Category: Press Releases

CRT Concerns Not Addressed in Omnibus Bill- Discussions with Congressional Offices Continue

December 16, 2015

CRT Stakeholders and Friends,

Unfortunately a delay in the implementation of the inappropriate January 1st Medicare cuts to Complex Rehab Wheelchair Accessories was NOT included in the Omnibus Budget Bill that Congress published last night.

We are continuing to have discussions with our Senate and House champions on alternative resolutions to stop these cuts and thereby avoid hurting people with disabilities who rely on Complex Wheelchairs.

As soon as we have additional information we will provide an update.

Regards,

Don

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

NCART Comments on CMS Proposed Rule for Miscellaneous DME Items

Download These Comments

July 9, 2015

Submitted electronically to: CodingComments@cms.hhs.gov

Subject: Miscellaneous Code Comments
To Whom It May Concern:

The following comments are submitted on behalf of the National Coalition for Assistive and Rehab Technology (NCART) in regards to the notice CMS posted online entitled “Healthcare Common Procedure Coding System (HCPCS) Codes Used for Processing Medicare Claims for Miscellaneous Durable Medical Equipment (DME)”.

NCART is a national association of suppliers and manufacturers focused on ensuring individuals with significant disabilities and chronic medical conditions have appropriate access to Complex Rehab Technology (CRT) products and services. We collaborate with consumers, clinicians, and physicians along with federal, state and private policy makers to establish and protect appropriate coverage, coding, and payment policies for CRT. Our membership includes over 300 Medicare CRT supplier locations across the country and the country’s leading CRT equipment manufacturers.

CRT products include medically necessary and individually configured manual wheelchairs, power wheelchairs, seating systems, and other adaptive equipment such as standing devices and gait trainers. People with high‐level disabilities such as ALS, Cerebral Palsy, Multiple Sclerosis, Muscular Dystrophy, Spinal Cord Injury, and Traumatic Brain Injury depend on CRT to address their medical needs, maximize their function and independence, and minimize health care costs. The provision process is service‐ intensive involving evaluation, configuration, fitting, adjustment, or programming and the equipment must then be supported with ongoing service and repair.

Flaws In This Process

At the outset, NCART agrees with the need to develop additional distinct HCPCS codes in order to appropriately capture items that are currently billed as “miscellaneous” items. However we have serious concerns with the process CMS is using.

We are very concerned that CMS continues to make coding, coverage and payment decisions which significantly impact access to important technology for people with disabilities in a manner that prevents stakeholder inclusion, and meaningful, upfront, open discussion to arrive at the best outcomes. This case is an illustration; minimal public notice and a limited time period for written comment with no opportunity for meaningful public exchange.

This notice was not broadly communicated to the affected community of stakeholders, and instead was merely included in a CMS “All Medicare” email weekly newsletter. Further, providing a short period of time for the public to provide comments on a coding proposal with such broad implications to beneficiary access is insufficient.

When it comes to ensuring access to the specialized technology (i.e. Complex Rehab Technology) that people with high level disabilities depend on, the importance of an appropriate HCPCS coding system cannot be overstated. As we move forward we would appreciate the opportunity to collaborate with CMS to develop an enhanced process for discontinuing/revising existing HCPCS codes and for the development of new, distinct codes when the necessity for such codes is identified.

With this in mind we make the following comments and recommendations and ask that in the future sufficient time be allowed for greater stakeholder inclusion in order to produce the best outcomes for the Medicare program and its beneficiaries.

Comments and Recommendations on Proposed Miscellaneous Codes

There are many hundreds of items affected by this proposal, and in this particular case, our focus is on the development of revised miscellaneous HCPCS codes that impact wheeled mobility and seating accessories, components, and parts.

NCART agrees with the need for more HCPCS codes for miscellaneous DME and otherwise not classified wheelchair components and accessories. Our members have long held the position regarding the need for additional codes in general, and miscellaneous codes in particular, that would allow for more accurate tracking, and allow Medicare and other payers to identify new HCPCS coding needs.

However, NCART believes the coding and payment changes being proposed regarding miscellaneous codes will disproportionately negatively impact people with disabilities since miscellaneous wheelchair items are more prevalent on complex rehab wheelchairs. Due to the small population of people with disabilities that may need any one item, utilization is typically low for many important complex rehab technologies. As a result, CRT products are less likely to meet CMS’s threshold for establishing a unique HCPCS code and therefore are billed under a miscellaneous HCPCS code.

