CCD Letter to House Leadership on Health Care Reform

June 30, 2009

July 1, 2009


The Honorable Nancy Pelosi              The Honorable Steny Hoyer       

Speaker                                               Majority Leader                                       

U.S. House                                          U.S. House                    

Washington, DC 20515                      Washington, DC  20515     



RE: Healthcare Reform Legislation Must Protect First Month Purchase Option and  Include DMEPOS in the Basic Benefit Package

The Consortium for Citizens with Disabilities (CCD) writes to thank you for your work on healthcare reform legislation and to request your assistance in ensuring that individuals with disabilities are protected from inadvertent harm through two reform policies under consideration. The CCD is a coalition of national consumer, service provider, and professional organizations which advocate on behalf of persons with disabilities and chronic conditions and their families.

CCD believes that the goal of health care reform should be to assure that all Americans, including people with disabilities and chronic conditions, have access to high quality, comprehensive, affordable health care that meets their individual needs and enables them to be healthy, functional, live as independently as possible, and participate in the community. CCD appreciates and strongly supports your tireless efforts to bring about comprehensive healthcare reform.

However, we are concerned that the pressure to lower the cost of a reform bill could lead lawmakers to inadvertently modify two programs that may negatively impact individuals with disabilities:

1)      One such modification would eliminate the first month purchase option for power wheelchairs under Medicare. Medicare currently allows an individual to choose whether to purchase or rent mobility devices in the first month of use. Nearly all Medicare beneficiaries in need of power wheelchairs purchase their devices in the first month of delivery because they have long-term needs and often require a specific "fit" of each device to meet their medical and functional needs. The policy change under consideration would eliminate patient choice forcing beneficiaries to rent their mobility for thirteen months before they can own the devices. This proposal would essentially require wheelchair suppliers to purchase power wheelchairs from the manufacturers and finance these devices to beneficiaries over a thirteen-month period. We fear this policy change would cause suppliers to supply patients with wheelchairs based more on their diagnosis and prognosis than on their current mobility needs. Instead of suppliers tailoring the mobility devices to the needs of the beneficiary, suppliers may be incentivized to only finance more functional (and consequently more extensive) mobility devices to healthier patients with perceived longer-term need. All beneficiaries in need of power wheelchairs should have access to devices that help them remain functional and independent. CCD recommends Congress protect beneficiaries' first month purchase option in any healthcare legislation in order to ensure access to appropriate mobility devices for individuals with mobility impairments.

2)      The Tri Committee discussion draft does not require the essential benefits package to include coverage of assistive devices and related services that enable individuals with disabilities to facilitate their recovery and restore their ability to function and live as independently as possible. We appreciate that rehabilitative and habilitative services are included in that list, but the exclusion of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) as an essential category would result in people with significant injuries, chronic conditions and disabilities going without necessary assistive devices, such as prosthetic limbs and power wheelchairs. A lack of coverage for durable medical equipment, prosthetics, orthotics, and supplies and other assistive devices would have devastating consequences for individuals in need of this care. Congress should clarify in statute that DMEPOS must be covered in an essential benefits package. 


Thank you for your consideration of our position. If you have any questions, please contact Peter W. Thomas, CCD Health Task Force co-chair, at (202) 466-6550.




Cc:  Hon. Henry Waxman

        Hon. Charles Rangel

        Hon. George Miller

        Hon. Frank Pallone

        Hon. Pete Stark