January 26, 2017
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.
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.