Clear, consistent documentation requirements another must, trade group says. Industry and beneficiary advocates are keeping up the pressure on the Centers for Medicare & Medicaid Services to get its wheelchair coverage policy in line.
In December, CMS announced that rather than issuing new coverage guidance outright, it would put the coverage policy through the National Coverage Determination process (see Eli's HCW, Vol. XIII, No. 45, p. 355). CMS took comments on the NCD until Jan. 14.
The Power Mobility Coalition calls on CMS to issue immediate interim guidance implementing the functional-based ambulation standard instead of the old bed- or chair-confined standard. "Immediate interim guidance to contractors is required to ensure that all beneficiaries with limited or compromised mobility will have access to mobility products and services," PMC insists in its Jan. 14 comment letter.
A Clinician Task Force of the Coalition to Modernize Medical Coverage of Mobility expresses dismay that final coverage guidance could be six months off. "We were expecting coverage policy guidance by the end of 2004," says physical therapist Laura Cohen, co-coordinator of the task force, a group of physical and occupational therapists and other specialists in seating and wheeled mobility.
PMC also calls for: clear and consistent documentation requirements; keeping the fitting and furnishing of power wheelchairs open to non-clinicians; elimination of the in-the-home requirement for wheelchair coverage.
The task force also urges CMS to drop the in-the-home requirement, plus: recognize basic mobility as a functional activity; specify clear requirements for medical necessity documentation; link levels of beneficiary function to the specific equipment (HCPCS codes); and specify all key "terms of art" to avoid misinterpretation of the coverage criteria.
More information is available online at
www.cliniciantaskforce.org. New figures show the cost of home care is climbing. A telephone survey commissioned by insurance company Genworth Financial and conducted by CareScout found home health aide and homemaker services will cost consumers an average of $18.65 and $16.67 per hour, respectively. Those charges include information from three types of home health agencies - certified providers, licensed providers who are not Medicare certified, and non-licensed, non-certified providers.
More and more Americans are expressing a desire for home care, Genworth says in a release. "As 77 million people approach retirement, growing life expectancy is stimulating demand for long term care and, consequently, driving up costs for nursing homes, assisted living, and home care," says Buck Stinson, president of Genworth Financial Long Term Care. Florida HHAs may see more Medicaid business available - but that doesn't mean the news is great. After testing a Nursing Home Diversion pilot program since 1998, the state has decided to take the program, which aims to keep seniors out of nursing homes and in their own homes, statewide, reports the [...]
