As the name suggests, complex rehab technology (CRT) is complex, and our patients and their circumstances require a more specialized approach to care. U.S. Rehab fights and advocates for providers and patients at all levels of government, and we provide tools to help everyone get involved.
Keeping CRT Legislation a Priority
After many excellent meetings and conversations with members of Congress during the August recess, progress has been made with the current pieces of CRT legislation. As of October 1, 2019, the CRT manual wheelchair and accessory legislation (H.R. 2293) has 71 cosponsors and the senate companion bill, S. 1223, has 10 cosponsors. The separate benefit category legislation (H.R. 2408) has 33 cosponsors. This is excellent news, and we hope to keep this momentum going by continuing to advocate for these pieces of legislation and get them passed by the end of the year.
It is critical to keep these issues at the forefront of Congress’ mind as we move towards the end of the year. To keep CRT legislation a priority, we ask that you continue to follow up with your members of Congress and remind them to support these pieces of legislation if they haven’t already. To ask your member of Congress to support H.R 2293 and S. 1223, “Access to Complex Rehab Manual Wheelchair Accessories,” click here. To ask them to support H.R. 2408, “Ensuring Access to Quality Complex Rehabilitation Technology Act of 2019,” click here.
Manual CRT Legislation Clears More Hurdles in the House
On July 17, 2019, the House Energy & Commerce Committee approved H.R. 2328, the Reauthorizing and Extending America’s Community Health (REACH) Act, a bill containing CRT manual wheelchair and accessory legislation.
Specifically, this legislation will permanently remove manual CRT wheelchairs from the Competitive Bidding Program and suspend competitive bidding rates from being applied to manual CRT accessories for 12 months, beginning January 1, 2020. This bill, which was previously endorsed by the Energy & Commerce Health Subcommittee, continues to clear hurdles and gain support.
Read more here!
CRT Legislation Included in Veterans’ Health Care Bill; Participate in “August of Action” with VGM Government Relations
CRT Legislation Included in Veterans’ Health Care Bill
A new bipartisan health care legislation entitled the “HEARTS and Rural Relief” bill that relates to Veterans’ health care for returning troops (H.R. 3429) was approved unanimously by the Ways and Means Committee on June 26, 2019. This bill includes language from the CRT Manual Wheelchair bill (H.R. 2293) and, if passed, would stop Medicare from applying Competitive Bid payment rates to critical components (accessories) of Complex Rehab Manual Wheelchairs and will permanently exempt Complex Rehab Wheelchair systems from the Medicare Competitive Bidding Program. Bill H.R. 3429 is now positioned to be considered for a House floor vote.
Participate in “August of Action” with VGM Government Relations
As the August recess approaches, legislators have scheduled many town halls, lunches, and appointments with constituents back in their home states. That means that VGM’s “August of Action” will begin soon. Any concerns about CRT, competitive bidding, DME reimbursement and other issues need to be shared with congressional representatives and senators as we continue to educate our legislators on these concerns that affect our members and their customers.
Click here to read the full article.
Action Needed to Support CRT Legislation; DME Updates; VGM Advocacy Postcards Available
Last month, there were excellent strides for CRT legislation. We ask that members continue to contact their members of Congress and ask them to support H.R. 2293/S. 1223 (Complex Rehab Manual Wheelchair Bill) and H.R. 2408 (CRT Separate Benefit Category Bill).
Other updates include:
- Competitive Bidding Program: VGM’s Expanded Calculators are Available Now
- Oklahoma and Nevada Governors Sign Sales Tax Exempt Bill
- VGM Advocacy Postcards Available
Click here to read the full update.
CRT Legislation Gains Momentum in Time for National CRT Conference
In the last month, there has been a lot of momentum regarding CRT legislation. This momentum provided attendees of the National CRT Leadership and Advocacy Conference with an excellent opportunity to further advocate for CRT legislation. Click here to read more.
CRT Manual Wheelchair Accessory Bill Introduced
H.R. 2293, “Protecting Access to Complex Rehab Manual Wheelchairs Act,” was introduced on April 12 by Representatives John Larson (D-Conn.) and Lee Zeldin (R-N.Y.). This bipartisan legislation will permanently exclude manual complex rehabilitative technology (CRT) wheelchairs from the Competitive Bidding Program and will stop Medicare from applying competitive bidding rates to manual CRT wheelchair accessories for 18 months. This allows time to develop permanent policy change. Click here to read more.
Recapping March Legislative Efforts
Towards the end of March, there was a large amount of positive news in regards to CRT legislative efforts. These items of good news included discussions that occurred at the International Seating Symposium (ISS) in Pittsburgh, the recent passage of a separate benefit category legislation in Tennessee, and continued efforts by state associations, such as conversations at Big Sky AMES where CRT reimbursement concerns were addressed and an update from KMESA on Kentucky’s Medicaid MCO bill. Click here to read more.
