WASHINGTON--CMS' latest power mobility changes have caught the attention of three U.S. senators, who are urging the agency to rethink its new policies and its timeline for implementation.

In a letter to HHS Secretary Michael Leavitt and CMS Administrator Mark McClellan, Iowa Sen. Charles Grassley said parts of the power mobility interim final rule, released Aug. 24, "appear to be overly restrictive, confusing and impossible to successfully implement in the proposed time frame--fueling fraud, waste and abuse in the Medicare program."

At the same time, Pennsylvania Sens. Rick Santorum and Arlen Specter are pushing for a delay in implementation of the rule and 63 new power mobility codes released in September.

While the interim final rule eliminates the CMN for power mobility devices, requiring providers to submit only a physician's prescription for Medicare reimbursement, it requires providers to gather patient records from physicians that document medical necessity and supply them upon request. (See HomeCare Monday, Aug. 29.)

"In the sprint to publish these requirements, CMS may have added an unnecessary degree of subjectivity to this process," Grassley wrote in his Sept. 29 letter. Elimination of the CMN may open the door to "fraud, confusion and subjectivity," he said.

"At the very least," Grassley continued, CMS must "clarify its [national coverage determination]" and "provide additional guidance" on its provisions. He added that CMS should consider working with contractors to ensure consistency throughout the four DMERCs as they work to develop their local coverage determinations.

Grassley, chairman of the powerful Senate Finance Committee, which oversees Medicare, urged CMS to reconsider the Oct. 25 implementation date for the interim final rule. "It seems as if CMS is trying to finish a puzzle with some essential pieces missing," he said.

He also asked how competitive bidding and supplier quality standards would affect the PMD benefit, and requested a response from McClellan by Oct. 11.

In a separate letter to McClellan, also dated Sept. 29, Santorum and Specter proposed delaying implementation of the new PMD codes until July 1, 2006, and delaying the interim final rule until April 1. "The absence of a reasonable period for advance preparation to the change in rules may overwhelm PMD providers and manufacturers striving to comply and remain commercially viable," the senators wrote.

Last month, CMS released 63 new power mobility codes--replacing the 49 that were issued in February--along with revised product testing requirements. They are scheduled to take effect Jan. 1. (See HomeCare Monday, Sept. 19.)

A delay would allow more time to educate physicians, clinicians and providers about the new rule; make sure all questions are answered and resolved prior to implementation; and give DMERCs and outside vendors time for their systems to accept the changes, the senators said. Delaying the code changes would also give manufacturers time to adjust and retest products according to the new standards.