Draft LCD Threatens Access to Mobility Devices
A draft Local Coverage Determination (LCD) and revised payment codes recently proposed by the DMERCs would make it even more difficult for people with mobility impairments to obtain a power mobility device or the most appropriate device.

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BACKGROUND

 

A draft Local Coverage Determination (LCD) and revised payment codes for power mobility devices were released by the Durable Medical Equipment Regional Carriers (DMERCs) the week of Sept. 19th. The LCD provides additional guidance for the National Coverage Determination (NCD) on mobility assistance equipment, which became effective on May 5, 2005.

 

This draft LCD makes it even more apparent that the DMERC and the Centers for Medicare and Medicaid Services (CMS) are committed to interpreting the “in the home” language in the most restrictive manner possible.

 

Should this draft LCD be implemented as is, people with mobility impairments would face significant difficulties obtaining a power mobility device or the most appropriate device.

 

The draft LCD and final NCD stand to harm beneficiaries with disabilities by:

 

·       Denying them access to mobility devices needed and/or appropriate for use outside of the home

·       Confining coverage to those devices necessary for the beneficiary to complete only 5 activities (eating, bathing, toileting, grooming and dressing) inside the home, and

·       Prioritizing fraud, abuse and spending reductions rather than providing the most appropriate device to the beneficiary

 

HOW YOU CAN HELP

 

The DMERCs are accepting comments on the draft LCD until October 31, 2005. We encourage you and your members to contact your senators and representatives asking that they contact CMS regarding the discriminatory “in the home” restriction.

 

The ACA is in the process of formulating our comments and will share them when they are complete.

 

Search by your state at the following two sites to submit an email to your representative (http://www.house.gov/writerep/) and senator (http://www.senate.gov/).

 

Information regarding submission of comments can be found on the four DMERC Web sites. In addition, a public meeting will be held by each DMERC to receive comments. Information regarding this meeting may be obtained from each individual DMERC Web site below.

 

Region A

TriCenturion, LLC

www.tricenturion.com

 

Region B

AdminaStar Federal

www.adminastar.com

 

Region C

Palmetto GBA

www.palmettogba.com

 

Region D

CIGNA Government Services

www.cignamedicare.com

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