Support Legislation to Fix Medicare's "In the Home" Restriction

Currently, Medicare only provides coverage for mobility devices that are necessary for use inside a beneficiary’s home. In other words, Medicare will grant coverage for a wheelchair or “scooter” that a person needs in order to brush their hair or cook their dinner, but will not provide them with a device if they need it to get to their physician’s office, attend their place of worship, go to the grocery store, return to work, or simply participate in community activities.

This discriminatory restriction runs counter to numerous government initiatives to improve access to independent living for people with disabilities including the "Ticket to Work Program," Olmstead Supreme Court Decision, New Freedom Initiative, and Americans with Disabilities Act.

In March, Congressmen Langevin (D-RI) and Ramstad (R-MN) introduced the Medicare Independent Living Act of 2007 (HR 1809) - bipartisan legislation in the House to eliminate Medicare's "in the home" restriction on mobility devices.

The ITEM Coalition is encouraging you to email your Representatives using the draft letter below, asking them to cosponsor legislation to eliminate the "in the home" restriction on mobility devices in order to provide access to the community for people with disabilities. Please feel free to edit the letter and to share your own challenges in accessing the assistive technology that you or a loved one needs.

Sample Letter for Campaign

Subject: Please Support Legislation to Fix Medicare's "In the Home" Restriction on Mobility Devices

Dear [ Decision Maker ] ,

I am writing to urge you to cosponsor legislation to modify Medicare's "in the home" restriction on mobility devices (HR 1809).

Currently, Medicare will only provide coverage for mobility devices that a beneficiary needs for use inside his/her home, but will not provide access to the devices that they need to move beyond their front door.

Medicare's "in the home" restriction fails to take into account beneficiaries' need to access their communities including work, school, religious services, the grocery store, and even their doctor's offices. Additionally, the restriction runs counter to numerous government initiatives to improve access to independent living for people with disabilities including the "Ticket to Work Program," the Olmstead Supreme Court Decision, the New Freedom Initiative, and the Americans with Disabilities Act.

Congressmen Langevin and Ramstad have introduced the "Medicare Independent Living Act of 2007" - legislation to eliminate the "in the home" restriction on mobility devices for those with long-term mobility needs. I encourage you to become a cosponsor of this important legislation to ensure that beneficiaries can access the devices they need to live healthy and independent lives.

Thank you for your consideration.

Sincerely,

Campaign Launched:
April 24, 2006

Background Information

Section 1861(n) of the Social Security Act, 42 U.S.C. § 1395x(n) defines Durable Medical Equipment (DME) as “used in the patient's home.” This language was originally intended to define DME as devices that were provided outside of an institution such as a hospital or skilled nursing facility and, therefore, warranted separate reimbursement under Medicare Part B. However, the Centers for Medicare and Medicaid Services (CMS) has interpreted this language to mean that Medicare will not cover devices that beneficiaries need to move beyond their front doors, access their communities, and live independently.

Policies such as these contradict numerous government initiatives aimed at increasing access to independent living for people with disabilities, including the Americans with Disabilities Act, the "Ticket-to-Work Program," the New Freedom Initiative, and the Olmstead Supreme Court Decision.

Unfortunately, over the last several years, CMS has issued a series of policies and regulations that will further impede access to appropriate mobility devices. In May 2005, the agency issued a new National Coverage Determination (NCD) that not only strengthened the “in the home” language, but also confined coverage to those devices that are necessary for beneficiaries to complete five in-home activities of daily living.

Over 100 Members of Congress signed letter to Secretary Leavitt asking him to modify the “in the home” restriction through the regulatory process in order to improve access to the community for people with disabilities in June/July 2005. However, CMS continues to impose the “in the home” restriction on Medicare beneficiaries in need of mobility devices. The legislation that Congressmen Langevin and Bass have introduced would clarify that this restriction does not apply to mobility devices for people with disabilities.

Please urge your Members of Congress to support this important legislation!

1875 Eye Street, N.W. - Twelfth Floor - Washington, D.C. 20006 - Phone: (202) 349-4260 - Fax: (202) 785-1756