Source: AAHomecare Alert 6/18/2024
Last week, the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) announced two significant changes to address long-standing requests from mobility stakeholders. These changes will benefit both suppliers and beneficiaries by making home assessments and replacements for wheelchairs more efficient processes.
More Flexibility for Manual Wheelchair Home Assessments
Prior to this change, Medicare required an in-person home assessment for manual wheelchairs. The industry was able to work with the DME MACs and CMS during the PHE to allow only indirect assessments. Recent publications were unclear on whether an indirect was allowed followed by an in-person. This update allows for indirect assessments such as a phone call, easing the burden on suppliers and improving access for beneficiaries in remote areas. The indirect assessment documentation must clearly detail the beneficiary's home layout, surfaces, and any obstacles that might impact wheelchair use.
See more details on the new assessment guidance here. The change goes into effect on July 1.
Streamlined Replacement for Wheelchairs When the Manufacturer Goes Out of Business
Under the current policy, if a wheelchair manufacturer ceased operations and replacement parts became unavailable, beneficiaries faced challenges obtaining a replacement chair. This update allows Medicare to treat such wheelchairs as "lost" if no aftermarket parts exist. This means beneficiaries can follow existing procedures for obtaining replacement equipment, similar to situations where a wheelchair is lost, stolen, or damaged beyond repair.
This change offers a clear solution for beneficiaries who rely on wheelchairs from manufacturers that are no longer in business.
Find additional information on the replacement guidance here. The change goes into effect on July 8.
AAHomecare thanks the DME MACs for these changes that will improve assessment and replacement processes for both suppliers and beneficiaries.
** OAMES would also like to thank all who were involved in making these improvements to the Medicare benefit.