Wheelchair Ruling Protested

Wheelchair Ruling Protested
- Salt Lake City Tribune
August 09, 2007

Wheelchairs designed for use outside the home will no longer be covered by Medicaid under a rule change that disabled-rights advocates say is misguided, and one occupational therapist likened to placing hundreds of Utahns on house arrest.

Utah health officials say the rule simply codifies existing practice. For more than a decade, Medicaid has paid only for manual and motorized wheelchairs deemed medically necessary and designed for use in the home, said Medicaid budget supervisor Don Hawley.

"Just because the design is for the home doesn't mean it won't be suitable for outside," said Hawley. "But we're not going to pay for someone to have nobby sports tires."

Advocates fear, however, the rule will be taken too literally by front-line claims workers and used to deny benefits.

"In the home" is a Medicare term that has been misinterpreted and expanded over the years, said Matt Knotts, director of the Disability Law Center. "A disability doesn't stop at the door."

Jerry Costley, with the Disability Rights Action Committee, finds the rule offensive, saying "the message it sends is very much one of segregation."

Matt Lowell, a physical therapist at Shriner's Hospital, said he has worked with patients who might be able to get around in the home with a walker, but need a wheelchair to go to work, grocery shopping or church.

"This is like placing disabled people on house arrest," said Lowell.

Lowell was among a dozen people to protest the "in the home" provision at a hearing Wednesday. The rule also seeks to stop Medicaid payment for prosthetic limbs with special shoes and post-chemotherapy wigs and hair replacements.

Fewer than 1,000 beneficiaries would be affected, said Hawley. By comparison, the temporary loss of dental and vision care in previous years touched tens of thousands of people.

Hawley said the goal isn't to save money, but to guard against overspending and fraud. About $13 million of Medicaid's $7 billion budget was spent on medical devices in 2006.

What is affected

* Wheelchairs specifically designed for use outside the home
* Prosthetic limbs with special shoes
* Post-chemotherapy wigs and hair replacement