CMS Sets New Pricing Policy for CRT MWC Accessories

The Centers for Medicare & Medicaid Services (CMS) will no longer apply Medicare competitive bidding-derived pricing to accessories for Complex Rehab Technology (CRT) manual wheelchairs.

The July 29 notification from CMS came after years of education and lobbying from the CRT industry and consumer organizations. In that time, the industry and its Congressional champions succeeded in getting multiple manual wheelchair accessory bills introduced on Capitol Hill.

In the end, however, CMS made a policy change on its own, bringing a rather sudden finish to the long fight to protect consumer access to CRT accessories.

Previously, an Extension Through September

In June, CMS announced it was extending its suspension of CRT manual wheelchair accessory payment cuts as the agency re-examined its funding policy.

“As reported at the end of June, CMS had extended a temporary suspension of any cuts until September 30,” said NCART Executive Director Don Clayback in a July 29 bulletin to stakeholders. “This was done to allow more time for their review of our request for a permanent policy. We are sincerely grateful to CMS for making today’s policy decision and protecting access for people with disabilities who depend on these individually configured CRT wheelchairs and seating systems.”

Clayback also recognized the many advocates who’d come together to lobby CMS for change.

“This outcome was the result of several years of collaborative advocacy within the CRT community to ensure these damaging cuts did not go into effect,” he noted. “We want to thank Representatives John Larson (D-Conn.) and Lee Zeldin (R-N.Y.), and Senators Bob Casey (D-Pa.) and Rob Portman (R-Ohio) for their ongoing leadership and support. We also extend thanks to their Congressional colleagues and Committee staff.”

And Clayback extended appreciation to the many organizations who’d gotten involved as well: “Special thanks to all the consumer, clinician, provider, and manufacturer individuals and national organizations for coming together. Consumer and clinician groups included the ITEM Coalition, United Spinal Association, Christopher and Dana Reeve Foundation, ALS Association, Spina Bifida Association, Paralyzed Veterans of America, Center for Medicare Advocacy, Clinician Task Force, and others. Provider and manufacturer groups included NRRTS, U.S. Rehab, AAHomecare, and RESNA.”

The final rule regarding the new funding policy was published Aug. 4 in the Federal Register. It states a change to policy “to reflect that complex rehabilitative manual wheelchairs, certain other manual wheelchairs, and accessories furnished in connection with these wheelchairs are excluded from the DMEPOS CBP [Competitive Bidding Program].”

A further explanation later in the final rule noted that CRT power wheelchair accessories were excluded from competitive bidding-derived pricing some time ago, and added that CRT manual wheelchair accessories would now be excluded as well: “This final rule also finalizes a Medicare provision adopted in an interim final rule with comment period published in the May 11, 2018, Federal Register … that excludes the fee schedule amounts for wheelchair accessories (including seating systems) and seat and back cushions furnished in connection with Group 3 or higher complex rehabilitative power wheelchairs from adjustments based on information from the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program.

“In response to public comments on the IFC [interim final rule with comment period] published in the May 11, 2018, Federal Register, we are also finalizing an extension of this policy to wheelchair accessories (including seating systems) and seat and back cushions furnished in connection with complex rehabilitative manual wheelchairs in this final rule.”

Read the final rule HERE.

 

About the Author

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

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