WASHINGTON--A controversial CMS rule that does away with Medicare's power mobility certificate of medical necessity and requires suppliers to keep patient records on file has been put on hold for a few months.

On New Year's Eve, President Bush signed into law the Labor-HHS appropriations bill, which includes a provision that prohibits CMS from using resources to implement or enforce its interim final rule for power mobility devices until April 1.

A few days after the IFR took effect Oct. 25, Sen. Arlen Specter, R-Pa., introduced the amendment in an effort to delay its implementation.

The measure also instructs CMS to issue a proposed rule by Jan. 1--though that has yet to be published--followed by a final rule to be issued Feb. 14.

Industry leaders also were relieved that a provision in the original amendment that would have reduced payments for power mobility devices by 1.5 percent was removed from the final version.

"This gives suppliers a bit of breathing room to better educate physicians about documentation," said Cara Bachenheimer, vice president of government relations for Elyria, Ohio-based Invacare Corp. "But if providers have already made operational plans, they should continue to do that."

The IFR caused an uproar among mobility stakeholders following its release in late August (see HomeCare Monday, Aug. 29, 2005). Opponents claimed that the new requirements were confusing and contended that CMS did not provide enough time to educate parties about the changes and implement processes to incorporate the new regulations.

Rita Hostak, vice president of government relations for Sunrise Medical, said she is concerned the delay may cause additional confusion for some suppliers and physicians, but she added that it does give CMS the chance to improve upon the rule. "It is critical for there to be clarity regarding what defines adequate documentation to support medical need for power mobility equipment. This should be highly predictable and objective, whether it is being viewed by a physician, therapist, supplier or someone in medical review," Hostak said.

Also, she pointed out, with the various pieces of mobility guidance that have been published by CMS at different times since the NCD was released, "the delay provides an opportunity to publish it all in one well-written regulation."

Until CMS issues further details on how to handle documentation for mobility claims, Invacare recommends the following:

--Beneficiaries should continue to have a face-to-face exam with the prescribing physician, but the 30-day time period between the date of exam and the date the physician provides the supplier with a prescription and supporting documentation is suspended. If there is a longer period of time between these two events, the claim should not be denied.
--The NCD for mobility assistive equipment still determines the coverage criteria, and suppliers should use this as a base to educate physicians about Medicare coverage criteria.
--Suppliers should use the delay period to better educate prescribing physicians on the coverage criteria (for example, educate physicians on the nine questions in the NCD).
--If your company is comfortable complying with the requirements of the IFR issued Aug. 26, 2005, Invacare said, "we do not see any reason to change your operations. We expect any new rule to be substantially similar to the one issued in August."

To view the text of the appropriations bill, also known as H.R. 3010, visit http://thomas.loc.gov.

To view the IFR, click here.