RAMP Report: CMS Asked to Make 'Mobility For Mobility's Sake' An ADL in New Medicare Coverage Policy

3/16/2005 3:53:00 PM


To: National Desk

Contact: Michael K. Frisby, 202-625-4328 or Mike@FrisbyAssociates.com, for the Restore Access to Mobility Partnership

WASHINGTON, March 16 /U.S. Newswire/ -- The following is the RAMP Report from the Restore Access to Mobility Partnership:


Volume II Issue 6

March 16, 2005

Clinicians, consumers and industry representatives have offered the Centers for Medicare and Medicaid Services (CMS) many suggestions on how to improve its proposal for a new coverage policy for Mobility Assistance Equipment (MAE). RAMP urges that these recommendations be seriously considered so that the final policy will include appropriate revisions and clarifications.

The most recent draft indicates that serious attention must still be given to developing the coverage criteria, documentation requirements and the roles to be played by clinicians and suppliers. Stakeholders are anxiously awaiting a new policy, but CMS must balance the need to act quickly, with ensuring that they have produced a new coverage policy that is clear, concise and meets the needs of beneficiaries, suppliers and the government.

As CMS works to finalize the policy, RAMP will focus attention on some problem areas. Today, we discuss the need for CMS to clarify two lingering questions about the new coverage policy:

-- Will mobility for mobility's sake be a condition that can trigger a beneficiary's Medicare coverage for an MAE?

-- Will mobility for mobility's sake be included as an activity for daily living (ADL) in the new coverage policy, joining activities such as grooming, toileting, dressing and preparing food?

Thus far, there are mixed signals on how CMS intends to handle this important issue.

The draft National Coverage Determination (NCD), which is the foundation for the new national coverage policy, is more restrictive on the issue of mobility for mobility sake than the accompanying Draft Decision Memo. In the decision memo, mobility for mobility sake is cited as one criterion for providing coverage. Yet, in the NCD, that language has been omitted from the clinical criteria for MAE coverage.