New House Bill to Fix CRT Manual Wheelchair Accessories

August 3, 2017

CRT Stakeholders and Friends,

Representatives Lee Zeldin (R-NY) and John Larson (D-CT) will be introducing legislation in September to stop CMS’ application of Medicare Competitive Bid pricing to accessories used with CRT manual wheelchairs. This will replace the previously introduced broader bill, H.R. 1361, written to prohibit CMS from using Competitive Bid pricing for accessories used with either CRT power or CRT manual wheelchairs.

The CRT “power” wheelchair accessories issue was resolved in late June when CMS announced a policy clarification stating it would not use Competitive Bid pricing for accessories used with Group 3 CRT power wheelchairs. We again thank CMS and Congress for that needed action.

Unfortunately, the clarification did not extend to accessories used with CRT “manual” wheelchairs so this follow up legislation is required. Passage of this new bill is needed to fix the current disparity that prevents people who use a CRT manual wheelchair from having the same access to CRT accessories as those using a CRT power wheelchair. The new legislative language can be viewed here.

During the August recess Representatives Zeldin and Larson are seeking additional House members to join in the September introduction. You can see the list of members who have already agreed to be an original cosponsor here. If your Representative is not on the list, please reach out and ask him/her to sign on by contacting either office. Use the Issue Paper available here to make your request.

Thanks for your continued engagement and we’ll keep you updated on the progress.

Regards,

Don

Donald E. Clayback
Executive Director | NCART
Office 716-839-9728 | Cell 716-913-4754
dclayback@ncart.us | www.ncart.us

P.S. If you’d like to stay updated on CRT news, join our mailing list here!

CRT Power Wheelchair Accessories Cuts Averted

June 23, 2017

CRT Stakeholders and Friends,

Late today the Centers for Medicare and Medicaid Services (CMS) announced it will NOT be applying Medicare Competitive Bid Program information to reduce payment rates for Complex Rehab Technology (CRT) Group 3 power wheelchair accessories. This averts significant cuts that were scheduled to go into effect July 1 and avoids drastic reductions in access to this specialized equipment.

This is great news people with disabilities who rely on CRT Group 3 power wheelchairs. Unfortunately, there was no change in payment rates for accessories used with CRT manual wheelchairs. But we will build on this victory and pursue relief from cuts to CRT manual accessories as we continue to work with Congress and CMS to protect CRT access.

A copy of the CMS announcement can be found here. CMS instructs providers to continue using the KU modifier for billing accessories furnished with CRT Group 3 power wheelchairs. There are no additional actions required for claims with dates of service on or after July 1.

Our thanks to HHS Secretary Tom Price and CMS Administrator Seema Verma for making this needed policy correction. We particularly thank CRT Champions Senators Bob Casey (D-PA) and Rob Portman (R-OH) and Representatives Lee Zeldin (R-NY) and John Larson (D-CT) for their leadership and commitment to protect people with disabilities. Additional thanks to the leadership and staff of the Senate Finance, House Energy & Commerce, and House Ways & Means Committees who worked very hard to resolve this issue. Please take time next week to email your Members of Congress and thank them for their support.

This policy correction would never have happened without the dedication and collective advocacy work of the whole CRT community! Sincere thanks to all the consumers, disability organizations, clinicians, providers, manufacturers, and others who worked extremely hard to produce this outcome. It’s through CRT stakeholders coming together in even greater numbers that this was accomplished.

With your continued support and engagement, we will build on this win and work even harder to protect access to CRT on the federal, state, and private insurance levels.

Regards,

Don

Donald E. Clayback
Executive Director | NCART
Office 716-839-9728 | Cell 716-913-4754
dclayback@ncart.us | www.ncart.us

Top Ways That You Can Stay On Top Of Your Congress Member

Staying in touch with your congressional representative is crucial if you want your voice heard and your views to be known.  Finding ways to get a hold of your representative can be tricky because of their busy schedules and all of the other people who want to discuss matters with them.  At NCART, we wanted to share some simple ways that you can take part in the debate with your member of Congress and make a change!

Resistbot

By using this technology, your texts are turned into faxes to your representative by the service.  Overtime, you’ll unlock more uses of Resistbot to become a more influential advocate.

Email

Email is the fastest, most popular way to get in touch, but so many people use this platform that it is important to make your views stand out by being innovative, factual, and to the point.  You can also look online for forms that your member of Congress may provide for you to send a message to them.

Countable

This service seeks to give you a greater voice in politics.  Countable gives you a simple and short overview of the bills your representatives are debating.  Then it lets you send emails to them describing how you feel about the issue and how they should vote.