Needed Changes to the Proposed Codes and Descriptors

The specific codes being proposed are problematic and inadequate. Under the proposed coding changes, CMS is planning on 6 new HCPCS codes:

1.) KXXX1‐ Durable Medical Equipment, Miscellaneous, the Purchase Price Does Not Exceed $150
2.) KXXX2‐ Durable Medical Equipment, Miscellaneous, the Purchase Price Exceeds $150
3.) KXXX3‐ Wheelchair Component or Accessory, Miscellaneous, the Purchase Price Does Not Exceed $150
4.) KXXX4‐ Wheelchair Component or Accessory, Miscellaneous, the Purchase Price Exceeds $150
5.) KXXX5‐ Repair Part For Use With Beneficiary Owned Durable Medical Equipment, Other Than Wheelchair, Not Covered Under Supplier Or Manufacturer Warranty, Not Otherwise Specified
6.) KXXX6‐ Repair Part For Use With Beneficiary Owned Wheelchair, Not Covered Under Supplier Or Manufacturer Warranty, Not Otherwise Specified

As already stated, NCART agrees that more HCPCS codes are needed. In the area of miscellaneous codes, NCART recommends that CMS establish codes using a different way of stratifying the technology.

Rather than using payment categories to differentiate codes, NCART recommends that CMS use the following descriptors/differentiators to properly segregate the products under the following codes:

1) KXXX1‐ Durable Medical Equipment, Miscellaneous
2) KXXX2‐ Durable Medical Equipment, Component or Accessory, Not Otherwise Specified
3) KXXX3‐ Durable Medical Equipment, Repair Part for Use with Beneficiary Owned, Not Covered Under Supplier or Manufacturer Warranty, Not Otherwise Specified
4) KXXX4‐ Standard Wheelchair, Component or Accessory, Not Otherwise Specified
5) KXXX5‐ Standard Wheelchair, Repair Part for Use with Beneficiary Owned, Not Covered Under Supplier or Manufacturer Warranty, Not Otherwise Specified
6) KXXX6‐ Complex Rehabilitative Wheelchair, Component or Accessory, Not Otherwise Specified
7) KXXX7‐ Complex Rehabilitative Wheelchair, Repair Part for Use with Beneficiary Owned, Not Covered Under Supplier or Manufacturer Warranty, Not Otherwise Specified

Needed Changes to the Fee Schedule Methodology and Payment Category Assignment

CMS indicates that fee schedules will be developed for KXXX1‐KXXX4. NCART strongly disagrees with the notion of developing a fee schedule for miscellaneous HCPCS codes. Not only are these codes used to bill a wide range of products, as new codes are created and new technology brought to market, the products that are being billed under these codes will change. To develop a fee schedule is inappropriate, arbitrary and will create a barrier to innovation and access to existing technology.

Items billed under miscellaneous codes do not necessarily have anything in common other than they are “not otherwise classified”. CMS indicates they used billed amounts from July 1, 1986 through June 30, 1987 to establish fee schedule amounts for certain proposed new codes. It is unclear what code was used for miscellaneous wheelchair accessories or options during this timeframe, as K0108 was not implemented until 1993. Further, NCART believes that there is no evidence that the items billed under miscellaneous codes from 20 to 30 years ago are the same ones being billed today. The only guarantee from the method CMS has applied to establish fee schedules is that it will result in over‐payment for many items and deny access to others.

Under this CMS proposal, many items would be paid at levels that are significantly less than their acquisition cost. The maximum that a provider can recoup if they bill a KXXX4 through the term of the capped rental is $560.83, even though acquisition costs may exceed this by a substantial amount.
Suppliers will not be able to provide items at a loss and, as such, beneficiaries will be forced to suffer financial hardship to obtain the items privately or be denied access to the item.

The proposal would increase program integrity risk by establishing reimbursement ceilings and six point plan logic (routinely purchased or capped rental) on miscellaneous codes. CMS would virtually eliminate any billing less than the allowable amount. In light of the harm that would occur to beneficiaries and the risks that would result to the system, there is no reasonable basis for implementing a fixed allowable for items billed under any miscellaneous code.

