Cure SMA Applauds Federal Agency Decision that Should Lead to Better Insurance Coverage for Seat Elevation Systems in Power Wheelchairs

Thanks to the advocacy of individuals with spinal muscular atrophy (SMA) and others, the Centers for Medicare and Medicaid Services (CMS) now considers seat elevation systems in power wheelchairs as being “reasonable and necessary” for purposes of Medicare coverage.

The federal agency updated its national policy to allow Medicare coverage for seat elevation systems in power wheelchairs if the individuals required a seat elevator to assist with seat transfers or to improve reach related to mobility related activities of daily living (MRADLs) in their homes.  Previously, CMS did not consider seat elevators as being medically necessary.

“The updated seat elevator decision is a huge victory for people with SMA and other individuals who utilize a power wheelchair,” said Maynard Friesz, Vice President of Advocacy at Cure SMA. “The expanded determination should make it more likely that seat elevation systems in power wheelchairs will be covered through Medicare and possibly other insurance plans.”

CMS reversed its restrictive Medicare seat elevator coverage decision after considering public comments from Cure SMA and other national disability organizations. In 2022, CMS agreed to consider new evidence and disability community feedback related to its previous coverage decision. During a public comment opportunity, Cure SMA shared the experiences and views of adults with SMA and families of children with SMA who highlighted how seat elevators helped to improve mental and physical health, increase quality of life, and promote independence. “Without the ability to reach an elevator button, I literally would not be independent enough to keep my current job,” said an adult with SMA featured in Cure SMA’s public statement.

The CMS decision, which governs coverage within Medicare, could also lead to improved insurance coverage for seat elevation systems for individuals covered through insurance plans. Many insurance plans consider the CMS determination when making their own coverage decisions.

Thank you to all individuals with SMA and their families who shared their feedback and experiences with Cure SMA during this process. The SMA community’s feedback and advocacy were key in securing this advocacy victory. To learn about other issues important to individuals with SMA and their families, visit Cure SMA’s Advocacy Action Center.

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