Significantly more stringent criteria for qualifying for power chairs is supposed to be effective November 15, 2006. The following is the information provided to me by the ALSA National Office when I asked about this subject.



Many in the ALS community may have heard about new coverage policies Medicare has proposed for power wheelchairs that are scheduled to be implemented on November 15, 2006 . The changes result from Medicare's attempt to cut down on fraud and abuse in the benefit for scooters and power wheelchairs, expenditures for which have risen from $43 million in 1995 to $1.2 billion in 2003 according to the Centers for Medicare and Medicaid Services (CMS).


We want you to know that the Patient Services and Advocacy Departments of The ALS Association are actively following the development of the proposed changes to ensure that people with ALS will continue to have access to needed power mobility devices. At this time, it is unclear to what degree the proposed changes will impact people with ALS specifically. The changes that have been proposed, including changes to the reimbursement rates paid to Medicare providers, apply to all power mobility devices ranging from scooters to high-end power wheelchairs and differ depending on the type of device and the needs of beneficiaries.


ALSA also is aware that action alerts and sample letters have been circulated that encourage people to contact CMS and Members of Congress to express opposition to the new reimbursement rates and coverage policies. Please keep in mind that these letters were not drafted by ALSA and are not written specifically for people with ALS, but for anyone who may need a scooter or any type of power wheelchair. Therefore, if you choose to send a letter, please remember that you may be asked to detail how the new rules will specifically impact you.


ALSA currently is requesting feedback from our Chapters as well as from individuals about their specific concerns with CMS' new reimbursement rates and coverage policies. The Patient Services Department is compiling this information and will work with the Advocacy Department to take any additional steps that are necessary to promote the interests of the ALS community.


We also are strongly encouraging Chapters and PALS to closely monitor this situation if the policies are implemented on November 15 without changes. Specifically, we are requesting people report to their local ALSA Chapter or to the Patient Services Department (alsinfo@alsa-national.org) any difficulties that PALS experience, such as issues with seating, transfer ability, and having the appropriate chair features. This feedback is absolutely essential and not only will help ensure that we accurately deliver the concerns of the ALS community to Congress and CMS, but also that Congress and CMS take immediate action to address these concerns.


ALSA will provide additional information as it becomes available. In the meantime, please contact the Advocacy Department (advocacy@alsa-national.org) or the Patient Services Department (alsinfo@alsa-national.org) if you have any questions or would like to share your concerns about the proposed changes.