News in brief - April 17, 2006

CMS issues final Medicare rule on power wheelchairs - Transitional coverage expires for Medicare drugs - Bill would stop new citizenship documentation rule for Medicaid from going into effect - Okla. House and Senate pass reimportation bills

CMS issues final Medicare rule on power wheelchairs

Regulations on physicians prescribing power mobility devices to their Medicare patients were finalized early this month with the issuance of a federal rule.

Medicare will pay for power wheelchairs or scooters as long as a doctor conducts a face-to-face exam, determines the patient's need for a mobility device and provides supporting medical evidence to the equipment supplier. In the one major change from its interim final rule issued last August, the Centers for Medicare & Medicaid Services decided to give physicians 45 days, rather than 30 days, to provide this information.

CMS tightened the rules in an attempt to combat fraudulent prescribing of wheelchairs under Medicare. To account for the extra work required of doctors or their assistants to collect and submit the supporting documentation, Medicare will make an extra administrative payment.

Transitional coverage expires for Medicare drugs

March 31 marked the end of the period during which Medicare Part D enrollees could receive coverage for their medications regardless of whether the drugs were on the approved lists of their new plans.

The Centers for Medicare & Medicaid Services implemented the 90-day transitional coverage plan to ensure that beneficiaries who signed up at the beginning of this year would have time to switch to alternate medications if drugs were not covered under their Medicare drug plans. Beneficiaries who sign up now will receive 30 days worth of noncovered drugs before the plans stop paying for them.

In allowing the 90-day period to expire, the Bush administration rejected calls from Democratic lawmakers to extend the expiration date until beneficiaries and their doctors can figure out how to ensure access to necessary drugs.

"We're very concerned that many elderly and disabled citizens will not be able to obtain the drugs they desperately need if the transition policy ends," a group of 10 Senate Democrats wrote in a March 28 letter to the White House.

"Many will not even learn their drugs are no longer covered until they go to their pharmacy to fill a prescription and are turned away."

Bill would stop new citizenship documentation rule for Medicaid from going into effect

A campaign to overturn a fiscal year 2006 federal budget provision that will require Medicaid recipients to document their citizenship starting July 1 is attracting attention. Sen. Daniel Akaka (D, Hawaii) has offered a bill that would repeal the requirement.

The AMA has called on lawmakers to scrap or postpone the legislation to give patients more time to gain access to a birth certificate or passport, rather than just certifying their citizenship in writing as they do now.

The California Medical Assn. last month expressed its concern that many Medicaid recipients, notably disabled or incompetent nursing home patients, might be unable to track down documentation. The CMA cited estimates that as many as 4.6 million citizens might lose their coverage because of the new rule.

But with the push to clamp down on illegal immigration, Akaka's chances of success are unclear. Rep. Tom Coburn, MD (R, Okla.), committed last month to holding a hearing on the issue at a Homeland Security and Governmental Affairs subcommittee, which he chairs. He told AMNews that he did not intend to support the bill but there was nothing wrong with examining the issue. "I don't agree that if you are an illegal alien, you have a right to health care," he added.

Okla. House and Senate pass reimportation bills

The Oklahoma Legislature in March advanced two bills that would allow pharmacists and residents to import prescription drugs from Canada or European countries.

Under the House-approved bill, the Oklahoma State Board of Pharmacy would set up a Web site where residents could buy drugs from Canadian pharmacies; however, the measure is contingent upon approval by the U.S. Food and Drug Administration. Meanwhile, the Senate passed a bill that would permit state pharmacists to sell prescription drugs obtained from Canada or European countries in spite of FDA restrictions.

The Oklahoma Pharmacists Assn. has not taken a position on either measure. "We felt they would be impossible to implement because of certain features," said Executive Director Phil Woodward. Those include violating the federal ban on drug importation and putting pharmacists at risk for losing their liability insurance.