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May 7, 2008
Dear Majority Leader Reid, Chairman Baucus, and Ranking Member Grassley: The undersigned members of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition write to request your assistance in ensuring that individuals with mobility impairments have access to appropriate power wheelchairs under the Medicare program. The ITEM Coalition is a consumer-lead coalition of disability-related organizations with the goal of improving access to assistive devices, technologies, and related services for individuals with disabilities of all ages. Section 608 of the House-passed Children's Health and Medicare Protection ("CHAMP") Act would eliminate the initial purchase option for power wheelchairs under Medicare, requiring that individuals, instead, rent their mobility devices for thirteen months prior to transfer of the device's ownership to the beneficiary. While we continue to support efforts to reduce fraud and abuse in the Medicare mobility device benefit, we fear that this provision will have the unintended consequence of reducing appropriate access to power wheelchairs for individuals with mobility impairments. Nearly all Medicare beneficiaries in need of power wheelchairs purchase their devices upfront, in the first month of delivery. This is because most individuals have long-term needs and often require a specific "fit" of each device to meet their medical needs. The impact of this legislative proposal would be to require wheelchair suppliers to purchase power wheelchairs from the manufacturers and then essentially finance these devices to individuals over a thirteen-month period. This creats an enormous disincentive for suppliers to serve Medicare beneficiaries and, as a result of this policy change, we fear beneficiaries may be evaluated for wheelchairs based on their diagnosis and prognosis, rather than their current mobility needs. Moreover, combining this significant change in policy with the numerous other changes occurring in the mobility device benefit will add to the confusion and uncertainty present in the benefit and may further compromise access to appropriate mobility devices. Therefore, we encourage you to reject this provision in any healthcare legislation you consider this year in order to ensure access to appropriate mobility devices for individuals with mobility impairments. Thank you for your consideration. Sincerely, American Academy of Physical Medicine and Rehabilitation
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