In light of the harm that would result, there is no reasonable basis for developing fee schedules for these codes. NCART believes all of the miscellaneous codes should be priced based on contractor individual consideration to ensure that an appropriate amount is paid for the item being provided and that access can be preserved.

Regarding the proposal to assign miscellaneous codes to six point plan payment categories under Section 1834(a)(1)(B) of the Social Security Act (routinely purchased and capped rental), NCART must express its concern and strong opposition. We assert that making classification decision for miscellaneous codes solely on MSRP is unfounded. To classify items as capped rental purely based on the MSRP of that item is not compliant with CMS’ own rules regarding payment category assignment. Regardless of the code used to bill items in 1986 and 1987, these items have been routinely purchased by Medicare more than 75% of the time. Further, to classify any accessory as capped rental when it is being provided with a base item that is classified as purchase adds a significant burden and cost to suppliers. CMS allows capped rental items billed with certain power wheelchairs, when the beneficiary has elected to purchase at initial issue, to be billed as a purchase.

NCART recommends that CMS allow this same provision for any option or accessory being provided with DME or wheelchair base item that is purchased. CMS should allow the beneficiary to choose rental or purchase depending on their individual situation, or length of need for the item being billed for all options, accessories. We also agree that all repair parts should be purchased when provided on beneficiary owned bases.

Summary

In closing, NCART believes that adequate and appropriate HCPCS codes are the foundation for coverage and payment policies that ensure appropriate access and the best health outcomes for Medicare beneficiaries. CMS has a responsibility to make coding decisions that do not impede appropriate access and unfortunately this proposed miscellaneous ode set will result in serious access issues to a vulnerable population. We believe that many of the current policies fail to meet the needs of people with disabilities.

It is very important for HCPCS codes to recognize technological differences between products which address different clinical needs. We recognize the challenge that can occur in trying to properly administer the program as it relates to the primary Medicare beneficiary population. However NCART also believes that CMS must take the needs of the smaller, but equally important, population of Medicare beneficiaries who are eligible for the program based on disability.

In order to preserve access, provide better tracking, and improve the efficiency of the Medicare program we recommend the following modifications to CMS’ coding proposal:

1.) Modify the proposed Codes and Descriptors to read as follows:
a. KXXX1‐ Durable Medical Equipment, Miscellaneous
b. KXXX2‐ Durable Medical Equipment, Component or Accessory, Not Otherwise Specified
c. KXXX3‐ Durable Medical Equipment, Repair Part for Use with Beneficiary Owned, Not Covered Under Supplier or Manufacturer Warranty, Not Otherwise Specified
d. KXXX4‐ Standard Wheelchair, Component or Accessory, Not Otherwise Specified
e. KXXX5‐ Standard Wheelchair, Repair Part for Use with Beneficiary Owned, Not Covered Under Supplier or Manufacturer Warranty, Not Otherwise Specified
f. KXXX6‐ Complex Rehabilitative Wheelchair, Component or Accessory, Not Otherwise Specified
g. KXXX7‐ Complex Rehabilitative Wheelchair, Repair Part for Use with Beneficiary Owned, Not Covered Under Supplier or Manufacturer Warranty, Not Otherwise Specified

2.) Continue the current policy of determining payment amounts for miscellaneous codes based on contractor individual consideration.

3.) Provide that the payment methodology allows the option for payment to be made as a purchase.

As stated above, NCART has a sincere desire to join other impacted stakeholders in collaborating with CMS to address issues within the HCPCS coding area in order to produce the best outcomes for the Medicare program and Medicare beneficiaries. Please let us know how we can be of further assistance.
Sincerely,

Donald E. Clayback Executive Director 716‐839‐9728
dclayback@ncart.us | www.ncart.us

CRT Stakeholders Call on Lawmakers to Protect IL Medicaid Beneficiaries

FOR IMMEDIATE RELEASE
May 19, 2015

CONTACT
Don Clayback, NCART Executive Director, 716-839-9728, dclayback@ncart.us
Coalition of Complex Rehab Technology stakeholders call on Illinois Lawmakers to protect, not punish, Medicaid beneficiaries with severe disabilities

Urgent action needed to reverse payment cuts and ensure
people with disabilities access to specialized wheelchairs and adaptive equipment
Buffalo, New York – A coalition of Complex Rehab Technology (CRT) stakeholders made up of people with disabilities, medical professionals, disability rights advocates, and CRT providers from across Illinois are sending an urgent message to state lawmakers – in the quest for Medicaid cuts, don’t punish Illinois Medicaid beneficiaries who need specialized CRT products and services. To restore access and prevent negative consequences, recent payment policy changes and cuts to CRT must be rescinded now.

