CRT’s New Dawn
It’s time for editors to recap the year — the good and the bad. Part of that task — part of my responsibility — is to balance the year’s challenges (which are never in short supply) with good news, even if the “good” items are mere silver linings.
But 2023 was the year that the Centers for Medicare & Medicaid Services (CMS) agreed to Medicare coverage for power seat elevation on power wheelchairs for qualifying beneficiaries. Seat elevation coverage comes after decades of advocacy from the Complex Rehab Technology (CRT) industry. And this was the year of H.R. 5371, the Choices for Increased Mobility Act, which re-establishes a path for Medicare beneficiaries to pay out of pocket to upgrade to a titanium or carbon fiber frame for their ultralightweight wheelchairs.
Our H.R. 5371 story (page 11) discusses how the bill could have a larger impact, since the ultimate theme of the bill — and of this overall advocacy effort — is to give wheelchair riders greater freedom of choice regarding wheelchair configurations and technological advances that could result in better functional and long-term outcomes.
So this bill feels different. H.R. 5371 isn’t the first time the CRT industry has turned to Congress for legislation regarding funding and policy. But this bill seems different because unlike previous legislative efforts (competitive bidding exemptions, for example), H.R. 5371 goes on offense.
Rather than being reactive and desperately defensive, H.R. 5371 is about wheelchair riders claiming the common-sense right to pay to upgrade to titanium or carbon fiber. This legislation wouldn’t cost the Medicare fund any additional money. Riders are saying, “Give us the right to make our own choices as consumers, at our own cost.”
As with any legislation or policy that goes into the books, the bill could set a precedent. One of the issues that some stakeholders have expressed about 5371 is that it provides a pathway to better outcomes for riders who can afford to upgrade. Those who can’t afford to upgrade would be left out — and that’s a significant number, given the perpetual problem of under- and unemployment among people with disabilities.
But the bill could be the first step toward expanding freedom of choice. If clinicians and researchers can document better outcomes from custom configurations, for example, shouldn’t all wheelchair riders benefit? While so many previous years were about building protective barricades, 2023 will be known as the year that CRT saw a new dawn.
Laurie Watanabe, Editor