April Medicare Power Seat Elevation Policies Now in Effect

[F3Head]

https://mobilitymgmt.com/briefly-medtra ... ign=111524

Medicare Power Seat Elevation Policies Now in Effect
Medicare’s new power seat elevation coverage policies — including the implementation of a single Complex Rehab Technology HCPCS code (E2298) — began April 1.

According to a March 20 bulletin from NCART, the fee schedule amount of $2000.34 is now in effect, though the Centers for Medicare & Medicaid Services (CMS) “delayed a decision on replacing standard power seat elevation codes K0830 and K0831. The DME MACs will calculate local fee schedule amounts to pay claims for covered items during this interim period until a final decision is made.”

F3HEAD

[Burgerman]

So in about 9 months time we will hear the batteries are not lasting, and inadequate range etc - and this is bcause of the: "they are now made in china" nonsense which will start up all over again!

[martin007]

What are the changes for the user?

[Burgerman]

They will all get a seat lift.

[martin007]

Will the insurance pay for all the lift powerchairs?

[Burgerman]

No insurance doesent pay for anything. The public pay the insurance. And they pay for a huge profit caused by a lack of free market as well as the highly over regulated crony paid for corrupt system. Insurance has no money, only your money!

But yes, everythone can now get a lift I think. But you can here too. At least nobody ever refused me one from the equally wasteful NHS system. Because I need one.

The difference is that I understand the downsides. And sidestep them as I have 5 chairs. Only 2 have lift.

[martin007]

I understand.
Insurance will get more expensive...

[ex-Gooserider]

It's a Medicare thing, which is taxpayer funded mostly so no direct impact on insurance rates. It may increase a copay IF you get a lift... There are some things that you need to be eligible, but they are pretty simple if you can get approved for a power chair in the first place (they mostly only give manual chairs to paras) and have enough upper body function for a lift to be helpful...

We are now pushing for them to make a similar decision on standing chairs.

ex-Gooserider

[Burgerman]

But a stander doesent make a good daily chair. So its a thing you need in adition really.

[martin007]

It's a Medicare thing, which is taxpayer funded mostly so no direct impact on insurance rates. It may increase a copay IF you get a lift... There are some things that you need to be eligible, but they are pretty simple if you can get approved for a power chair in the first place (they mostly only give manual chairs to paras) and have enough upper body function for a lift to be helpful...

We are now pushing for them to make a similar decision on standing chairs.

ex-Gooserider

Even if the insurance is public, its costs have to be paid somehow.
A gentle and silent way is through the inflation produced by the increase of the money supply.
A less painful way to empty people's pockets.

[jefferso]

But a stander doesent make a good daily chair. So its a thing you need in adition really.

My Permobil F5 VS stander works for me as a daily chair. And it's the only practical way I can get the stretch and weight bearing of standing. I used to have a manual chair and a manual standing frame. Every time I used it, it took two transfers with assistance I didn't always have. Every extra transfer was a risk and extra time. With the standing chair, I can do it several times a day and it really helps with pressure relief. I still have low bone density in hips but it might have been worse without the daily weight bearing. I know the chair could be simpler, lighter, better in many ways without all the standing stuff, but then I probably would not end up doing the standing nearly as much. It's a flying car with all the disadvantages, but without it I probably wouldn't go flying.

In the US I got Medicare to pay for my Permobil C500S stander in 2010 by appealing up to administrative judge with evidence and support from doctors and PTs. Unfortunately such appeals aren't precedent setting, so each one is a roll of the dice.

[Burgerman]

Yes its like a seat lft. Its useful for some all day because for THEM its a compromise wrth making.

But the problem here is that a chair with no seat lift or other electric options can often have both bigger batteries, and is much better to drive because it weighs 100kg instead of 190kg... That extra 90kg, is a massive different. Frequently that seating option means GRP34 (smaller battries) too. This means that the chair usually has a not very rigid seating system compared to the non lift version, and half the mass. And so apart from being much worse to drive, and having maybe half to 2/3rds tha actual range it eats its batteries in maybe 7 months insted of 2 years. Because a deeper average daily discharge level - even if you never go more than a couple of mles - means that the battery dies in half the time.

But now because they *can* get these seating options like lift (by far the heaviest option that makes for a non rigid seat mounting) then its "free" so they will! Without any understanding of the consequences or downsides. And thats why I have 3 chairs without a lift. And only 2 with it. When I want to dive into town, fast or drive my van the higher seating, heavier weigh, worse range and worse drivability on a more flexi base mean I use one of the 3 chairs without lift. Same if I am going to the pub. I cannot drive a chair with lift like I stole it as its like a creaky jelly and too heavy! A different experience. If I am staying at home I use a lift chair. As it helps doing some things. So you need BOTH options!

But I do understand the downsides. The vast majority will be here complaing that the batteries dont last of hae no range etc. Because they thought a lift was free and so had one! When they didnt really need it. Sometimes its what you dont add that improves things!

Of course this is a great thing for those that really need it. But I am surprised that this wasnt always the case.