Kim Brown, the 2012 Ms. Wheelchair Illinois, has joined the effort because she is concerned and does not want to see lawmakers overlook the needs of the tens of thousands of people with disabilities in Illinois. Brown was born with Spina Bifida but she wants everyone to know that hasn’t held her back.

She has earned two Master’s degrees, is a Senior Business Analyst in Chicago, and states CRT is very important to her. “My wheelchair is basically my legs,” Brown said. “The equipment I use is highly specialized and individually tailored to fit my needs. I use my chair every single day. I urge Illinois lawmakers to rescind these cuts to protect access for the many people who, like me, have Complex Rehab Technology needs.”

As a result of recent policy changes and payment cuts the two largest CRT providers in the state have had to temporarily suspend all but emergency services to the Medicaid program. The availability and proper provision of CRT products and supporting services enables people with disabilities to address their medical needs and maximize their independence. It also plays a key role in helping the state control and reduce Medicaid costs.

“There are only a handful of qualified companies who provide these specialized wheelchairs and adaptive equipment to Illinois Medicaid beneficiaries.” said Don Clayback, Executive Director of NCART. “If nothing is done to reverse these major cuts, this drop in access will significantly compromise the health and independence of children and adults with disabilities and at the same time increase the cost for medical care and hospitalization.”

Unfortunately access to this specialized equipment has been reduced due to major Medicaid payment cuts. In the last 30 days Illinois CRT companies that supply these products have been hit with multiple unexpected cuts from (1) an unannounced April change in the CRT payment methodology and (2) a just announced May 1st across-the-board payment cut of 16.75%. As a result, the two largest CRT providers in the state have been forced to temporarily suspend the provision of almost all products and services.

Jill Sparacio is an occupational therapist in Chicago and has been in practice for over 25 years. She works with children and adults with disabilities who require specialized wheelchairs and other adaptive equipment. “The important role that CRT plays can’t be overstated. Are the savings in cuts to CRT going to be noticeable in terms of the state’s budget compared to the detriment that the cuts will cost? Any savings that causes reductions in access will be more than offset by increased costs for resultant medical care, need for increased assistance within a person’s home, as well as loss of income by putting a person’s job in jeopardy.”

Sparacio continued “What’s truly unfortunate is that many of the people impacted by these cuts have severe disabilities and have no voice or ability to advocate for themselves. The state needs to find a way to deal with the budget issues without hurting this frail population.”

The coalition of CRT stakeholders is asking lawmakers to fix these access problems by working with the Illinois Department of Healthcare and Family Services to rescind the recent changes to payment rates and policies.

“While everyone understands the need for the state to closely examine and make changes in the Medicaid program, such changes should not be at the expense of the people in the state who have the greatest needs. We are sending an urgent message to lawmakers to do the right thing for people with disabilities who require this equipment.” said Melissa Pickering, Executive Vice President of Payer Relations for Numotion.

“The people our companies serve typically require care twenty four hours a day, seven days a week,” said Ed Curley, Vice President of Business Development and Payer Relations for National Seating & Mobility. “The equipment we provide to our customers is something they depend on every single day. All we are asking is for the state to recognize the specialized needs of people with severe disabilities and make needed changes to protect them and their families.”

 

ABOUT NCART

NCART, the National Coalition for Assistive and Rehab Technology, is a national organization of suppliers and manufacturers of Complex Rehab Technology (CRT) products and services used by people with significant disabilities and chronic medical conditions. NCART seeks to ensure these individuals have appropriate access to CRT products and supporting services. In pursuit of that goal, NCART works with consumers, clinicians, and physicians along with federal, state and private policy makers to establish and protect appropriate coverage, coding, and quality standards. Find out more at www.ncart.us.

