On December 9, 2003, the Center of Medical Services (Medicare), enacted a new plan to address fraud from power mobility reimbursement by enhancing its policies. While certainly everyone supports steps to combat fraud in any industry, including mobility products, one of the enacted Medicare changes potentially harms powerchair users directly, possibly denying us with disabilities the vital mobility products that we need.
Under the new guidelines, which are retroactive to affect existing consumer as well as those of tomorrow, Medicare enacted, "...If the patient is able to walk either without any assistance or with the assistance of an ambulatory aid, such as a walker, the power wheelchair is denied as not medically necessary."
The immediate concern is that the language is so unspecific to the definition of walking with "assistance" that it may inappropriately exclude many of us with severe disabilities from the mobility we cannot live without. Even in my own case, having among the severest cases of cerebral palsy, the language could be misconstrued to deny me mobility because, I, according to an interpretation of the law could theoretically walk a single step in my living room if "assisted." No doctor, therapist, or eyewitness would every tell you that I am not the most fitting person for a powerchairs due to my condition, but a distant Medicare case worker now has the language to deny powerchair mobility in situations like mine. In fact, every powerchair user I know, from James Doty of WheelchairJunkie.com to Christopher Reeves, who's walked with assistance, could be denied a powerchair based on the policy. The decision of whether you qualify for a powerchair is now entirely in the blanket language of Medicare policy, rather than dictated by your condition and a doctor's prescription. The nature of the language makes it quite possible that true need no longer has bearing on qualifying for mobility.
Of additional concern is that, according to the newly enacted guidelines, if you've had a powerchair funded by Medicare during the past 8 years, you're subject to a reexamination of your original case, literally running the risk of having your powerchair physically removed from you. (Yes, you read that correctly - removal of your existing mobility.)
The question, then, is, how could this happen to us, how could our mobility and lives be placed in such peril without anyone knowing?
The answer is, the Medicare changes were enacted without anyone's knowledge - no public hearings were held, no notice was given, no one within the disabled community was taken into account. Public debate would have given us the chance to speak up for ourselves and our community, but we were denied a voice. If the ADA brought some semblance of equality, the new Medicare guidelines that potentially remove our mobility may prove catastrophic to the disabled community, dramatically reducing our access to education and employment - someone in many of our situations cannot participate in society without powered mobility. My concern is that this specific passage doesn't prevent fraud among providers, but mistakenly detracts from the lives of those with disabilities, those truly in need.
At this moment, the lives of millions with disabilities, including yours and mine, personally, hinge upon the misdirected blanket language of the new Medicare guidelines. While we all believe in law enforcement and anti-fraud efforts, the language within the guidelines lends itself toward misinterpretation, possibly harming those of us who need mobility the most. For the sake of your mobility and mine, we must immediately voice our alarm over this potentially devastating action, appealing to the government to open a dialogue regarding this issue, ensuring that all citizens with disabilities can access independence and freedom through mobility.