The sticking point, I think, is whether a Palm Pistol can meet Medicare’s vague and nebulous standards of “medical necessity” to qualify for reimbursement. My writing a prescription and stating that the patient requires something as a matter of necessity typically isn’t enough.

They have their own rules which are Byzantine, on a good day. I had a dying patient who required Marinol (a prescription form of THC) to suppress her nausea and improve her appetite. Medicare flatly rejected paying for my prescription, despite the widespread use of Marinol in hospice patients with similar problems. She died without receiving it.

(I was offered a choice of rewriting my prescription for another medication that was wholly inappropriate, but cheaper. I refused.)

Just a foretaste of what’s to come…

The Palm Pistol is already declared a standard handgun under ATF rules. My understanding of the rule is, that if it’s declared a “medical device” by FDA rules, if a doctor is willing to prescribe it, then medicare will have to pay for it.

But regardless of that. ATF has already declared it a pistol, so you can get it through normal means as a firearm. The question now is whether a doctor can prescribe it, and medicare pay for it.

As a physician, I’m looking forward to prescribing these.

(Unfortunately, I doubt Medicare will pick up the tab. I have a hard enough time getting them to cover wheelchairs.)

Interesting question: If the FDA ruling forces the BATF to grant the Palm Pistol an exemption from AOW status under an implementation of the ADA (enough abbreviations yet?), would the exemption be granted on a case-by-case basis of “medical need” — or for the device regardless of who owns it?

If the device is exempted from AOW status, what sort of doors will be opened for the reclassification of other palm pistols or “knuckle dusters” with unusual trigger mechanisms and shapes?

If not, what happens to the exempt status if the owner dies? Does it become an AOW? Does the owner’s surviving spouse or estate then become liable for the transfer tax and paperwork?

Heh.