ThinkUp

This tool is used as a way to gauge popular sentiment through social media.  ThinkUp shows social media analytics so government officials can learn more about their followers.  By liking your representative’s social media posts over certain topics, they will be able to go in and see what is most popular so your voice is heard.

Advocacy Groups

Apart from spending money to lobby, many advocacy groups have created networks in order to have connections with members of Congress.  Advocacy groups do research over main pieces of legislation and know who is on which committees.  By knowing this, they will be able to organize meetings, phone trees, and small campaigns, so if you stay involved with a group, you will have more immediate access to your Congress person.

By using these diverse tools and strategies, you will be able to successfully get your views across when contacting your Congress person.  At NCART, we believe these different tactics can help you can make the difference you’ve been wanting!

 

Learn Latest on Healthcare Policy Changes

March 30, 2017

Healthcare policy and coverage changes are the talk of the country. If you are a CRT stakeholder you need to be informed on what is being discussed and what lies ahead.

Thankfully this important topic will be covered at the National CRT Leadership and Advocacy Conference being held April 26 and 27 at the Hyatt Regency Crystal City in Arlington, Virginia. Three Washington DC experts will provide education and discussion on April 26 from 10:00 AM to 11:30 AM.

“Healthcare Policy- What’s in the Air?”- This panel presentation will provide an overview of the issues, options, and politics in Washington regarding healthcare policy. Attendees will hear directly from DC veterans active in this arena about the dynamics in play as the President and Congress look to improve healthcare on a national and state level. On the panel will be Eric Gascho, Vice President of Government Affairs at the National Health Council along with Amy Cunniffe, Principal, and Sarah Egge, Senior Manager, with the Washington Council at Ernst & Young. This will be a great primer in advance of our Congressional visits.

One more reason to join us in Washington as we take the CRT message to Congress! Get signed up for the conference today at http://www.ncart.us/crtconf. And be sure to book your hotel room, they’re going fast!

Regards,

Don Clayback, NCART
dclayback@ncart.us

Weesie Walker, NRRTS
wwalker@nrrts.org

Medicare Call Re Prior Authorization for Certain Group 3 Wheelchairs

March 15, 2017

CMS is holding a Special Open Door Forum call tomorrow, March 16, from 2:00 PM to 3:30 PM ET regarding the new Medicare Prior Authorization (PA) requirement for two CRT Group 3 Power Wheelchair codes.

This PA requirement goes into effect in the states of Illinois, Missouri, New York, and West Virginia for dates of service of March 20 or after.  The PA requirement will expand nationwide in July.

The two codes impacted are K0856 (Group 3 Standard Power Wheelchair with Single Power Option) and K0861 (Group 3 Standard Power Wheelchair with Multi Power Option).

You can find the full announcement with additional call details here.  The dial in number is 1-800-837-1935 and the Conference ID # is 85144406.

The call will be recorded by CMS for later playback.  Details will be posted at the CMS Open Door Forum website.

April CRT Leadership and Advocacy Conference

February 3, 2017

CRT Stakeholders and Friends,

It’s time to sign up for this year’s National CRT Leadership and Advocacy Conference put on by NCART and NRRTS! We’re meeting on April 26 and 27, 2017 at the Hyatt Regency Crystal City in Arlington, Virginia. You’re invited to join other CRT stakeholders for a great program of education, advocacy, and networking.

A major part of the conference is visiting Members of Congress to push for passage of our “CRT Wheelchair Accessories” and our “CRT Separate Benefit Category” legislation. We built good momentum last year thanks to everyone’s efforts. But this year’s visits are critical to getting passage of permanent fixes and improvements.

We need as many CRT advocates as we can get taking the CRT message directly to Congress. To enable greater attendance, and recognizing the demands on people’s time and dollars, we have condensed this year’s conference program to two days and reduced the conference fee to only $199.

Attendees will benefit from industry-driven topics, unique networking opportunities, regulatory and legislative updates, and Capitol Hill appointments with their Members of Congress. You can download the conference flyer here.

The conference snapshot looks like this:

Leadership Day – Wednesday, April 26 – CRT focused presentations covering health care reform, federal and state regulatory/legislative issues, and getting prepped for Congress. The schedule: 10:00 AM to 11:30 AM “Health Care Reform”; 11:30 AM to 1:00 PM- Lunch On Your Own; 1:00 PM to 3:00 PM “Industry Update”; 3:00 PM to 3:30 PM- Networking Break; 3:30 PM to 5:00 PM “Congressional Prep and State Delegation Meetings”; and 6:00 PM to 8:00 PM- “CRT United Reception”.

