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Amplitude

Bipartisan Senate Group Urges Medicare Changes

October 20, 2021
0

Tammy Duckworth, one of the Senate’s strongest advocates for disability rights and the only amputee currently serving in the chamber, is pushing for Medicare changes that would offer greater insurance coverage for wheelchair-using amputees, and might eventually impact the way Medicare covers prosthetic technology.

“We write to request that the U.S. Centers for Medicare and Medicaid Services (CMS) act expeditiously to make an affirmative benefit category determination clearly establishing that standing and seat elevation systems embedded in power wheelchairs fall under the definition of durable medical equipment (DME),” begins the letter, which Duckworth co-authored with Tennessee Republican Marsha Blackburn and Pennsylvania Democrat Bob Casey. The Senators argue that such a change would align with a judge’s finding in 2014 that advanced wheelchair technology “serves a medical purpose.”

It’s that last phrase—”serves a medical purpose”—that could have implications for Medicare’s coverage of prosthetic limbs. If that definition can be made to stick for mobility-related wheelchair technology, it bodes well for the possibility of similar changes in Medicare coverage for prosthetic devices. Duckworth, a bilateral lower-limb amputee, uses both wheelchairs and prosthetic legs for mobility assistance.

“This long overdue CMS action would make sure Medicare beneficiaries with personal mobility deficits receive the reasonable and necessary [Mobility Assistive Equipment] that restore[s] function required to perform mobility-related activities of daily living and avoid medical problems and chronic injuries,” the letter concludes.

You can read the full letter here. We’ll keep tabs on how this resolves.

Tags: Insuranceinsurance coverageMedicaretammy duckworthwheelchairs
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