For years, the HME and rehab technology industries have tried, with marginal success, to involve us—the consumers—in their fights with Washington. As Congress passed laws and CMS imposed new regulations and cut reimbursements, the industry tried to convince us that we would be the big losers. In truth, the threats to our well-being have largely not materialized, and we have been essentially absent from the battles.

But that is not the case now with the effort to remove the onerous "in the home" language from the CMS lexicon. It's simple: this time, it is our fight. This time, CMS has used an overzealous interpretation of the words and intent of antiquated legislative language to trample our civil rights.

This time, by saying that Medicare (and by extension, Medicaid and private payers) will only pay for mobility devices needed to perform "mobility-related activities of daily living such as eating, dressing, bathing and toileting within the home," CMS ignores the fact that ADLs include everything we do from the time we wake until we fall asleep.

This time, the national coverage decision for power mobility devices (PMDs) ignores the acts of Congress and the decisions of the federal courts that say unequivocally that we have the right to be full participants in the lives of our communities. The Americans with Disabilities Act (ADA) became law in 1990—more than 15 years after the "in the home" language first appeared in the Social Security Act.

The ADA, the world's first comprehensive civil rights law for people with disabilities, tore down barriers that had kept many people with disabilities out of sight for generations. The legislative language of the ADA called on government at every level to work to ensure an inclusive society without physical or attitudinal barriers to segregate the disability community. CMS' "in the home" provision is a step backward for the disability rights movement.

In 1999, Congress enacted the Ticket to Work & Work Incentives Improvement Act. This legislation addressed one of the biggest employment barriers for people with disabilities: lack of access to affordable health insurance. To remedy that, TTW/WIIA allowed people with disabilities to buy or continue Medicare coverage if they returned to or entered the work force.

Through the "in the home" rule, CMS fails to allow for technology needed to go to work or go to school, much less participate in "normal" community activities, like your child's Little League game or a trip to the coffee shop. That technology can be different than what is needed to perform the "mobility-related ADLs in the home."

The landmark US Supreme Court decision Olmstead v Georgia is clear: people with disabilities have the right to live in the community in the least restrictive environment possible. CMS creates an arbitrary, discriminatory restriction by denying coverage for mobility devices needed to function outside of the home. It's the equivalent of sentencing us to house arrest.

The "in the home" rule strikes at the core of hard-fought-for disability rights. It is up to us to take this matter personally and change the law.

Write your Representatives in Congress and request that they join their colleagues as cosponsors of HR 1809, The Medicare Independent Living Act of 2007, introduced by Congressmen Langevin (D-RI) and Ramstad (R-Minn). Express the kind of moral outrage and righteous indignation that only we, the people whose civil rights are violated by the "in the home" rule, can articulate.

Become part of the coordinated campaign to pressure Congress to pass this legislation, supported by the National MS Society, Paralyzed Veterans of America, the National Council on Independent Living, and many others. Get angry because if CMS is allowed to prevail, we will be denied the rehab and assistive technology we need to be equal participants, fully engaged in the communities we call home.

This is not a battle we can shy away from or leave to others—such as the rehab provider community—in hopes that their business interests will carry the day. This battle can be won only by advocates, imbued with passion and armed with facts.

We, the people with disabilities who rely on appropriate rehab technology to do the things that make life rich and full, must assume leadership positions in the campaign to see HR 1809 signed into law. We must mount the kind of concerted and focused grassroots campaign it took to bring the ADA to the president's desk. The rehab industry can play a role in helping us shape our arguments, but this time the responsibility for getting the job done is ours.

Cara C. Bachenheimer, JD, is VP of government relations for Invacare Corp. David T. Williams is a political and legislative strategy consultant.