Newsletter – September 2005 (page 4)

GOVERNMENTAL NEWS

Comments on ACAA Proposed Rule

“Access Now” filed its comments regarding the U.S. Department of Transportation’s proposed new rules to the Air Carrier Access Act – the law that provides access to air travel for people with disabilities. “Access Now” expressed its view (see below) that the USDOT’s proposed rules were more about protecting business interests than in protecting the rights of people with disabilities, and the proposed changes in the law only limit the ability of people with disabilities to travel by commercial aircraft. No date has been set for the issuance of the final regulations.

COMMENTS OF “ACCESS NOW, INC.” – MARCH 22, 2005

What has become all too common under the current federal administration is that executive branch agencies, such as the USDOT, are more interested in protecting business interests than in protecting the rights of people with disabilities. This Notice of Proposed Rulemaking (NPRM) makes a number of changes in the regulatory law that will serve to limit the ability of people with disabilities to travel by commercial aircraft. The NPRM weakens our access rights under the Air Carrier Access Act (ACAA) and its current implementing regulations in several ways at the same time as the weaker proposed regulations will be applied to foreign flag air carriers.

Those most harmed by the proposed rule are those with legs that do not bend (due to fusions, braces, etc.) and those with service animals. This rule proposes that people with legs that do not bend simply put their unbending leg out into the aisle. (They ignore those who have two legs that do not bend). They do not address what such people should do with their legs during take off and landing, when the FAA requires that the aisle be clear, or what one does with an unbendable leg when the cabin crew rolls the beverage or food cart up the aisle. As far as service dogs are concerned, this proposed rule would require a service dog to fit in the 16 inch wide space under the seat in front of the passenger with a disability. People with guide dogs and mobility assistance dogs, all of which are too large for that small space, would no longer be able to fly on any commercial aircraft.

Similarly, the lack of accessible lavatories on aircraft with one aisle means that some mobility-disabled passengers will be subjected to the indignity of wearing special undergarments if they must travel on commercial aircraft. This is simply unacceptable, inasmuch as it eviscerates the intent of the ACAA.

On behalf of the members of “Access Now, Inc.”, we wish to register our objection to the Proposed Rule as delineated above. Thank you for your consideration.

Important Medicare News

CMS ISSUES UPDATED REGULATIONS FOR POWER WHEELCHAIR AND POWER OPERATED VEHICLE CLAIMS

CERTIFICATE OF MEDICAL NECESSITY NO LONGER REQUIRED

On August 26^th the Centers for Medicare & Medicaid Services (CMS) published an Interim Final Rule in the Federal Register regarding appropriate access for people with Medicare to power operated vehicles – commonly called “scooters” ‑ and power wheelchairs. The Interim Final Rule will become effective for services on or after October 25. Comments will be accepted until November 25, and a final rule will be published at a later date.

The Interim Final Rule is the latest action by CMS implementing a Power Wheelchair Initiative first announced in April 2004 provisions in the Medicare Modernization Act of 2003 affecting power wheelchairs and power scooters. It is meant to underscore the principle that a beneficiary’s physician or treating practitioner is in the best position to evaluate and document his or her clinical condition and medical needs. “This Interim Final Rule is a critical step in ensuring that people with Medicare have access to appropriate technology to assist them with mobility,” said CMS Administrator Mark B. McClellan, M.D., Ph.D. “[T]his Interim Final Rule is part of a comprehensive strategy to help Medicare beneficiaries get the mobility assistance equipment they need while avoiding unnecessary administrative burdens and inappropriate Medicare spending.”

CMS is eliminating the requirement that a Certificate of Medical Necessity (CMN) signed by the prescribing physician or other treating practitioner accompany claims for power wheelchairs and scooters. In place of the CMN, the Interim Final Rule describes the clinical documentation from a patient’s medical record that must be submitted along with a written prescription to the supplier before the supplier delivers a power wheelchair or scooter to the beneficiary. “Documentation in the medical record of the beneficiary’s need for assistance with mobility in the home, as well as the type of technology needed, not only is the best evidence of medical necessity – it also helps to promote continuity of care for our beneficiaries,” said CMS Acting Chief Medical Officer, Barry Straube, M.D. “And we are recognizing this in our payments to providers.”

CMS is notifying physicians, other treating professionals and power mobility device (PMD) suppliers, of this Interim Final Rule through its Medicare listserves. CMS is also targeting educational efforts to physicians, other practitioners who prescribe power wheelchairs and power scooters as well as to PMD suppliers, to help them understand the new criteria and documentation requirements before the implementation date. This includes new billing instructions for suppliers.

In early September, CMS will hold a special Open Door Forum to address power wheelchair and power scooter issues. The Open Door Forum will offer physicians, suppliers and other stakeholders the opportunity to participate in person or by conference call in a discussion with senior staff about Medicare policies.

For further information you can view the Interim Final Rule and Fact Sheet on the CMS Website at http://www.cms.hhs.gov/coverage/wheelchairs.asp The official contact for the Interim Final Rule is Karen Daily; you can telephone her directly at (410) 786-0189 (reference file code CMS-3017-IFC). You can also telephone CMS toll-free at (877) 267-2323 or (866) 226-1819 (TTY) or locally at (410) 786-3000 or (410) 786-0727 (TTY).