Congress to CMS:
Delay new rule on mobility equipment so Medicare
beneficiaries are not hurt; Lawmakers say interim rule will
cause confusion, hurt seniors and disabled
WASHINGTON, Oct. 24 /U.S.
Newswire/ -- Asserting that disabled and senior citizen
constituents may be hurt, Members of Congress are urging the
Centers for Medicare & Medicaid Services (CMS) to delay
implementing an interim rule tomorrow that would bring
wholesale changes to the process for Medicare beneficiaries
to obtain power mobility equipment.
At least 50 congressmen
and senators, including Senate Finance Committee Chairman
Charles Grassley (R-IA), have written or signed letters to
Health and Human Services Secretary Michael O. Leavitt and
CMS Administrator Dr. Mark McClellan. The lawmakers ask CMS
to delay implementing the vast revisions as scheduled
tomorrow because the stakeholders - physicians, clinicians,
suppliers, manufacturers and Medicare beneficiaries - have
concluded that the regulations will make it more difficult
for Medicare beneficiaries to obtain power wheelchairs and
scooters.
Sen. Rick Santorum (R-PA.)
met privately with Dr. McClellan to discuss his concerns,
while other lawmakers have called CMS. The Ohio
congressional delegation has scheduled a meeting with Dr.
McClellan for Tuesday afternoon, and congressional
delegations from Florida, Texas and New Jersey have written
letters.
"There has been an
outpouring of concern from Congress because lawmakers are
worried about the impact that these regulations will have on
their constituents if they are not changed before they are
implemented,'' said Mal Mixon, Chairman and CEO of Invacare
Corp. "We hope CMS is listening. We all want a process that
works, and allows Medicare beneficiaries to receive the
equipment they need to increase their mobility. But for that
to happen CMS needs to delay the interim rule and make the
changes that have been recommended by stakeholders.''
At issue are significant
changes in the process used for determining and documenting
the medical necessity of power wheelchairs and scooters
provided to Medicare beneficiaries.
Among the chief concerns
are the expanded responsibilities for physicians in the
prescribing and documentation process. The stakeholders say
that it will take a significant education program for
doctors to understand what is now required of them, and
currently none is planned. In addition, CMS eliminated the
Certificate of Medical Necessity (CMN) form, which
historically was the form filled out by the physician to
document the medical necessity for mobility equipment.
Without the CMN, Durable Medical Equipment Regional Carriers
(DMERCs) who review Medicare claims, will rely on physician
chart notes for their patients, documents that vary widely
from doctor to doctor, and will likely lead to subjective
and inconsistent reviewing of claims.
"I am concerned that the
elimination of the CMN without a scripted form will open the
door to more confusion and subjectivity between your
contractors,'' wrote Rep. Solomon Ortiz (D-TX.), adding that
"due to the number of outstanding issues, I join my
colleagues in their attempts to delay such a rule...''
Moreover, the New Jersey
delegation questioned in their letter whether it was
"feasible'' to implement the interim rule as scheduled,
noting that there was no physician education plan, that
claims and payment software won't be ready until April and
that the comment period for the rule doesn't end until
November 25. "Implementing new policies and procedures prior
to having the systems and software fully updated and tested
reduces program integrity, increasing the potential for
errors and abuse,'' wrote Rep. Frank LoBiondo (R. N.J.), and
10 fellow members of the New Jersey delegation.