Medicare Separate Benefit Bill Reintroduced in U.S. House

A bill that would establish a separate Medicare benefit category for complex rehab technology (CRT) has been reintroduced in the U.S. House of Representatives.

H.R. 1516 was reintroduced by Rep. Joe Crowley (D-N.Y.) and Rep. Jim Sensenbrenner (R-Wisc.), the members of Congress who introduced a CRT separate benefit bill to the previous session of Congress. That bill expired when the Congressional term ended.

In a March 20 statement to members and other stakeholders, NCART Executive Director Don Clayback said the new bill’s language is the same as the former’s, “with one important addition. HR-1516 includes a new provision that will allow all CRT codes to be billable as a ‘purchase’ rather than subject to ‘capped rental’ treatment. This recognizes the individualized nature of CRT items and that they are supplied to meet permanent, not short-term, needs.”

In an interview with Mobility Management, Clayback explained why classifying CRT as rental items is a lose-lose-lose situation for Medicare beneficiaries, CRT providers and even the Medicare program itself.

“As you know, CMS changed their policy to where they reclassified certain items to capped rental,” Clayback said. “The theory for capped rental is based on a person having a short-term need for equipment that they use on a temporary basis. CRT items are individualized to the person; it presents problems from the provider perspective, trying to individualize a piece of equipment or technology to a person which really is based on a long-term need. And you’re now going to be paid for that based on a monthly payment.

“It compromises the type of equipment and the quality of equipment that the person gets, and as importantly, if this person needs this equipment more than 12 months, which I would say is the case for 99 percent of CRT equipment, Medicare actually pays more over the rental period than if they just purchased it outright. With things being classified as rental, it makes it more difficult for the provider to really individualize a piece of equipment for that person’s specific needs. For the Medicare beneficiary, it compromises their access to the right type of equipment, and from a financial perspective, it actually costs the Medicare program and the beneficiary more money if that item is rented over a 13-month period when it could be purchased outright.”

It’s a message that’s also resonating with the consumers who use CRT. Clayback said the Muscular Dystrophy Association will officially support the new bill.

“They will be mobilizing their membership to reach out to Congress to push for passage,” the NCART announcement said. “MDA joins the list of over 50 national consumer and medical professional organizations supporting the CRT bills.”

During the last session of Congress, 168 members of the House supported the CRT separate benefit category bill. The Senate companion bill had 22 co-signers.

Clayback indicated a new Senate companion bill would be re-introduced soon by Sen. Thad Cochran (R-Miss.) and Sen. Chuck Schumer (D-N.Y.), who introduced the bill into the previous session of Congress.

For more information on H.R. 1516 and to stay up to date on the bill’s progress, visit ncart.us or nrrts.org.

About the Author

Laurie Watanabe is the editor of Mobility Management. She can be reached at lwatanabe@1105media.com.

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