On September 20, 2006, the Centers for Medicare and Medicaid Services (CMS) issued clarifications to the Local Coverage Determination (LCD) for power mobility devices (PMDs). The purpose of this clarification is to protect access for Medicare beneficiaries to the full range of technologies that are reasonable and necessary for them while taking into account their medical conditions, functional abilities and home environments. Moreover, this clarification ensures that there will be no confusion surrounding the basic intent of Medicare's policy: the right equipment at the right price. CMS' clarification underscores our responsiveness to feedback from manufacturers, suppliers, and clinicians and ensures that there is enough flexibility in providing a beneficiary the right PMD. For example, one of the modifications made to the LCD is to clarify the language providing for a "least costly alternative" determination that was widely misinterpreted as a blanket down-coding of Group 2 (general use) to Group 1 (light weight) power wheelchairs. The complete policy may be viewed by clicking on the links to the websites below. It is also important to note that the PMD codes, fee schedule amounts, and LCDs were originally scheduled to take effect on October 1, 2006. In order to allow for additional time to prepare for implementation of the fee schedule amounts and LCDs, however, these changes will be effective on November 15, 2006. A fact sheet from CMS is also available through the link below. |
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