is counsel to the Power Mobility Coalition.

RAMP's other objective is to make sure that if there are any changes, CMS conducts them appropriately with "meaningful input" from all groups affected, including beneficiaries and suppliers, Bachenheimer tells MLR.

Consumer groups are "outraged at what the government seems to be doing," Bachenheimer says.

CMS and the DMERCs issued the change as part of Operation Wheeler Dealer, the feds' crackdown on fraud and abuse in the power wheelchair arena. "The DMERCs and CMS are now overreacting by attempting to restrict access to wheeled mobility across the board using bulletin issuances," says Dr. Paul Metzger, the former medical director for Region C DMERC Palmetto GBA, in a letter distributed to providers by RAMP.

Metzger urges suppliers to send their comments on the policy to DMERCs and CMS, even though they haven't asked for them. "There is nothing stopping your organization from issuing comments anyway," Metzger says in the letter. "Please distribute news of this incredible attempted bureaucratic coup before it can be further implemented and allowed to quietly become, by default, the new standard of LMRP development and issuance."

CMS continues to ignore the industry's pleas for at least a meeting on the controversial change, Bachenheimer says.