101 Signers on House CRT Letter to CMS!

CRT Stakeholders and Friends,

Thanks to everyone for taking the time to reach out to their Representatives over the past several weeks asking them to sign on to the House of Representatives letter to CMS regarding the application of Competitive Bid Pricing to Complex Rehab wheelchair accessories. As a result of all your efforts the letter will be going to CMS with 101 signatures!  See the commplete list of signers at www.access2crt.org.

This is an extremely impressive number, both in terms of quantity AND in terms of quality. The letter shows very strong BIPARTISAN support on the need to fix this problem with a blend of 53 Democrat and 48 Republican signatures. Even more important, of those 101 Members 34 are on either the key Ways & Means or Energy & Commerce Committees. These are the Representatives that OVERSEE the Medicare program on the House side.

More work lies ahead. The letter is a significant step toward a resolution, but we now must continue to work with our Congressional champions and CMS to get a formal rescission of the announced policy change and a commitment to maintain the current payment policy for Complex Rehab wheelchair accessories in 2016. Congress has asked CMS to respond to their request within 30 days.

Next week many of us will be in Washington for the National CRT Conference to carry the CRT message to Congress. Our conversations will focus on two areas: (a) the need for CMS to follow the Congressional request in the House letter and (b) securing co-sponsors for the “Ensuring Access To Quality Complex Rehabilitation Act”.

We’re looking forward to a very productive week!

Regards,

Don

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

Rep. Sensenbrenner and Rep.Crowley Reintroduce CRT Bill- H.R. 1516

Download this Press Release

FOR IMMEDIATE RELEASE
Thursday, March 19, 2015

Contact:
Ben Miller (Sensenbrenner) 202-225-5101 Courtney Gidner (Crowley) 202-225-3965

Sensenbrenner & Crowley Reintroduce Legislation to Improve Access to Complex Rehabilitation Technology for Medicare Patients

(WASHINGTON) – Congressmen Jim Sensenbrenner (R-Wis.) and Joe Crowley (D-N.Y.) today reintroduced the Ensuring Access to Quality Complex Rehabilitation Technology Act, which would help ensure patients with disabilities or severe medical conditions have access to highly specialized medical equipment. The bill establishes a distinct Medicare benefit category for complex rehabilitation technology products (CRT), such as specialized power wheelchairs and adaptive seating systems. It would also allow the Centers for Medicare & Medicaid Services (CMS) to better target its payment and coverage policies by adopting higher quality standards for suppliers, improving oversight to prevent fraud and abuse and expanding eligibility criteria for beneficiaries.

Congressman Sensenbrenner: “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. Americans with disabilities should not be denied rehabilitation or medical equipment that can enable them to live and work freely and independently. With increased flexibility and proper oversight, we can help those in need while inhibiting fraud and abuse.”

Congressman Crowley: “Complex rehabilitation technology products can make a world of difference for people with severe disabilities and other medical conditions, and our legislation will remove barriers to getting these wheelchairs and other services to those who need them to lead a more independent life. I look forward to advancing this legislation that recognizes the importance of maintaining access to these products, as well as puts in place much-needed quality standards and consumer protections that strengthen the Medicare program for individuals, clinicians, and suppliers.”

The Ensuring Access to Quality Complex Rehabilitation Technology Act is supported by multiple patient, medical professional and supplier organizations, including: American Association for Homecare, American Physical Therapy Association, Brain Injury Association of America, Christopher and Dana Reeve Foundation, Easter Seals, National Association for Home Care & Hospice, National Coalition for Assistive and Rehab Technology, National Multiple Sclerosis Society, Paralyzed Veterans of America, and United Spinal Association.

Successful Congressional Briefing On CRT

Successful CRT Congressional Briefing Held July 15, 2013

A very successful Congressional Briefing on Complex Rehab Technology (CRT) and the related Medicare Separate Benefit Category legislation was held in Washington, D. C. on July 15th. The briefing was entitled “Enabling Independence for People with Disabilities: the Importance of Complex Rehab Technology” and was co‐hosted by the Congressional Bipartisan Disabilities Caucus and the offices of Representatives Joe Crowley and Jim Sensenbrenner. There were approximately 100 people in attendance with 71 Congressional offices represented (57 House offices and 14 Senate offices).

