January 6, 2012
CMS listens amid concerns expressed by lawmakers and stakeholders, including the AAPM&R
On December 29, 2011, the Centers for Medicare and Medicaid Services (CMS) informed members of Congress that the agency will delay a controversial wheelchair prepayment demonstration project following strong opposition from lawmakers and stakeholders. CMS gave assurances that it will give at least 30 days' notice before the demonstrations begin.
Under the demonstration, CMS would require prepayment review of all Medicare power wheelchair claims in the following states: California, Florida, Illinois, Michigan, New York, North Carolina, and Texas. CMS, in the first phase of the demo, would request documentation from suppliers supporting the need of devices after physicians have written prescriptions for the devices and beneficiaries have been issued the wheelchairs. In phase two of the demonstration, CMS would move to a newly developed "prior authorization" program in the same states three to nine months after the implementation of the demonstration.
In late December, the Academy wrote a letter to Acting CMS Administrator Marilyn Travenner urging that the demonstration for "prior authorization" of power mobility devices (PMD) that was scheduled for January 1, 2012 be delayed to provide additional time to ensure that access to PMD was not unnecessarily disrupted for Medicare beneficiaries with mobility impairments.
The Academy also participated in helping to mobilize a bipartisan group of 22 House lawmakers in late December to delay the prepayment demonstration on power wheelchairs after stakeholders including industry and patient groups advocated against the three-year seven-state demonstration.