Senators Hassan, Blackburn, Casey, and Duckworth Urge Improved Medicare Mobility Equipment Coverage

WASHINGTON – Senators Maggie Hassan (D-NH), Marsha Blackburn (R-TN), Bob Casey (D-PA), and Tammy Duckworth (D-IL) are pushing the Centers for Medicare and Medicaid Services (CMS) to ensure that people with disabilities can access the mobility equipment that they need to live independently.

The Senators are requesting that CMS conduct a comprehensive review of its coverage of mobility assistive equipment for Medicare beneficiaries. Under its current interpretation, CMS only covers mobility assistive equipment – such as wheelchairs, canes, and scooters – that is considered reasonable and necessary for daily life activities that occur within the home. The Senators are asking for a reassessment of this standard to ensure that individuals with disabilities can get the support they need to live independently and to participate in their communities.  

“Current Medicare coverage limitations on equipment used outside the home can limit patients’ access to mobility equipment and to their communities…[The current Medicare] interpretation can lead to coverage denials for wheelchair users and cause delays in obtaining appropriate equipment. These delays can result in health injuries and secondary health conditions, increasing costs for the program and taxpayers,” the Senators wrote in a letter to CMS Administrator Chiquita Brooks-LaSure and Department of Health and Human Services General Counsel Samuel Bagenstos. “Timely access to [mobility assistive equipment] can enable beneficiaries with disabilities to fully participate in community life.”

To read the Senators’ letter to CMS, see below or click here.

Dear Administrator Brooks-LaSure and Mr. Bagenstos:

We are writing to urge Centers for Medicare and Medicaid Services (CMS) to conduct a full review of its 2005 National Coverage Determination for Mobility Assistive Equipment (MAE) for Medicare beneficiaries, including its interpretation of the “in the home” requirement. Current Medicare coverage limitations on equipment used outside the home can limit patients’ access to mobility equipment and to their communities. While we commend CMS for the recent announcement to cover seat elevation technology in Medicare-covered power wheelchairs, more must be done to ensure beneficiaries can access MAE.

In the 2005 National Coverage Determination and subsequent guidance, CMS has determined that coverage of MAE is reasonable and necessary only for activities of daily living occurring within the home. This interpretation can lead to coverage denials for wheelchair users and cause delays in obtaining appropriate equipment. These delays can result in health injuries and secondary health conditions, increasing costs for the program and taxpayers.

Timely access to MAE can enable beneficiaries with disabilities to fully participate in community life. However, MAE coverage delays and denials continue to limit beneficiaries’ access to appropriate equipment, preventing individuals from full participation in the community.

Access to appropriate equipment is critical for those living with mobility-impairing conditions. We request that CMS comprehensively reassess its 2005 National Coverage Determination for MAE and its interpretation of the “in the home” requirement to ensure that individuals with disabilities have the necessary support to live independently in their communities.

Thank you for considering this request.

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