ALSA Advocacy Update: Power Wheelchair Coverage


As we reported in earlier updates, the Advocacy Department and Patient Services Department of The ALS Association have been closely monitoring changes in the Medicare coverage policies for power wheelchairs and scooters. With those changes scheduled to take effect today, we want to share with you the latest update on this issue.

We are pleased to report that CMS has made additional revisions to the new polices, increasing reimbursement rates paid to suppliers for power chairs, including many of the higher end chairs used by PALS. These increases help address concerns that the previously proposed rates were too low and did not accurately reflect the cost of power chairs and scooters.

These changes are in addition to earlier revisions CMS made to the new coverage polices. Those revisions removed the “stand and pivot” transfer test as one of the coverage criteria, helping to ensure PALS continue to have access to higher end chairs. CMS also added language that recognizes the progression of ALS and other diseases to allow beneficiaries to qualify for certain power chairs even though they may not yet need all of the features of the chair.

The revisions that CMS has made to the coverage policy and reimbursement rates are important and seek to address many of the concerns that have been raised. Although we are pleased with the latest revisions, we will continue to closely follow implementation of the new policies. Therefore, we strongly encourage PALS and ALSA Chapters to immediately report to us any difficulties PALS may experience accessing needed power mobility equipment. This is critical and will help us to promptly communicate concerns to CMS and Congress and address any difficulties that may arise.

If you or someone you know experiences problems accessing needed power mobility equipment, please contact Pat Wildman in the Advocacy Department at pwildman@alsa-national.org or toll-free at 1-877-444-ALSA. Chapters and individuals also may report problems to ALSA’s Patient Services Department at alsinfo@alsa-national.org or 1-800-782-4747.

If you have any questions about this update or would like additional information, please contact Pat Wildman.