Next stage of comments for Medicare seat elevation coverage

[lgelb]

As previously discussed, there has been an effort to get seat elevation coverage for PALS and other patients using Group 3 power wheelchairs.

CMS has now opened a 30-day comment period on a preliminary decision to fund this feature. These comments will help inform how the coverage is actually implemented, so everyone is again encouraged to chime in. The memo and link to submit comments is here.

 

[Doing My Best]

Thank you for the link. I notice the proposal will only provide coverage for wheelchair users that can perform transfers themselves, using arm strength to push up from the chair and pivot. Is it worth making a case for a broader application, to include those whose lack of upper body strength means they require help with transfers? Or is that battle already lost and we should just comment to approve the proposal as written?

 

[lgelb]

There is no harm in asking for more flexibility, but usually the decision summary memo is the ceiling of what comes to pass. But do not take it literally.

The takeaway continues to be: order your PWC early in the disease. How the order is written to maximize coverage is an art that good PTs/OTs/DMEs have mastered.

 

[Tomswife]

Our Aetna medicare advantage rejected not only the seat elevation function, but also the attendant control. ATTENDANT CONTROL!!!

 

[Clearwater AL]

Another frustrating story of a Medicare advantage plan... where they completely
take over Medicare itself. I have two relatives that had to fight to get out of their
plans. They are just with Medicare alone finding paying the co-pay is safer.
They found so many things were not true as stated.... even the dental thing.
Most of all being told their doctor dropped from the plan.... no, they were
forced out of the plan in some wording for referrals.

I hope things eventually work out for you.

 

[richdees23]

Team Gleason was very helpful. They provided funding for my PWC elevation feature. I filled out an application and they coordinated with my PWC provider [Numotion]. The whole process was efficient and relatively quick. They are also an excellent resource for voice banking.