The one hour program opened with a welcome from Todd Adams, Representative Jim Langevin’s Legislative Director, introducing the topic on behalf of the Congressional Bipartisan Disabilities Caucus. Don Clayback, Executive Director of the National Coalition for Assistive and Rehab Technology, followed by providing an overview of CRT covering what it is, who uses it, the benefits, how it’s provided, and the access challenges that exist.

Paul Tobin, President of United Spinal Association, then reviewed the important role CRT plays in the lives of people with disabilities including how it assists in maximizing function and independence, how it reduces healthcare costs, how it enables people to fully access their communities and engage in education, employment, and other activities of living. Adam Lloyd, a college professor from Maryland (who uses a power wheelchair and chin control), then told his personal story and how important CRT has been in the aspects of his life: his education, his employment, his quality of life, and the management of his healthcare.

Mr. Tobin and Mr. Clayback then reviewed the key aspects of the “Ensuring Access To Quality Complex Rehabilitation Technology Act” (H.R. 942 and S. 948), and fielded a variety of questions. The attendees were very attentive and we had a solid 15 minutes of questions and answers. To wrap up, Nicole Cohen, Representative Crowley’s Legislative Assistant, and Kara Webster, Representative Sensenbrenner’s Legislative Assistant, spoke on the need for additional co‐sponsors and encouraged attendees to talk to their “bosses” about becoming a co‐sponsor to the CRT legislation.

The forum provided a great CRT educational opportunity. Of the 71 Congressional offices in attendance, only 17 had already signed on to H.R. 942 or S. 948 to date. That meant 54 Member offices now know more about CRT and can be asked to become co‐sponsors. The related follow up is underway to secure additional Congressional support for the CRT legislation.

Release Date: 16-Jul-2013

Senators Schumer And Cochran Introduce Companion Bill S. 948

Senate Bill Introduced To Create Separate Benefit Category for Complex Rehab Technology

Senators Chuck Schumer and Thad Cochran Join In Bipartisan Introduction of Senate Companion Bill S. 948

May 15, 2013

‐ The Separate Benefit Category (SBC) Steering Committee is pleased to announce the introduction of Senate legislation to create a separate benefit category for Complex Rehab Technology within the Medicare program. Senior Senators Chuck Schumer (D‐NY) and Thad Cochran (R‐MS) have joined in a bipartisan introduction of Senate Bill S. 948, the “Ensuring Access To Quality Complex Rehabilitation Technology Act of 2013”.

S. 948 creates a separate benefit category for Complex Rehab Technology (CRT) within the Medicare program so that adequate access to these critical products and supporting services can be assured.  The legislation appropriately distinguishes these specialized products and makes other required changes, including increasing related standards and safeguards, to better address the unique needs of individuals with disabilities and medical conditions who rely on CRT to meet their medical needs and maximize their function and independence

This legislation is a companion to House Bill H.R. 942 which was introduced in March of this year with bipartisan support by Congressmen Joe Crowley (D‐NY) and Jim Sensenbrenner (R‐WI).

Senator Schumer is a senior Senate Democrat who has served in Congress for 33 years; elected to the House in 1980 and elected to the Senate in 1998. He is Chair of the Senate Rules Committee and a member of the Senate Finance Committee, Judiciary Committee, and Banking, Housing, and Urban Affairs Committee. Senator Cochran is a senior Senate Republican who has served in the Senate since 1978. He is a member of the Senate Appropriations Committee, Rules Committee, andAgriculture, Nutrition and Forestry Committee.

“We are honored and grateful to have these two well respected Senators introduce CRT legislation. This bill will protect the needs of people with disabilities and now that we have legislation introduced in both the House and Senate we look forward to continuing to create awareness of CRT issues and securing additional co‐sponsors and passage”, said Don Clayback, SBC Steering Committee Chair.

 The SBC initiative has garnered broad support from the consumer and clinical communities. Over 40 national groups have signed on in support of the legislation and its objectives. The list includes the ALS Association, American Association of People with Disabilities, ITEM Coalition, National Council on Independent Living, Paralyzed Veterans of America, United Spinal Association, American Association of Occupational Therapists, American Association of Physical Therapists, and the American Academy of Physical Medicine and Rehabilitation.

Last year the House Bill enjoyed strong bipartisan support from 39 House Members, which included 13 members from the key House Ways and Means and Energy and Committees. The group also included both the Republican and Democrat Co‐Chairs of the House Bipartisan Disabilities Caucus.

