Power Wheelchair Expert Article
CHANGES IN POWER WHEELCHAIR BENEFIT: ELIMINATION OF 1ST MONTH’S PURCHASE OPTION
(50PlusPrime) LATHRUP VILLAGE, MICHIGAN --
Please Note: These changes do not affect the eligibility standards or documentation requirements. If you can not complete your activities of daily living in your home safely or in a reasonable amount of time, then you are still qualified under Medicare for a power wheelchair. You must have a medical necessity and you will still need a mobility evaluation by your doctor. Source One Medical will take care of all the necessary paperwork for you. At the end of the rental period, you will own the equipment and Medicare will continue to maintain the equipment for you during the “5 year reasonable useful lifetime” period.
Effective for items provided on or after January 1, 2011, standard power wheelchairs must be furnished on a monthly rental basis like other capped rental durable medical equipment (DME).
PLEASE NOTE: It is extremely important that all Source One personnel know and understand the rental program. We must ensure the patient along with any spouse or power of attorney understand that the power wheelchair is the property of Source One Medical during the 13 month rental period. Transfer of ownership only occurs at the end of the 13th month.
Below is a list of FAQs from Medicare:
Q1. When standard power wheelchairs (PWCs) are provided on a rental basis, can they be covered for short term indications?
Q2. How will the "look back" period affect the review of PWCs?
Q3. A PWC is being rented and the beneficiary goes into a hospital and nursing home for an extended stay. The supplier elects to pick up the wheelchair. When the beneficiary is ready to go back home, would there be a problem with providing a different model wheelchair within the same HCPCS code?
Q4. If a patient who is renting a PWC moves, is a new in-home assessment required?
Q5. If a patient with a PWC moves and their new home will no longer accommodate the PWC that they have, will Medicare pay for a new PWC?
Q6. If a patient who is renting a PWC goes into a hospital/nursing home for an extended time and the supplier picks up the wheelchair and the beneficiary is discharged to home, would a new capped rental period start and what documentation would be required?
Q7. If, during a capped rental period, a PWC is lost, stolen, or irreparably damaged and a new PWC is provided, does a new CR period start?
Q8. Is there any situation in which a supplier can be paid for repair to a PWC during a capped period – e.g., if the supplier has information to indicate that the repair is required due to "malicious damage" or "culpable neglect" by the beneficiary?
If the supplier believes that a wheelchair repair is required because of malicious damage or culpable neglect by the beneficiary, the supplier can present the information to the DME MAC for investigation. If the DME MAC, in consultation with the CMS, agrees that the beneficiary is responsible for the damage, the supplier can charge the beneficiary.
If you have questions how these changes may affect your benefits, please contact a Source One Medical representative.
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