WASHINGTON--In a statement issued Friday, the Restore Access to Mobility Partnership applauded CMS for working with stakeholders to clarify some issues in the newly revised Local Coverage Determination for power mobility devices. However, the coalition of power mobility manufacturers and suppliers reiterated industry concerns that additional policy revisions and pricing information are still needed.

Last month, the DME Program Safeguard Contractors issued the revised LCD, eliminating the "least costly alternative" determination, or automatic downcoding, that had drawn fire from both patient advocates and equipment manufacturers (see HomeCare Monday, Sept. 25).

While RAMP said it appreciates the change, it is requesting additional assurances from CMS that downcoding will not occur. "At this point, stakeholders are merely seeking a letter or some kind of other written confirmation that this will be the policy so that it won't ever be an issue in the future when claims are under appeal or under review," the organization said.

RAMP also said CMS should eliminate the stand-and-pivot criterion used to determine whether a Medicare beneficiary qualifies for a Group 3 power wheelchair. Only patients who are incapable of an "independent transfer" qualify for a Group 3 chair, but some stakeholders are concerned that a literal interpretation of "independent" could include people who face a severe struggle to transfer themselves.

This requirement should be replaced with clinical criteria that will provide access to the proper medical equipment for patients requiring complex rehabilitation, RAMP said.

Moreover, RAMP said that more should be done to address the future medical needs of patients with progressive and degenerative conditions. "But CMS is currently saying that their future needs should be addressed through the review and appeals process, which in many cases may delay patients from receiving the proper power wheelchair--when they need it," the statement read.

The issue could be resolved if CMS added language to the LCD providing coverage of Group 3 wheelchairs or higher to beneficiaries living with progressive and degenerative conditions, RAMP said.

The organization also stressed the need for pricing information, because "if the fee schedule is too low for certain power wheelchairs and scooters, suppliers and manufacturers won't be able to provide the equipment."