For more information on the Separate Benefit Category for Complex Rehab Technology visitwww.access2crt.org or contact Don Clayback, SBC Steering Committee Chair, atdclayback@ncart.us or 716‐839‐9728.

Release Date: 16-May-2013

Washington State CRT Legislation Passed

4/24/2013- On Monday the Washington State Legislature passed legislation (Bill HB 1445) which provides separate recognition of Complex Rehab Technology (CRT) within the state’s Medicaid program.  The bill passed in both the Senate (46 to 0) and the House (92 to 3) and has been forwarded to Governor Inslee for his signature.  The signing is expected to take place in mid-May and the legislation will then take effect January 1, 2014.

This is the first CRT recognition bill to be passed at the State level.  It provides a solid precedent to share as part of our Medicaid advocacy work in other states.  It’s also another positive step in establishing greater CRT awareness with policy makers and protecting access for people with disabilities.

Read the Press Release

Release Date: 24-Apr-2013

Crowley And Sensenbrenner Announce Legislation For CRT

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Crowley, Sensenbrenner Announce Legislation to Improve Access to Complex Rehabilitation Technology for Medicare Patients

(Washington, D.C.) – Today, Reps. Joe Crowley (NY-14) and Jim Sensenbrenner (WI-5) announced the reintroduction of the Ensuring Access to Quality Complex Rehabilitation Technology Act (H.R. 942), legislation that helps ensure patients with disabilities or severe medical conditions are able to access the highly specialized medical equipment that meets their needs and helps improve their day-to-day lives. Specifically, the bill establishes a distinct Medicare benefit category for complex rehabilitation technology products (CRT), such as specialized power wheelchairs and adaptive seating systems. This would allow the Centers for Medicare & Medicaid Services (CMS) to better target their payment and coverage policies to this unique type of equipment, by adopting higher quality standards for suppliers, improving oversight to prevent fraud and abuse, and expanding eligibility criteria for beneficiaries to access these products.

“For people with disabilities or other medical conditions, complex rehabilitation technology products aren’t a luxury, they’re a necessity,” said Rep. Crowley. “Our legislation will help ensure more patients can access the high-quality products and services they need to help them lead a better, more independent life. And, it puts forward much-needed quality standards and consumer protections, making the Medicare program stronger for individuals and suppliers as a result.”

“As someone who has been a leader in the past, fighting for the rights of the disabled, I want to ensure that all Americans have full access to the best tools available, giving them the ability to live each day to the fullest,” said Rep. Sensenbrenner. “Disabled Americans should not be denied the benefits of proper rehabilitation or medical equipment that can provide them the opportunity to live and work freely and independently. With increased flexibility and proper oversight, we can ensure help for those in need while inhibiting fraud and abuse.”

Currently, the Medicare program includes CRT products in the same category as standard durable medical equipment, like traditional manual wheelchairs, which limits access and product choice, as individuals that use CRT products differ from the traditional Medicare population. These individuals experience physical, functional and cognitive challenges every day as a result of significant disabilities or other medical conditions, such as cerebral palsy, muscular dystrophy, multiple sclerosis, and spinal cord injuries. Grouping CRT products with other durable medical equipment doesn’t allow CMS the flexibility to address the distinctive needs of the individuals that use these products or the suppliers that assist them. Furthermore, these complex and often customizable CRT products require a broader range of services and specialized personnel, as well as much more training and education for suppliers to ensure appropriate use. Congress has previously recognized unique situations like this one by creating a separate benefit category for orthotics and prosthetics, another highly specialized medical equipment category, which has its own medical policies, accreditation standards, and payment calculations.

In addition, the bill includes provisions to ensure these items are being prescribed appropriately to prevent fraud and abuse, including requiring that a licensed physical or occupational therapist evaluate the patient, increased quality standards for suppliers of these products, and a supplier accreditation process to ensure compliance with these enhanced quality standards. The bill will also remove barriers that beneficiaries currently face in obtaining this equipment; for example, by making it easier for patients in skilled nursing facilities to transition to home or community care.

The Ensuring Access to Quality Complex Rehabilitation Technology Act is supported by multiple patient, medical professional and supplier organizations, including: American Association for Homecare, American Physical Therapy Association, Brain Injury Association of America, Christopher and Dana Reeve Foundation, Easter Seals, National Association for Home Care & Hospice, National Coalition for Assistive and Rehab Technology, National Multiple Sclerosis Society, Paralyzed Veterans of America, and United Spinal Association.

