Baltimore
Years of wrangling over power mobility CMNs will soon be moot according to a new process that eliminates the document entirely.
Under an interim final rule unveiled in August, providers need only submit a physician's prescription for reimbursement of Medicare claims for power mobility devices. They will, however, be responsible for gathering patient records that document medical necessity. The new rule is scheduled to take effect Oct. 25, but suppliers will need to submit a partially completed CMN until system changes are fully implemented in April 2006.
“This interim final rule is a critical step in ensuring that people with Medicare have access to appropriate technology to assist them with mobility,” CMS Administrator Mark McClellan said at an Aug. 24 press conference announcing the new rule, calling it “a comprehensive strategy to help Medicare beneficiaries get the mobility assistance equipment they need while avoiding unnecessary administrative burdens and inappropriate Medicare spending.”
The new rule also requires physicians and treating practitioners to perform a face-to-face exam before writing a prescription, which the HME provider must receive within 30 days.
Providers also are required to gather clinical information supplied by the doctor or practitioner that proves medical necessity before delivering a power wheelchair or scooter.
According to Kimberly Brandt, director of CMS' Program Integrity Group, this will allow questions to be asked about changes in the patient's health or about progression of the clinical condition that warrants the equipment.
“The physician is in the best position to document and evaluate clinical and medical need,” said McClellan, who called the power wheelchair and scooter CMN “extra paperwork.”
While physicians already can file for payment for the office visit to evaluate patients, he said CMS is authorizing an additional physician payment of about $21 for preparing and providing the documentation to suppliers.
The documentation does not need to be submitted to the DMERCs with every claim, McClellan said, but suppliers should keep it on file to supply upon request.
