Medicare’s In The Home Wheelchair Restriction Heads For The Door

A number of organizations have for some time been hot to change Medicare standards that keep people from getting the wheelchairs that they need. Insiders and advocates have come to call this restriction the In The Home (ITH) restriction.

(March 31, 2007 press release)

Today, the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition lauds the introduction of important bipartisan legislation by Congressmen Langevin (D-RI) and Ramstad (R-MN) to modify Medicare’s “in the home” restriction on mobility devices.

“This legislation will help ensure that individuals with disabilities have access to appropriate mobility devices and, in turn, improved access to their communities,” said Congressman Jim Langevin, Co-Chair of the Bipartisan Disabilities Caucus. “It is time we remove this outdated restriction and better align Medicare policies with the disability community’s goal of independent living.”

The Medicare Independent Living Act (H.R. 1809) would significantly improve community access for Medicare beneficiaries with mobility impairments by removing a discriminatory restriction that bases the coverage of mobility devices solely on an individual’s mobility needs inside their home.

“It is long overdue for Congress to repeal Medicare’s ‘in the home’ restriction on mobility devices and give people living with disabilities the dignity and freedom of independent living,” stated Congressman Ramstad, also a Co-Chair of the Bipartisan Disabilities Caucus.

The statutory “in the home” language was originally meant to define durable medical equipment (DME) as devices that were provided outside of a hospital or skilled nursing facility and, therefore, warranted separate reimbursement under Medicare Part B, rather than Part A. However, over time, Medicare has chosen to interpret this language in a way that restricts coverage of mobility devices to only those that are reasonable and necessary in the individual’s home.

“Perpetuation of the ‘in the home’ restriction contradicts numerous other government initiatives such as the Americans with Disabilities Act, the Olmstead Supreme Court decision, the Ticket-to-Work Program and the New Freedom Initiative – all aimed at improved community access for individuals with disabilities,” stated Lee Page with the Paralyzed Veterans of America and a member of the ITEM Coalition Steering Committee. “An individual’s need for mobility does not end at their front door, but rather extends to places such as work, school, and the community in general.”

“This legislation is vitally important to individuals with mobility impairments because it will help connect the goal of independent living with the tools necessary to achieve this goal.” stated Paul Precht of the Medicare Rights Center and member of the ITEM Coalition Steering Committee. “We look forward to working with the bill’s sponsors to ensure its passage at the earliest opportunity.”

The ITEM Coalition was formed in 2003, and its 74 member organizations include a diverse set of disability groups, aging organizations, consumer groups, labor organizations, voluntary health associations, and non-profit provider associations. The ITEM Coalition’s purpose is to raise awareness and build support for policies that improve coverage of assistive devices, technologies and related services for people with disabilities of all ages. For more information on the ITEM Coalition, please visit