WASHINGTON--Pennsylvania Sens. Rick Santorum and Arlen Specter are urging CMS to issue clear documentation requirements for Medicare coverage of mobility equipment.

In a letter dated Aug. 5 to CMS Administrator Mark McClellan, the senators said they "remain concerned with the lack of clear instructions to [DMERCs] and for providers as to how they are to document the medical necessity of power mobility products under the coverage policy."

Since CMS released a new mobility coverage policy on May 5, providers, manufacturers and others have argued that the agency has not provided enough guidance on required claims documentation under the new policy.

The senators pointed out that "providers regularly encounter inconsistencies within the four DMERC regions on how documentation is interpreted. In addition, providers are faced with the DMERCs' placing extreme emphasis on a physician's chart notes to justify medical necessity, even though physicians do not routinely document medical information in their charts to the level of specificity that the DMERCs are requiring." According to the senators, evaluations from clinicians or letters of medical necessity should be used by claims processors if there is an audit.

The senators also raised concerns that a revised wheelchair certificate of medical necessity, power operated vehicle policy and final face-to-face examination rule--all expected to be released by CMS--may not be adequate to determine medical necessity.

The mobility policy also has caught the attention of Ohio Sen. George Voinovich, who last month sent a letter to HHS Secretary Michael Leavitt asking that the companion regulations be released soon.

"I think these letters have a significant impact," said Seth Johnson, director of government affairs for Exeter, Pa.-based Pride Mobility. "We really want to know what the rules of the road are. And providers want to know so they know with certainty when they submit a claim they are going to get paid."