Capitol Hill Day – Thursday, April 27 – Our historic annual lobbying event. Providers, manufacturers, consumers, and clinicians will take the CRT message directly to Congress through in-person meetings on Capitol Hill. The schedule: 9:00 AM to 4:30 PM Capitol Hill Visits; and 6:00 PM to 7:30 PM “Debriefing Reception”.

Now’s the time to get signed up so you get a spot and hotel room. Don’t wait too long and risk being shut out. You can get more details and register at www.ncart.us or www.nrrts.org.

This promises to be a great conference and we look forward to seeing many of you there!

Regards,

Don Clayback, NCART
dclayback@ncart.us

Weesie Walker, NRRTS
wwalker@nrrts.org

CRT Separate Benefit Category Legislation Reintroduced

January 31, 2017

CRT Stakeholders,

Great news from Congress for people with disabilities who rely on Complex Rehab Technology!

CRT Champions Representatives Jim Sensenbrenner (R-WI) and Joe Crowley (D-NY) have joined together to reintroduce the “Ensuring Access to Quality Complex Rehabilitation Technology Act of 2017” in the House of Representatives. The new bill number is H.R. 750.

In his announcement (see here), Representative Sensenbrenner stated “As a leader in the fight for the rights of the disabled, I want to ensure all Americans have access to the tools needed to live each day to the fullest. Disabled Americans should not be denied rehabilitation or medical equipment that can enable them to live and work freely and independently.”

Representative Crowley said in his announcement (see here), “This legislation would guarantee that patients have access to the high-quality products and services they need to lead a more independent life. For those with disabilities and other medical conditions, these complex rehabilitation technology products are necessities.”

The CRT Community is very thankful to Representatives Sensenbrenner and Crowley for their continued leadership in protecting access for people with disabilities. This legislation finished last year with strong bipartisan support with 173 Representatives and 20 Senators signed on.

We will be updating our websites and supporting materials to assist Stakeholders in reconnecting with their Members of Congress to re-sign past cosponsors or secure new cosponsors in this Congressional session.

On another important front, work is underway to reintroduce legislation in Congress to provide a permanent stop to the application of Medicare Competitive Bid pricing to CRT Wheelchair Accessories. This bill is expected to be reintroduced as we move into February.

Thanks for your continued support! Stay tuned for more details.

Regards,

Don
Donald E. Clayback
Executive Director | NCART
Office 716-839-9728 | Cell 716-913-4754
dclayback@ncart.us |www.ncart.us

Medicare Eliminates Billing Option for Certain Manual Wheelchair Upgrades

January 26, 2017

CRT Stakeholders,

Last month the DME Medicare Administrative Contractors (MACs) issued a joint publication indicating that titanium wheelchair frames and patient weight capacity upgrades were not separately billable to Medicare.  A copy can be found here.  The article indicates these features were included in the initial fee schedules developed for manual wheelchairs.

This is the most recent example of policy changes and re-interpretations over the past few years implemented by CMS and its contractors that eliminate access.  This policy announcement prevents Medicare beneficiaries with disabilities from obtaining complex rehab technology (CRT), even if they are willing to pay for upgrades themselves.

To work to resolve this access problem, we have formed an NCART Work Group and developed an Issue Paper to share with policy makers and advocates.  A copy can be found here.  We have also reached out to CMS with our concerns and are pursuing other channels in the Congressional and advocacy arenas.

We will keep you updated on our progress and next steps that may be required.

Regards,
Don

Donald E. Clayback
Executive Director | NCART
Office 716-839-9728 | Cell 716-913-4754
dclayback@ncart.us |www.ncart.us

P.S. If you know of other CRT stakeholders who would like to receive these types of updates please have them sign up at the NCART website.

Medicare CRT Wheelchair Billing Announcements

December 28, 2016

Dear CRT Providers and Manufacturers,

We wanted to notify you of 3 significant Medicare billing announcements that will impact you in 2017:

1.) Continued Use of KU Modifier for Billing for Group 3 Power Wheelchair Accessories with Dates of Service from January 1, 2017 through June 30, 2017- CMS has announced that “Section 16005 of the 21st Century Cures Act extends the PAMPA provisions of unadjusted fee schedules for Group 3 wheelchair accessories and cushions used with Group 3 complex rehabilitative power wheelchairs through June 30, 2017. To implement the extension, the 2016 KU fee schedule amounts have been updated by the 2017 0.7 percent covered item update and will be added to the 2017 DMEPOS fee schedule file. Suppliers should continue to use the KU modifier when billing for wheelchair accessories and seat and back cushions furnished in connection with Group 3 complex rehabilitative power wheelchairs with dates of service January 1, 2017 through June 30, 2017.” This is very good news and should prevent an interruption in the processing of these claims as we move into 2017.