CRT Advocacy Continues in 2019
U.S. Rehab and VGM Government Relations continue to keep members informed on any legislative updates that are made in the industry. Some new items that members should be aware of include the recent webinar discussing the 2019 legislative landscape, the passage, planning and monitoring of bills that protect and benefit the industry, and upcoming opportunities to advocate for the industry. Click here to read more.
Join U.S. Rehab at the National CRT Leadership and Advocacy Conference in May
Registration for the annual National CRT Leadership and Advocacy Conference is now open! Join U.S. Rehab and other industry stakeholders on May 1-2 at the Renaissance Arlington Capital View Hotel in Arlington, VA. Click here to learn more and to register.
No Action Taken on CRT Legislation
Last month, the original CRT manual wheelchair accessories bill - H.R. 3730 - was included in a new, larger Medicaid bill, H.R. 7217, also known as the IMPROVE Act. After passing the House on Dec. 11, the bill went to the Senate. However, this was not passed by the Senate before the end of the 115th Congress.
To read more, click here.
Monitoring the Progress of H.R. 7217
On December 7, 2018, important provisions for the CRT manual wheelchairs (including language from H.R. 3730) is now part of the Medicaid/CRT bill. This “IMPROVE Act,” also known as H.R. 7217, passed in the U.S. House of Representatives on December 11 and is currently under the Senate hotline process.
The CRT provisions in this bill include:
- A permanent exemption from the Medicare Competitive Bidding Program for CRT manual wheelchair bases (just like CRT Group 3 power wheelchairs).
- An 18-month “suspension” in Medicare’s Competitive Bidding Program payment rates to CRT manual wheelchair accessories. These accessories will go back to being paid at the traditional Medicare rates (just like CRT Group 3 power wheelchair accessories). The 18-month suspension goes from 1/1/19 to 6/30/20 and will allow time for the needed discussion to make a permanent policy change.
Click here to learn more.
Your Help is Needed – Protecting Complex Manual Wheelchair Users through H.R. 3730
Now that the midterm elections are over, there are several year-end priorities once the House and Senate return to Washington D.C. that must be completed before the 115th Congress adjourns. One of these priorities include the passage of H.R. 3730, which serves to prevent complex manual wheelchairs and accessories from being competitively bid. This legislation would restore appropriate Medicare payment rates for critical components of complex rehab manual wheelchairs. There are currently 119 cosponsors, and new representatives that come onboard help drive the demand for this important legislation to be passed. Read more.
Mark your calendars! NCART is organizing a National CRT Congressional Call-In Day on Wednesday, November 14 to get the attention of Members of Congress after elections to pass H.R. 3730. All CRT advocates are encouraged to participate in this post-election effort. More information from NCART will be provided soon!
Newly Released ESRD Final Rule Demonstrates CMS Falls Short On Protecting Patient Access To Medical Equipment
On November 1, 2018, CMS published the ESRD Final Rule (CMS-1691-F) containing information on Competitive Bidding Program (CBP) reforms and 2019 Medicare payment rates. Upon analysis from industry stakeholders, including NCART, AAHomecare and VGM Government Relations, the final rule issued by CMS, despite several acknowledgments of the current program being highly flawed, is extremely disappointing. CMS’ lack of definitive action does not protect patient accessibility, at least until a new round is set in place.
Click here to read more.
The Latest Mobility News on Capitol Hill
In recent years, there has been plenty of instability in the DME market due to many regulatory unknowns and plenty of, “we’ll wait and see what happens,” with reimbursement relief from the legislative (Congress) and executive branch (CMS) of the government. While both major regulations proposed by CMS leave plenty to be desired, they are a strong indication that the tides are changing CMS headquarters in Baltimore.
Breaking Down Two Major Sections of the CMS Proposed Rule:
1. Lead item bidding has the potential to simplify the bidding process but must be structured properly to protect patients.
2. Current CBA Contracts Expire and Changes to Reimbursement Rates
Click here to read more.
NCART Survey Highlights Major Decrease in Access
NCART recently conducted a survey of over 400 Medicare supplier locations to assess the impact of continued Medicare payment cuts to Complex Rehab manual wheelchair accessories. The results indicate that there has been a major decrease in access. Click here to read more.
New VGM Interactive Tool Allows Suppliers to See Where Reimbursement Lines Fall
This interactive map allows suppliers to assess where CMS has deemed rural, non-rural and competitive bidding areas. Whether a supplier wishes to explore new territory, find out which area a new patient resides in, or where the competitive bidding area lines are, this tool should prove to be helpful and informative.
Click here to view the interactive map.
