Thank you William Jenkins for your letter to use as an example and add to. I know it should be doublespaced, I have to write in WordPad and when I copy it will not single space and it would take me hours to correct as it copies so weird, all the sentences broken up. This is my letter together with the letter they wrote from the web site. I think this web site will give you further information and a format of this documentation. I wrote a letter to individual congressmen and use this web site . Dana _http://capwiz.com/medgroup/mailapp/_ (http://capwiz.com/medgroup/mailapp/) click on issues and legislation and then go down to the bottom of the page and click on Medicare’s 11/15/06 Power Mobility Fee Schedule I wrote about this a couple months ago to the legislators, but am writing again. You can also call an 800 number, but I don't have that in bed, it's on my cell phone. I will include tomorrow Thank you for using The MED Group Mail System
Message sent to the following recipients: Secretary Leavitt Herb Kuhn Kimberly Brandt Laurence Wilson Lisa Zone Leslie Norwalk Representative Moore Senator Brownback Senator Roberts Message text follows: Dana Wray 7935 Fairway St Prairie village, KS 66208-3964 December 6, 2006 [recipient address was inserted here] Dear [recipient name was inserted here], I am writing to strongly communicate the need to delay the new Medicare Power Mobility Fee Schedule published by the Centers for Medicare and Medicaid Services (CMS) scheduled for an November 15, 2006 implementation. As published, these drastic price reductions will limit and deny access to medically appropriate power mobility products and services for Medicare beneficiaries, especially those beneficiaries with severe disabilities. This will not only hurt Medicare beneficiaries, but also children and other adults with complex disabilities that require this equipment to meet their daily medical and functional needs. For almost three years now CMS, physicians, clinicians, consumers, providers, and manufacturers have worked on improvements and safeguards to the Medicare power mobility benefit. However, given the drastic cuts in the reimbursement amounts it appears that all this time and effort may be undermined by a rush to implement changes before key issues are resolved and an appropriate implementation period is provided. Moving forward without making the required corrections and allowing an appropriate time period for implementation will create major access problems for Medicare beneficiaries and others. The new fee schedule drastically reduces reimbursement for complex rehab products used by severely disabled consumers by up to 33% or more. These products are used by beneficiaries with severe diagnoses such as ALS, muscular dystrophy, cerebral palsy, spinal cord injury and severe brain injury. These reductions will eliminate the availability of the appropriate power wheelchair and service required by Medicare beneficiaries and other individuals with complex disabilities. In developing the new fee schedule, CMS utilized a pricing methodology that has been universally recognized as flawed. In fact, CMS itself has admitted the methodology does not work and is in the process of putting a new methodology in place. As an example of the problems, the fee schedule provides that a Group 2 power wheelchair (less complex) will be reimbursed at a higher rate than a Group 3 power wheelchair (more complex). These changes are the most dramatic since the establishment of the power mobility benefit under Medicare: 64 new codes, new pricing, new coverage criteria, and new documentation requirements. How can these possibly be implemented effectively and smoothly with such a short period of time for physician and clinician education and the major operational and educational changes required within each Medicare provider's operation? Given the significant concerns being expressed by all stakeholders- physicians, clinicians, consumers, providers, and manufacturers- I respectfully but strongly request that the November 15, 2006 effective date for the published pricing and coverage policies be postponed until all identified issues are resolved. Once these issues are resolved, the revised information can then be published and a 120 day implementation period provided to allow for a smooth transition. To rush ahead without fixing the issues and problems that have been identified will undermine all the time and effort of the past three years and hurt the ability of Medicare beneficiaries and others with disabilities December 5, 2006 My personal thoughts I was recently made aware that Medicare will only provide powered wheelchairs which suit the person's needs inside his/her home. I am a C4-5 quadriplegic and use a powered wheelchair that would probably not be allowed with your new policies. Without my present chair, I would not be able to get into bed, wash my hair, get over my step on my door jam or get up my ramp in bad weather, or adjust my thermostat and reach things I need to get to. To say that this mandate appalls me is an understatement. Most powered wheelchairs that are only suited for indoor use are next to useless outside of the home. Since going outside at some times is a necessary activity, doing so in an underpowered chair only suited for indoor use would be dangerous, it might end up costing Medicare far more money due to accidents caused by unsafe use of such wheelchairs. Not to mention possible lawsuits that would eventually be filed. Then there are the thousands of jobs that could be lost because wheelchair manufacturers and distributors would be put out of business, resulting in lost tax revenue and higher unemployment expenses. Does Medicare really want disabled people to stay inside all of the time? Isn't that discrimination against people with disabilities and, therefore, in violation of the Americans with Disabilities Act (ADA)? Are we not allowed to venture outside for doctor appointments (something required to remain living in many cases), grocery shopping (another activity necessary to live), or just to enjoy going outside for a social activity (a vital activity for our mental health)? Are we to be condemned to a life inside our homes as if we were hermits? Back in the 1980, I was working so hard to be independent after being in a nursing home three years. I had to battle the state to remain independent on several occasions. I testified to get self-directed care in my state, so persons could live in their own homes without certified nurses aides. What good is independence, if you can not be members of the community, because your chair does not like you go outside as land is not perfectly flat with paved sidewalks and streets everywhere. We have to navigate over many different kinds of things to enjoy life cannot be stuck in our homes. How can the ADA, this landmarked legislation be such a violated act by the federal government. It is seems unconstitutional that a government agency that provides healthcare availability to the disabled would attempt to so blatantly violate an act of Congress. I'm requesting that this extreme restriction on the type of powered wheelchairs we can obtain through Medicare be changed. Being disabled and on Medicare should not mean we are relegated to being "out of sight, out of mind" as it seems this agency (Medicare) desires. I am only 53 years old and am not going to stay indoors the remainder of my life. This "wheelchair edict," as I call it, is far too limiting and needs to be changed. That change needs to be made as soon as humanly possible. This is of utmost importance as it affects both the physical and mental health of all persons needing powered wheelchairs. Please allow our doctors, Physical Therapists, Occupational Therapists and wheelchair seating specialists determine which wheelchairs best suit our needs as far as comfort, power, safety and health are concerned. Don't leave our ability to be mobile, safe and comfortable in the hands of a Medicare or Medicaid bureaucrat. People with disabilities struggle with many things. Don't make them struggle with independence in their communities. That is why my program is called Home and Community based services to allow us to be able to move freely in our communities. Respectively yours, Dana Wray
