‘We’re looking closely at Group 2’

WASHINGTON – There was one surprise in CMS’s proposed national coverage decision for power seat elevation systems: a request for specific comments on whether having the systems on Group 2 power wheelchairs serves a medical purpose. 

When the ITEM Coalition made its request to reconsider the NCD to expand coverage for seat elevation, it specified Group 3 wheelchairs. 

“The reasoning was, we needed to get a foothold in the DME benefit and we didn’t feel like doing them both at the same time was prudent,” said Peter W. Thomas, managing partner at Powers Law Firm in Washington, D.C., and co-coordinator of the ITEM Coalition. “Now that CMS has said that seat elevation is primarily medical in nature and part of the DME benefit, we’re looking closely at Group 2.” 

CMS will accept comments on the proposed NCD, including the request for specific comments on Group 2, until March 17 and then will publish a final NCD.  

The evidence base for seat elevation on Group 3 wheelchairs is largely the same for Group 2 wheelchairs, but there are “nuances,” between the two, Thomas says. 

“Our knee-jerk reaction is yes – the more access we can provide, the better,” he said. “But there are different factors involved, including different populations of users and differences in the chairs themselves. We just want to make sure we’re recommending something that’s safe. Does the Group 2 wheelchair population have issues with transfers and reach and line of sight? Absolutely, they do.” 

Joe Nahra, director of government relations at Powers Law Firm and co-coordinator of the ITEM Coalition, agreed, saying, “We’re broadly supportive (of expanding coverage to Group 2 wheelchairs). I think we’ve made a good argument for why seat elevation results in strong benefits. We just need to determine what kind of data can we use to support it (for Group 2).” 

It’s work that stakeholders are happy to do. 

“It’s a positive statement from CMS that they’re looking at it,” said Wayne Grau, executive director of NCART.”