HUGE Win for CRT Providers! CMS Overturns Inclusion of Power Chair Accessories in CBP

Posted on in Billing/Reimbursement, HME Government Issues, Legislation

By Collin Brecher, VGM Government Relations

Since 2014, complex rehab technology (CRT) providers have been fighting a battle to keep CRT wheelchair accessories from being inappropriately paid based on competitive bidding program information. The Centers for Medicare and Medicaid Services (CMS) announced on June 23 that it would be overturning its decision to use competitive bid rates to determine payment amounts for CRT power wheelchair accessories.

This covers only Group 3 complex power wheelchairs. In its announcement, CMS said, “…the 21st Century Cures Act currently allows higher payments for these items but is set to expire after June 30, 2017. By continuing these higher payments, this new action will help to protect access to complex rehabilitative power wheelchair accessories, on which, people with significant disabilities depend.”

To read the full announcement, click here

Conflicted with MIPPA

In November 2014, CMS issued final rule CMS 1614-F, which outlined the nationwide application of competitive bidding payment rates to non-bid areas. In December 2014, CMS released a Frequently Asked Questions (FAQ) document, which indicated CMS would use this bid pricing on CRT wheelchair accessories. This clearly conflicted with the 2008 Medicare Improvements for Patients and Providers Act (MIPPA) that specifically exempted CRT from the program.

There have been several efforts, including congressional letters, legislation, and committee inquiries on the issue. The team at the National Coalition for Assistive & Rehab Technology (NCART) carried the torch for the CRT industry to find a solution to this issue, and a lot of credit goes to the grassroots providers who continued to press the issue with their members of Congress. Don Clayback, executive director for NCART, made this issue his primary focus, and with the assistance of U.S. Rehab, AAHomecare, and others, CRT stakeholders continued to keep this issue high on the priority list of congressional offices.

VGM, U.S. Rehab Elated

Greg Packer, president of U.S. Rehab, offered great praise to the providers on the ground, saying, “We are thrilled to share that CMS has made the right decision to change course on applying competitive bid pricing to CRT wheelchair accessories. The clear intent of Congress, by both law and other inquiries, was to keep CRT out of the competitive bidding program. Due to the constant effort of U.S. Rehab providers remaining engaged with their members of Congress, the industry received a huge win.”

VGM Government Relations Director Tom Powers added, “CRT providers serve some of the most vulnerable patients in health care who heavily rely on this specialized equipment to maintain their independence and continue to be active citizens. This is a well-deserved win for CRT providers and beneficiaries across the country as the industry works to implement sustainable health care reforms that put patients first.”

Plenty of work remains on the next priority of the industry: the creation of a separate benefit category for CRT. U.S. Rehab remains committed to continuing conversations and building relationships on Capitol Hill to advocate on behalf of its membership and the beneficiaries it serves.