Wheelchair Ruling Protested
- Salt Lake City Tribune
August 09, 2007


Wheelchairs designed for use outside the home will no longer be covered by Medicaid under a rule change that disabled-rights advocates say is misguided, and one occupational therapist likened to placing hundreds of Utahns on house arrest.

Utah health officials say the rule simply codifies existing practice. For more than a decade, Medicaid has paid only for manual and motorized wheelchairs deemed medically necessary and designed for use in the home, said Medicaid budget supervisor Don Hawley.

"Just because the design is for the home doesn't mean it won't be suitable for outside," said Hawley. "But we're not going to pay for someone to have nobby sports tires."

Advocates fear, however, the rule will be taken too literally by front-line claims workers and used to deny benefits.

"In the home" is a Medicare term that has been misinterpreted and expanded over the years, said Matt Knotts, director of the Disability Law Center. "A disability doesn't stop at the door."

Jerry Costley, with the Disability Rights Action Committee, finds the rule offensive, saying "the message it sends is very much one of segregation."

Matt Lowell, a physical therapist at Shriner's Hospital, said he has worked with patients who might be able to get around in the home with a walker, but need a wheelchair to go to work, grocery shopping or church.

"This is like placing disabled people on house arrest," said Lowell.

Lowell was among a dozen people to protest the "in the home" provision at a hearing Wednesday. The rule also seeks to stop Medicaid payment for prosthetic limbs with special shoes and post-chemotherapy wigs and hair replacements.

Fewer than 1,000 beneficiaries would be affected, said Hawley. By comparison, the temporary loss of dental and vision care in previous years touched tens of thousands of people.

Hawley said the goal isn't to save money, but to guard against overspending and fraud. About $13 million of Medicaid's $7 billion budget was spent on medical devices in 2006.

What is affected

Wheelchairs specifically designed for use outside the home
Prosthetic limbs with special shoes
Post-chemotherapy wigs and hair replacements

http://www.healthdecisions.org/News/...?doc_id=129403

Utah Medicaid Buys Into The Home For Wheelchair Users

More bad news for wheelchair users. This time Utahns who depend on Medicaid for their wheelchair funding are taking the hit. This appeared in the Salt Lake Tribune.

“Wheelchairs designed for use outside the home will no longer be covered by Medicaid under a rule change that disabled-rights advocates say is misguided, and one occupational therapist likened to placing hundreds of Utahns on house arrest.

Utah health officials say the rule simply codifies existing practice. For more than a decade, Medicaid has paid only for manual and motorized wheelchairs deemed medically necessary and designed for use in the home, said Medicaid budget supervisor Don Hawley.

“Just because the design is for the home doesn’t mean it won’t be suitable for outside,” said Hawley. “But we’re not going to pay for someone to have nobby sports tires.”

Advocates fear, however, the rule will be taken too literally by front-line claims workers and used to deny benefits.”

I’m having a great deal of trouble with Hawley’s concept of a wheelchair is a wheelchair is a… I’m also having a problem with Don’s wisecrack sarcasm regarding not paying for “sports tires”. Hey Don, I’m sure that there are thousands of wheelers in Utah who thought that you were going to buy them sports tires. The requests are probably rolling in by the bag full and bringing your operation to a complete halt each and every day.

Here’s what I really think. I think that Mr. Hawley knows little about wheelchairs and even less about how important and necessary the right wheelchair is to a user. I also think that tossing about statements that have no relevance to the real world situation is nothing but cheap soapboxing and misinformation mongering. Yes, much of the general public may in fact agree with Mr. Hawley, but they probably have few insights by which to judge these matters.

Mr. Hawley on the other hand should have the insights and the knowledge to state his case with the relevance and sound logic that this serious matter deserves. Rather, he chose to convince the public by use of flawed homegrown logic on wheelchairs and a wallet launched wisecrack.

Doubt it not, many wheelchair using Utahns will be imprisoned within their homes because of this. The resultant cost of in-home services and the cost of increased medical expenditures for these people will far exceed the cost of an appropriate wheelchair, with or without “nobby sports tires”.

Hawley is not the only gatekeeper out there spewing this stuff. There are lots more in every state and at the national level. What I’m not hearing from them is the bottom line. In the event that people do loose their independence and mobility or are rendered “housebound” (such an ugly word), what then? Can the victims and their families go to their designated Hawley and say- “Hey, something went wrong. You said this wouldn’t happen. How about helping us out.” I’ll bet you a set of “nobby sports tires” that they won’t even make it through his door.

For most of us Utah is a far away place. Many of you may be thinking that this won’t or can’t happen in my corner of the world. Well, it already has, and there’s no safe haven. Medicare, a NATIONAL program, has been rolling out their “In the home” machine for several years now and they have some killer refinements on it yet to come.

If you think confining and restricting independence is acceptable then you probably wasted your time reading down this far. If you think that things need to change then it may be time for you to kick in and help with the changing.

Take action on this issue and join a campaign. If you don’t like structured campaigns then make some noise on your own. This isn’t a hard one to win. Similar to Mr. Hawley’s dollar based logic, it’s all in the numbers.
http://www.usatechguide.org/blog/uta...elchair-users/