New Leitten Study Provides Alternative Solution to Reduce Medicare Part A Costs
Leitten Consulting recently conducted a new study addressing cost shifts to Medicare Part A. This three-part study displays data for three areas where DME products are commonly used: fall injuries, COPD exacerbations, and untreated sleep apnea. The purpose of this study is to show that Medicare can allocate costs more appropriately by providing treatments up front while also providing better care to patients. Click here to read more!
From NCART: Cosponsor Update – Has Your Member Signed On?
In the two months since the 2018 National CRT Conference advocates have added 33 new cosponsors to our CRT legislation. That’s a great accomplishment! Thanks to those advocates for taking the time to build relationships with Members of Congress.
Congress will be taking their August recess in a few short weeks and are working on legislation that may be passed before then. Now is a great time to reach out to those offices who still haven’t signed on to CRT manual wheelchair accessories bills H.R. 3730 and S.486. Click here to ream more!
From the VGM Government Relations Team: Preparing for August of Action
With only about a month left until the August recess, Washington, D.C., legislators have scheduled a multitude of town halls, lunches, and appointments with constituents back in their home states.
This means that our “August of Action” is set to begin soon, and your voice is needed to continue building relationships that can help us make changes to Medicare policies in the fall. Any concerns about the IFR, competitive bidding, CRT, and other issues need to be shared with your congressional representative and senators as we continue to educate our legislators on all of these concerns that effect providers and beneficiaries.
Click here to read more!
CRT Win for Iowa: Governor Reynolds Vetoes Iowa Reuse Program Legislation
Just before the 2018 session came to a close, the Iowa Legislature added the authorization for Iowa Medicaid to create a reuse program for durable medical equipment and complex rehab. The legislation was pushed through the Health and Human Services Appropriations, Senate File 2418. In an announcement this afternoon, Governor Kim Reynolds has vetoed the section in the HHS appropriation which would authorize the reuse program.
Click here to read more!
I'm Just a Bill, a Manual Wheelchair Complex Rehab Accessory Bill (H.R. 3730) and I'm Standing Here on Capitol Hill!
Read about the 2018 National CRT Leadership and Advocacy Conference, where members of U.S. Rehab and the VGM Government Relations team met with members of Congress to gain support for H.R. 3730. This bill would exempt accessories that are being used on complex manual wheelchair bases from the competitive bidding rates. Click here to read more!
CRT Win For Wisconsin U.S. Rehab Members
The state of Wisconsin enacted The 2017 Wisconsin Act 306 on April 16, which focuses on assisting patients with complex rehabilitation needs. Advocates of the complex rehab technology (CRT) industry had a major impact in this effort by engaging with the community to push for legislation that protects patients with CRT needs.
Click here to read more.
White Paper Released: The Delivery of DMEPOS is in Jeopardy
"Do business with people who you like and who share your goals." - Warren Buffett
Each and every one of us enjoy working with people we like, just as Warren said. Some things are not that easy, however, as our business requires us to work with those that are not friendly, such as funding sources. CRT is not easy and our patients are not easy either. We are not standard DME and we are not able to competitively bid products and make it work because it is far too specialized. As a result, our patients and friends in this transaction have been let down by these funding sources.
We have to fight for them, and we at U.S. Rehab provide some tools to help do that together. We are putting a series of white papers together with a great deal of research and effort. These tools will give you the resources and ability to pass on to your congressional offices and/or lobbying friends who can help us get the message out. Please use this first white paper as part of a series of things that are not working to help the system. We are all about cost avoidance, not cost shifting. As you read the white paper, we show proven information throughout the market that helps the reader understand that we are a cost saver, not a cost driver. If you have questions, please let us know as we are here to help you, the industry and the patients.
The Delivery of DMEPOS is in Jeopardy
White Paper Resources
NCART: Decrease in CRT Providers
Jeffrey S. Baird, Esq, Billing Nonassigned
AAHomecare: HME Audit Key 2017
Jeffrey S. Baird, Esq, Selling at Retail
Kaiser Family Foundation, The Rising Cost of Living Longer, 2015
National Institute for Health Care Management Foundation, Concentration of Healthcare Spending Among Highest Spenders, 2013
Centers for Disease Control, 2017
Brian Leitten, How America Can Cut Waste, Save Billions & Improve Healthcare, 2017.
Gary A. Puckrein, Gail Nunlee-Bland, Farhad Zangeneh, Jaime A. Davidson, Robert A. Vigersky, Liou Xu, Christopher G. Parkin, and David G. Marrero, Impact of CMS Competitive Bidding Program on Medicare Beneficiary Safety and Access to Diabetes Testing Supplies: A Retrospective, Longitudinal Analysis, 2016.
U.S. Rehab continues to advocate for the CRT industry by participating in events such as the National CRT Leadership and Advocacy Conference in Arlington, VA each year.
It is essential for people to share their voices and show support for the access and protection for the CRT industry. Find the tools to reach out to your member of Congress by visiting www.access2crt.org.