WASHINGTON--Following last week's Open Door Forum and release of the DMERCs' LCD on power mobility equipment, a strong response from the Restore Access to Mobility Partnership, an industry coalition of powered equipment manufacturers and providers, emphasized that the scheduled Oct. 25 implementation of CMS' new interim rule on power mobility should be delayed.

"CMS has a responsibility to clarify procedural guidelines, as well as outline clear and concise documentation responsibilities," a RAMP statement said. "Failure to do so could cause the collapse of the power mobility industry, creating layoffs, forcing suppliers to stop selling mobility products and leaving thousands of Medicare beneficiaries without a means to obtain mobility equipment."

"We are heading towards a train wreck," stated Pride USA's President Dan Meuser. "We spent more than a year working with CMS to come up with a new coverage policy. But now all that hard work is in jeopardy if the coverage policy is not accompanied by a clear and concise set of regulations to govern how power wheelchairs and scooters get to the Medicare beneficiaries who need to address mobility deficits. CMS needs to review the many, many implications that have not been thoroughly considered. There is no way these new procedures are ready to be implemented by October 25, as is currently planned."

The coalition and its members, which include the American Association for Homecare, Invacare Corp., The Med Group, Mobility Products Unlimited, Pride Mobility and Sunrise Medical, also expressed other concerns.

"How can CMS possibly think about implementing new procedures when there are so many indications that they are not ready, and there are important missing pieces?" questioned Mal Mixon, Invacare's chairman and CEO. "There needs to be an extensive education process for doctors and other stakeholders, but that cannot begin until all the pieces are finalized. The Open Door Forum was an opportunity for stakeholders ... to raise our concerns about the new procedures. Now, CMS needs to slow down, carefully listen to our concerns and respond with a revised rule that is shaped with our input."

One of the coalition's biggest concerns is "CMS' decision to place more responsibility for documentation with physicians, and to rely on their chart/patient notes for documentation of medical necessity for mobility equipment. ... This scenario assumes that the physician has extensive knowledge of the range of mobility equipment," the statement said.

"Traditionally, this has been a team approach with the doctor, clinician and supplier working together on providing the best piece of equipment for the patient," said Michael Hammes, chairman and CEO of Sunrise Medical. "CMS is shifting much of the burden to doctors, whose primary responsibility is to look at the broader health of the patient."

Yet another issue is how to make the transition from the old coverage policy to the new one, according to RAMP. At the Open Door Forum, details about the 30-day period cited in the interim rule as the timeline from a physician face-to-face exam to a decision on the equipment being delivered were left unclear. "There also seemed to be an assumption by CMS that physicians are familiar with the new coverage policy that was introduced in the spring, even though there has been no education program to inform them," the statement said.

"Since the new coverage policy was released, we have said that clear documentation requirements have to be established. That has yet to happen," said John Ward, CEO of Mobility Products, adding that the interim rule "that CMS is trying to rush into place by October 25 is an attempt, but it lacks the kind of details that are needed. CMS must take the time to consider all the consequences and get this right."