On August 16, the Centers for Medicare and Medicaid Services (CMS) opened a National Coverage Analysis for Seat Elevation Systems as an Accessory to Group 3 Complex Rehabilitation Technology (CRT) Power Wheelchairs. Currently, Medicare does not offer any coverage for these systems to beneficiaries with mobility disabilities as they are deemed “not primarily medical in nature.” This omission is despite significant clinical evidence supporting the medical and functional benefits these systems provide, including for persons with limb loss and limb difference. Wheelchair users who spend all or nearly all of their time in a power wheelchair derive significant benefits from these systems, including safer transfers, more independent performance of mobility-related activities of daily living (MRADLs), and reduced risk of avoidable complications like pressure sores and injurious falls. CMS seeks written comments from the general public on whether to advance coverage for seat elevation systems through Wednesday, September 14, 2022.
At this time, CMS declined to open a review of coverage for power standing systems, which were included in the initial request submitted by the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition, a group of nearly 100 national non-profit organizations dedicated to increasing access to assistive devices and technologies for people with all types of disabilities. (The Amputee Coalition is a Steering Committee member of the ITEM Coalition.) CMS stated that power standing systems will be considered at an unspecified future date.
Public support from wheelchair users, physicians, other health care providers, caregivers, and organizations is critical to secure affirmative coverage for these medically necessary systems. The Amputee Coalition has supported this request for coverage in the past, and it is time for the limb loss community to weigh in! The ITEM Coalition has developed a “one-stop shop” website to guide individuals through the comment submission process and offer suggested talking points, background materials, and more. Persons with limb loss and limb difference, whether or not you currently use a wheelchair, are strongly encouraged to submit comments and tell CMS how amputees use these systems to advance their health, function, and independence. Also, please share this comment opportunity with any and all individuals with limb loss who may want to share their views as well. To make your voice heard, please visit www.rise4access.org.