Complex Rehab Legislative Update

Published in Complex Rehab on April 21, 2021

Legislation is always a hot topic in CRT and this year is no different. We have 5 major issues that we are working on: Stopping June 30 Cuts to CRT Manual Wheelchair Accessories, Establishing Coverage for Power Seat Elevation and Power Standing System, Securing Permanent Remote Service and Telehealth Options for CRT, Establishing a Medicare Separate Benefit Category for CRT, State Medicaid Cuts, and the Right to Repair legislation that is currently being introduced in several states. U.S. Rehab continues to work with NCART on all of these issues.

“U.S. Rehab is all in for the CRT industry, each state, and for the disability community to help foster independent providers across the country,” said Greg Packer, president of U.S. Rehab. “We want to see providers continue to provide products and services to the patient population. The consolidation of the industry has reduced the number of providers, which has impacted service levels and, in some cases, the advancement of the industry. The reduction of providers in the industry has not been conducive to the patients they serve; it ultimately impacts the end user’s ability to get the medically necessary equipment they need.”

Here’s an overview of the current legislative issues we are working on.

Stopping June 30 Cuts to CRT Manual Wheelchair Accessories

A suspension of using Competitive Bidding Program (CBP) rates for CRT manual wheelchair accessories was put in place and expires on June 30, 2021. As you may recall, CMS already exempted CRT power accessories in 2017, and Congress provided an 18-month statutory delay of the application of CBP pricing for CRT manual accessories last December, which is set to expire June 30, 2021. We need Congress to weigh in with CMS to make the exemption permanent to provide equal access to both CRT manual and power wheelchairs and accessories for Medicare beneficiaries.

Right to Repair State Legislation

There are bills that are spreading across the state level that would allow for end-users or anyone to repair their own equipment. While we understand that repairs are sometimes difficult to have completed due to reimbursement issues, we know that there is a huge risk when repairs are not properly completed by an authorized technician. Allowing an unauthorized person to repair equipment not only puts the end-user at risk of injury but also voids the manufacturer's warranty on the equipment and insurance won’t pay for the repair or parts if not completed by an authorized technician.

We have already seen this legislation pop up in Colorado and California. If you see this legislation pop up in your state, contact U.S. Rehab.

Establishing Coverage for Power Seat Elevation and Power Standing System

We are continuing to push and support the ITEM Coalition-led initiative for Medicare coverage of Power Seat Elevation and Power Standing Systems.

As of right now, power seat elevation is currently being reviewed by CMS. U.S. Rehab will continue to work with NCART and the ITEM Coalition to gather information regarding the needed HCPCS codes and fee schedule amounts. As a financial contributor to NCART and with Greg Packer as the vice president of the NCART Board of Directors, U.S. Rehab is completely involved in the process to advance power seat elevator and power standing in the marketplace for those who qualify.

Securing Permanent Remote Service and Telehealth Options for CRT

During the Public Health Emergency (PHE), physical and occupational therapists are allowed to do seating assessments through telehealth sessions. However, this option is scheduled to expire at the end of the PHE.

H.R. 2168 was introduced on March 23, 2021 by Rep. Mikie Sherill (D-NJ) and Rep. David McKinley (R-WV) and continues to gain bipartisan support. Allowing telehealth as an option for seating evaluations is important after the PHE expires. This legislation would allow PTs and OTs to continue to provide care and follow-up to their clients with disabilities who require CRT who may be unable to get to a clinic due to many factors including transportation or proximity to the wheelchair clinic.

Click here to send letters to your Representative and Senators to ask them to support this legislation. 

Establishing a Medicare Separate Benefit Category for CRT

The CRT industry has pushed for complex rehab equipment to be considered in a separate benefit category for many years. This would protect access to these critical technologies and related services for people with disabilities. A Medicare benefit category separated from DMEPOS would allow for needed improvements in coverage policies, coding, and quality standards to better address the needs of people who rely on CRT to manage their medical needs, minimize their health care costs, and maximize their function and independence.

State Medicaid Cuts

We continue to monitor reductions in state Medicaid reimbursement. If you are experiencing issues in your state, let us know.

To stay up to date, make sure to attend the monthly CRT industry webinars hosted by NCART, NRRTS, U.S. Rehab and the Clinician’s Task Force. If you have legislative issues that affect your business in your state, let us know.

“Moving from a Fee for Service payment model to Pay for Performance payment model will help patients get the highest quality service and equipment,” said Packer. “The model is evolving; over the next 5 years, service will be heightened, but it will take time for us to move that direction.”

It is more important than ever to make sure your voice and your client’s voices are heard on these issues. We are at the beginning of the 117th Congress. Make sure to contact your elected officials, introduce yourself, and help them understand the importance of CRT.

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