Duckworth, Blackburn, Casey Urge CMS to Cover Standing Elevation Systems in Power Wheelchairs to Help Improve Health and Mobility for Medicare Beneficiaries
Last year, CMS heeded the Senators’ bipartisan request and covered seated elevation systems—but not standing systems—for Medicare beneficiaries for the first time ever
[WASHINGTON, D.C.] — U.S. Senators Tammy Duckworth (D-IL), Marsha Blackburn (R-TN) and Bob Casey (D-PA) today called on U.S. Centers for Medicare and Medicaid Services (CMS) to help Americans with disabilities more easily get around and have better access to the equipment they need to live fuller, healthier and more independent lives. In their request, the Senators call for CMS to cover standing systems embedded in power wheelchairs under Medicare. The bipartisan letter to CMS Administrator Chiquita Brooks-LaSure comes after CMS announced a proposal last year that heeded the Senators’ request to provide Medicare coverage for seated elevation systems embedded in power wheelchairs for the first time ever.
“We write to express our gratitude for the recent decision by the Centers for Medicare and Medicaid Services (CMS) to cover seat elevation systems in Group 3 power wheelchairs under Medicare,” the Senators wrote. “However, we remain concerned that CMS has not yet initiated a National Coverage Analysis (NCA) for standing systems in these wheelchairs.”
Currently, Medicare beneficiaries with disabilities are forced to pay out of pocket for standing systems in power wheelchairs—a life-changing durable medical equipment that empowers users to independently conduct mobility-related activities of daily living (MRADLs), or outright denied access because they can’t afford such equipment out-of-pocket.
The Senators continued: “These [standing] systems enable users to achieve a standing position, which can greatly enhance their independence, improve metabolic functions, reduce the risk of secondary complications, such as pressure sores and osteoporosis, and improve their overall physical and mental well-being. The absence of Medicare coverage for these systems leaves many beneficiaries without access to critical technology that can significantly improve their health outcomes and quality of life.”
A full copy of the letter is available below and on Senator Duckworth’s website:
Dear Administrator Brooks-LaSure:
We write to express our gratitude for the recent decision by the Centers for Medicare and Medicaid Services (CMS) to cover seat elevation systems in Group 3 power wheelchairs under Medicare. This is a significant step forward in improving the quality of life for Medicare beneficiaries who rely on these complex rehabilitative technology wheelchairs.
However, we remain concerned that CMS has not yet initiated a National Coverage Analysis (NCA) for standing systems in these wheelchairs. As you know, standing systems in Group 3 power wheelchairs offer essential benefits to individuals with severe disabilities. These systems enable users to achieve a standing position, which can greatly enhance their independence, improve metabolic functions, reduce the risk of secondary complications, such as pressure sores and osteoporosis, and improve their overall physical and mental well-being. The absence of Medicare coverage for these systems leaves many beneficiaries without access to critical technology that can significantly improve their health outcomes and quality of life.
Our previous letter, dated October 14, 2021, highlighted the necessity for CMS to consider coverage for both seat elevation and standing systems. While we commend the agency for addressing the seat elevation component, the omission of standing systems from this coverage determination falls short of fulfilling the comprehensive needs of certain patients. Given the substantial evidence supporting the medical necessity and benefits of standing systems, we urge CMS to promptly open an NCA to evaluate the inclusion of these systems under Medicare coverage. This action is crucial to ensure that Medicare beneficiaries who require these advanced wheelchair features are not left behind.
We appreciate CMS's commitment to enhancing the lives of individuals with disabilities through thoughtful policy decisions. Opening an NCA for standing systems in Group 3 power wheelchairs aligns with this commitment to provide equitable access to vital rehabilitative technology, as well as to support advancing the development of rehabilitative technology for Medicare beneficiaries. Thank you for your attention to this important matter. We look forward to your favorable consideration and swift action to improve Medicare beneficiaries’ health and independence.
Sincerely,
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