I am a fan of Aaron Copland’s music, and one of my favorites is “Fanfare for the Common Man.”
Changes in the last week or so have made me think a lot of “the common man,” as well as the work done every day by Complex Rehab Technology (CRT) professionals in a small, unsung specialty of healthcare.
On Nov. 5, the Medicare DME MAC contractors — CGS Administrators (jurisdictions B and C) and Noridian Healthcare Solutions (jurisdictions A and D) — released new local coverage determinations (LCDs) for seat elevation on non-complex Group 2 power chairs. The LCDs, which go into effect Dec. 20, include Medicare coverage criteria for HCPCS codes K0830 and K0831, which had been on track to be excluded.
“The final LCD is being amended to incorporate stakeholders’ suggestions received during the open comment period,” the DME MACs’ announcement said.
On Nov. 10, President Donald Trump signed into law H.R. 1703, the Choices for Increased Mobility Act. With this change, Medicare beneficiaries will more easily be able to upgrade from aluminum to titanium or carbon fiber ultralightweight wheelchair frames because they will pay only the upgrade charge — not the cost of the entire wheelchair up front.
That previous policy — fronting thousands of dollars to pay for the entire chair, then waiting for partial reimbursement — had precluded some wheelchair riders from exercising their freedom of choice.
For both seat elevation and the frame upgrade, CRT advocates — both professionals and consumers — worked for years, scheduling countless meetings and educational discussions. There were conversations on Capitol Hill and product demonstrations in congressional offices.
The frame upgrade bill had been introduced before, in September 2023 as a House bill. And while it did not become law before the 118th Congress ended, this time — in the 119th Congress — this little bill-that-could made it through hearings, committee meetings and votes, through both chambers of Congress, and to the president’s desk, where it was signed into law as a stand-alone measure, rather than folded into a larger appropriations package.
As a former Schoolhouse Rock kid, I love imagining H.R. 1703 laboriously climbing those Capitol Hill steps, all alone, occasionally stumbling and sliding down to the bottom — but dusting itself off and starting its climb again.
CRT policy changes don’t make huge New York Times headlines. They don’t go viral or become memes. They aren’t adopted by mega-celebrities, and they don’t happen quickly. They are achieved through years of hard work, sure, but more than that, they are achieved through years of consistent, ongoing work.
And when policy changes and laws are achieved, it’s thanks to the determination of steadfast CRT warriors who keep going for as long as it takes.
There is nothing “common” about your knowledge and expertise, your dedication to more functional client outcomes, or your passion for advancing technology and access.
But the world would be a better place if your devotion were more common. Cheers. Well done.
