Kay Koch, OTR/L,ATP
The holiday season is upon us and while this may not be on your holiday wish list many people who use complex rehab wheelchairs would like it to be. HR 3730 has still not gotten the signatures needed to exempt Complex Rehab Manual Wheelchair Accessories from Competitive Bidding. Introduced in the house in September 2017, this bill amends title XVIII (Medicare) of the Social Security Act to prohibit the application of Medicare competitive acquisition rates to complex, rehabilitative, manual wheelchairs and accessories. (A competitive bidding program has replaced the use of established fee schedule amounts to determine payments under Medicare for certain durable medical equipment such as wheelchairs.) Will you contact your representative to wish them a happy holiday season and ask them to sign on?
It is important to recognize the label “accessories” is a Medicare policy term that does not properly convey that Complex Rehab wheelchair accessories are “critical components” such as seat/back pressure relieving cushions, positioning devices, recline/tilt systems, and specialty controls. These critical components are what allows the Complex Rehab wheelchair to be individually configured to meet the unique medical and functional needs of the person with a disability. The negative consequences of the current situation are not limited to just Medicare beneficiaries. They extend to children and adults with disabilities covered by Medicaid and other health insurances plans, since most payers follow Medicare policies.
Congressional action is required to provide equal access.
CMS has elected to group heterogeneous products under a single HCPCS billing code and as a result, the same code includes both Standard wheelchair accessories and Complex Rehab wheelchair accessories. Complex Rehab wheelchair accessories are different technologically, designed to meet a unique clinical need, and are costlier to provide than Standard products. CMS is taking information obtained through the competitive bidding of accessories used on standard wheelchairs and inappropriately applying that pricing to Complex Rehab accessories that were not part of the CBP ( Competitive Bid Program).
Congressional action is needed. This is a lingering issue that was not addressed in CMS’ June 23, 2017 policy correction. Accordingly, Congressional action is needed to stop CMS’ inappropriate application of CBP pricing and ensure equal access for Medicare beneficiaries and others with significant disabilities who rely on individually configured Complex Rehab manual wheelchairs. Representatives Zeldin and Larson, along with 41 original cosponsors, introduced H.R. 3730 on September 11, 2017 to replace the previous broader bill (H.R. 1361) and focus just on accessories used with Complex Rehab manual wheelchairs. This legislation must be passed as soon as possible. As of Dec 1, 2017, there are 24 Republican and 29 Democrat co-sponsors.
Please write or call your representative to ask for their support for this new legislation and to emphasize the importance of protecting patient access, not just to accessories used with complex rehab power wheelchairs, but also access to those used on complex rehab manual wheelchairs. Regardless of injury, illness, disability, or chronic condition, all Medicare beneficiaries should be eligible for the same access to medically necessary mobility devices, services, and accessories. Anything less can have serious consequences for beneficiaries. Urge Congress to pass H.R. 3730 to ensure that accessories used with CRT manual wheelchairs are protected. With the links below it will take less than 5 minutes of your time.
Please check this link here and contact your representative to either thank them for their support or ask for their support of this important legislation.
Thank you to www. NCART.us for the updates, new information and the following links:
Co-sponsors :
http://www.ncart.us/uploads/userfiles/files/HR%203730%20Cosponsors%20at%2012-1-17%20with%20Old%20Bill%20Cosponsors.pdf
Access2CRT.ORG for a link to email your representative :
http://cqrcengage.com/access2crt/app/write-a-letter?1&engagementId=395253