Congress Voices Concern for Availability of Low Vision Devices through Medicare

July 5, 2007

For more information, contact
Mark Richert
Director, Public Policy
mrichert@afb.net

On July 2, 2007, the co chairs of the Congressional Vision Caucus, Gene Green (D-TX-29), David E. Price (D-NC-4), Ileana Ros-Lehtinen (R-FL-18), and Patrick J. Tiberi (R-OH-12), sent a letter to Leslie V. Norwalk, Acting Administrator of the Centers for Medicare and Medicaid Services (CMS), expressing their concern over CMS's proposed exclusion from coverage for all low vision devices. The letter's text is provided below.

AFB-DC readers will recall that, on May 1, 2006, CMS, the federal agency responsible for management of America's public health care system, published a notice of proposed rulemaking on the competitive acquisition of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). (71 FR 25654). This proposed rule contains a provision referred to as the "low vision aid exclusion" which purports to "clarify" that the Medicare statute's exclusion of coverage for traditional eyeglasses bars coverage for all devices that may use a lens. While CMS has made the larger competitive acquisition rule final, CMS has indefinitely postponed final disposition of the proposed devices exclusion provision, meaning that the matter is still very much in play. The scope of the proposed eyeglass coverage exclusion encompasses all low vision devices with one or more lenses regardless of the size, form, or technological features of such devices.

In response to this unreasonable proposal, CMS received an extensive array of comments from consumers and professionals from within the vision loss, eye care, and disability communities. The letter of the Congressional Vision Caucus puts the most interested members of Congress on the record in opposition to the low vision devices exclusion and is intended to continue to draw attention to the need for a more sensible approach to coverage.

We want to recognize the contributions to our work in this area of AFB Policy and Research interns, Rebecca Price, Stacy Haack, and Martin Monson, whose proficiency with the issues and professional persistence were indispensable to achievement of this result. Congratulations!

Text of the Letter

Congress of the United States
House of Representatives
Washington, DC

July 2, 2007

Leslie V. Norwalk, Esq.
Acting Administrator
Center for Medicare and Medicaid Services
Department of Health and Human Services
7500 Security Boulevard Mail Stop: C5-1124
Baltimore, MD 21244

Dear Ms. Norwalk:

Re: 71 FR 25654

As co chairs of the Congressional Vision Caucus, we are writing to express our concern regarding the exclusion of low vision devices in the Competitive Acquisition for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS). We strongly urge CMS to reconsider the proposed "low vision aid exclusion."

In the proposed regulation, any device with one or more lenses, regardless of its usefulness to the vision-impaired, would fall under the statutory "eyeglass" exclusion. This proposal would have a tremendous negative impact on vision-impaired seniors who rely on devices such as hand-held magnifiers, video monitors, and other technologies that utilize lenses to enhance vision. Without these devices, many vision-impaired seniors are unable to live independently.

We are also concerned with the precedent that would be set by this proposal of limiting the access to assistive technology for people with disabilities. Rather than establishing coverage denials for all lenses, we respectfully recommend that CMS evaluate the medical and functional purpose of each lens device and make coverage decisions based on these evaluations. If a lens device is determined to fall under a Medicare benefit category, then coverage should be established by CMS.

Consistent with all applicable rules and regulations, we respectfully request that CMS reconsider the "low vision aid exclusion." Thank you for your careful consideration of this matter.

Sincerely,

Gene Green
Member of Congress

David E. Price
Member of Congress

Ileana Ros-Lehtinen
Member of Congress

Patrick J. Tiberi
Member of Congress