Senators Send “In-the-Home” Letter to CMS

• By Laurie Watanabe
• Sep 15, 2023

Four Senators have sent a letter to the Centers for Medicare & Medicaid Services (CMS) to ask for a review of Medicare’s infamous “in-the-home” requirement for mobility equipment.

In the Sept. 7 letter, Senators Maggie Hassan (D-N.H.), Marsha Blackburn (R-Tenn.), Bob Casey (D-Pa.), and Tammy Duckworth (D-Ill.) addressed CMS Administrator Chiquita Brooks-LaSure and Department of Health & Human Services General Counsel Samuel Bagenstos.

“We are writing to urge Centers for Medicare and Medicaid Services to conduct a full review of its 2005 National Coverage Determination for Mobility Assistive Equipment (MAE) for Medicare beneficiaries, including its interpretation of the ‘in the home’ requirement,” the letter said. “Current Medicare coverage limitations on equipment used outside the home can limit patients’ access to mobility equipment and to their communities. While we commend CMS for the recent announcement to cover seat elevation technology in Medicare-covered power wheelchairs, more must be done to ensure beneficiaries can access MAE.”

The bipartisan group of Senators pointed out that interpreting Medicare’s mobility coverage responsibilities as only covering activities of daily living that occur within a beneficiary's home results in claims denials for wheelchairs and can slow the process of obtaining medically necessary equipment.

“These delays can result in health injuries and secondary health conditions, increasing costs for the program and taxpayers,” the Senators said in the letter.

Providing relevant mobility equipment in a timely manner “can enable beneficiaries with disabilities to fully participate in community life,” the Senators added.

Read the entire letter here.