2.) Payment Cut Recoupment for CRT Manual Wheelchair Accessories with Dates of Service from July 1, 2016 through December 31, 2016- Per the 21st Century Cures Act, the July 1, 2016 fee schedule (with related payment cuts to non-competitive bid areas) was rescinded until the issuance of the January 1, 2017 fee schedule. The result of this is CRT providers will be able to recoup any July 1 payment cuts that were incurred for CRT manual wheelchair accessories (and other impacted DME claims such as Group 2 Power Wheelchairs) with dates of service from July 1, 2016 through December 31, 2016. CMS has announced that it “is currently working to implement this section and will be providing contractor instructions for re-processing the applicable claims. There is no action required for the suppliers at this time. Formal instructions will be issued in the near future.” Here again, good news that will allow providers to reprocess these claims to obtain additional payments once specific instructions are issued by CMS.

3.) Required Prior Authorization for 2 Group 3 CRT Power Wheelchair Base Codes (K0856 and K0861)- CMS has announced that they will be putting in place a Prior Authorization system for 2 CRT power wheelchair codes: K0856- power wheelchair, group 3 std., single power option, sling/solid seat/back, up to 300 pounds; and K0861- power wheelchair, group 3 std., multiple power option, sling/solid seat/back, up to 300 pounds. This is part of a national DME Prior Authorization initiative and these first codes will be implemented in 2 phases. The initial phase will be effective on March 19, 2017 in the 4 states of Illinois, New York, West Virginia, and Missouri. The second phase will be effective in the remaining states in July 2017. The CMS Fact Sheet can be found here and provides additional details, including the goal of an initial prior authorization response within 10 days. We will be working with CMS on the implementation of this new system.

Thanks to everyone who worked hard to get the year-end legislation passed in Congress to provide the payment relief in items 1.) and 2.). We will share additional information as it becomes available.

Regards,

Don
Donald E. Clayback
Executive Director | NCART
Office 716-839-9728 | Cell 716-913-4754
dclayback@ncart.us |www.ncart.us

Congress Passes Six-Month Delay in CRT Power Accessories Cuts

December 8, 2016

Good News for CRT Stakeholders.

Yesterday afternoon the Senate passed a 6-month delay of inappropriate Medicare payment cuts to CRT power wheelchair accessories as part of the 21st Century Cures Act. The House of Representatives passed the bill last week and it now goes to the President for signing into law.

The Cures Act also includes Competitive Bidding “rural relief” language that will retroactively rescind the broad DME July 1, 2016 Medicare cuts until January 1, 2017. This will allow CRT providers to recoup payment reductions to CRT manual accessories and other items provided from July 1 to December 31, 2016. The rescinded payment cuts will go back into effect on January 1, 2017.

As we have reported, the year-end challenge was to get our CRT legislation attached to a larger bill before Congress adjourned. Thankfully we were included in a year-end bill. Unfortunately, it is a short-term fix and does not expand the delay to CRT manual wheelchair accessories.

The reality is our Congressional supporters worked hard to get the best relief achievable within a difficult and limited year-end legislative environment. This 6-month period allows time for us to work with next year’s new Congress and Administration to pursue a permanent and more expansive fix through policy or legislation.

We will start 2017 with Congressional CRT support at its highest level ever. This provides a solid foundation to get a permanent stop to these inappropriate CRT accessories payment cuts and to establish a Separate CRT Benefit Category.

We sincerely thank all the Members of Congress for their support, particularly our CRT champions. Our champions include Senators Portman (R-OH), Casey (D-PA), Cochran (R-MS), and Schumer (D-NY) along with Representatives Zeldin (R-NY), Sensenbrenner (R-WI), Crowley (D-NY), Brady (R-TX), Tiberi (R-OH), Kelly (R-PA), Nunes (R-CA), Price (R-GA), Loebsack (D-IA), Larson (D-CT), DeGette (D-CO).

Please email your Members and thank them. Let them know we look forward to working with them next year to get the needed permanent changes implemented to protect access for people with disabilities.

Finally, thanks to all the people and organizations who worked hard this year reaching out to Congress to secure their support. CRT stakeholders are proving that while it takes time to get the attention of Congress, if you have a good plan, good advocates, and polite persistence progress can be made.

More details will follow as we move ahead.

Regards,

Don

Donald E. Clayback
Executive Director | NCART
Office 716-839-9728 | Cell 716-913-4754
dclayback@ncart.us |www.ncart.us