“I am so happy that Representatives Crowley and Sensenbrenner have reintroduced this important bill, HR 942, Ensuring Access To Quality Complex Rehabilitation Technology Act of 2013, which creates a separate benefit under Medicare for customized wheelchairs that will ensure our members with spinal cord injury and disorders living with significant disabilities such as multiple sclerosis, spina bifida or amyotrophic lateral sclerosis (Lou Gehrig’s disease) obtain the medical equipment they need to live independent, fully-functioning lives, as is their right,” said Paul Tobin, President and CEO of the United Spinal Association, a nationally-recognized organization based in Queens, N.Y. that works to improve the quality of life of all people living with a spinal cord injury or disease.

Release Date: 16-Mar-2013

NCART Releases New Educational Video: “Complex Rehab Technology‐ Essential For Health. Essential For Life.”

Video Will Serve As Cornerstone of Expanded CRT Advocacy Materials

Buffalo, NY – December 16, 2011 – The National Coalition for Assistive and Rehab Technology (NCART) has released an educational video entitled “Complex Rehab Technology‐ Essential for health. Essential for life”.  The video provides an introduction to Complex Rehab Technology (CRT) from the perspectives of individuals that rely on CRT for their health and independence, physicians that prescribe it, and consumer organizations that work to protect access.  Along with an introduction to CRT, the video also highlights policy changes that are needed to provide adequate access.

The video will be widely distributed and utilized to increase the awareness and understanding of CRT on both a national and state level.  It is designed to be used with legislators, public and private third‐party payers, and other policy makers.  It should be required viewing for anyone involved in matters relating to the coverage and payment of CRT products and related services.

The video shares the stories of 5 individuals who rely on Complex Rehab Technology every day to promote and protect their health, function, and independence.  The video also includes comments from a physician active in prescribing CRT and a national disability advocacy group leader.  Dr. Nicholas Holekamp, Chief Medical Director at Ranken Jordan Hospital, a pediatric specialty hospital in St. Louis, Missouri, discusses the medical and functional benefits of CRT.  Paul Tobin, President and CEO of United Spinal Association, a national advocacy and service organization, reviews the importance of CRT for people with disabilities and the need for adequate coverage and funding policies to provide adequate access.

In addition to the release of the video, NCART has also developed and updated a variety of additional CRT educational advocacy material that can be used with legislators, public and private third‐party payers, and other policy makers.  These materials can be accessed in the Educational area on the NCART website at www.ncart.us.Gary Gilberti, NCART President, said “As we continue to work on separate recognition for CRT through a Medicare Separate Benefit Category and other activities, helping policy makers at the federal, state, and private payer levels better understand what CRT is all about is critical.  They need to understand that it’s specialized equipment, that it’s used by a small group of children and adults with disabilities, and that it provides real medical and functional benefits.”  Gilberti continued “Policy makers cannot make appropriate coverage and payment decisions without knowing the details of the products, services, and benefits.  This video allows the people that use, prescribe, and advocate for CRT to share their perspectives across the country.   They’re real people and real‐life stories.  We know we need to create greater CRT awareness and this video is a great tool to assist in that process.”

Don Clayback, NCART Executive Director, stated “We’re very happy to have a new and powerful tool to help in national CRT advocacy efforts.  The title “Essential for health.  Essential for Life.” is meant to convey the important aspects of CRT.  As Frank Alberding says in the video “A wheelchair is not just a wheelchair.  It’s a part of me.”  That’s an important piece of the CRT message.”  Clayback added “The video, along with our other updated educational materials, will better equip everyone who is working on promoting and protecting access to this specialized equipment.  NCART will be making this video easily available for distribution and viewing.  We hope all CRT stakeholders will use it to foster a clearer recognition of CRT and of the related policy changes that are needed.”

The 11 minute video can be viewed at www.ncart.us.  To allow for varied types of presentations, a condensed 5 minute version will also be made available.  Copies of the videos and related information can be obtained by contacting Don Clayback, NCART Executive Director, at dclayback@ncart.us or 716‐839‐9728.

Release Date: 16-Dec-2011