"Congressional Technical Correction Necessary to Clarify Exemption of Complex Rehab Wheelchair Accessories from Medicare Competitive Bidding - Congress Must Act To Protect Access for People with Disabilities

The Centers for Medicare and Medicaid Services (CMS) has announced that it will apply Competitive Bid Program (CBP) pricing to Complex Rehab wheelchair accessories effective January 1, 2016.  This violates the intent of past Congressional legislation and would inappropriately reduce payment rates for 171 product codes from 20% to 50%.  If not rescinded, this will hurt Medicare beneficiaries with significant disabilities as it will cause major decreases in availability (or outright elimination) of individually configured Complex Rehab wheelchair systems that these individuals rely on.  These access problems will also extend to children and adults with disabilities covered under Medicaid and other health insurance programs.

On April 20th the House of Representatives sent a 101 signature bipartisan letter to CMS led by Representatives Bill Johnson (R-OH), Diana DeGette (D-CO), Mike Kelly (R-PA), John Larson (D-CT), Devin Nunes (R-CA), and Dave Loebsack (D-IA).  The letter requested that “CMS issue written clarification that accessories used with complex rehabilitative power and manual wheelchairs will continue to be paid at Medicare established fee schedule amounts and that such amounts will not be adjusted based on Medicare competitive bidding program pricing.”  Unfortunately CMS has formally responded to the House letter stating that it does not intend to change its policy nor follow the Congressional recommendation.

Needed Congressional Action:  In order to protect access to this Complex Rehab equipment for Medicare beneficiaries and other people with disabilities, Congress needs to legislate a technical correction to clarify that CMS cannot apply Competitive Bid Program pricing information to accessories used with Complex Rehab power and manual wheelchairs to prevent CMS’ application of these payment reductions scheduled for January 1, 2016."

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CRT Stakeholders and Friends,

Thanks to everyone for taking the time to reach out to their Representatives over the past several weeks asking them to sign on to the House of Representatives letter to CMS regarding the application of Competitive Bid Pricing to Complex Rehab wheelchair accessories. As a result of all your efforts the letter will be going to CMS with 100 signatures! Attached is the list of signers by state.

This is an extremely impressive number, both in terms of quantity, and in terms of quality. The letter shows very strong BIPARTISAN support on the need to fix this problem with a blend of 52 Democrat and 48 Republican signatures. Even more important, of those 100 Members 34 are on either the key Ways & Means or Energy & Commerce Committees. These are the Representatives that OVERSEE the Medicare program on the House side.

More work lies ahead. The letter is a significant step toward a resolution, but we now must continue to work with our Congressional champions and CMS to get a formal rescission of the announced policy change and a commitment to maintain the current payment policy for Complex Rehab wheelchair accessories in 2016. Congress has asked CMS to respond to their request within 30 days.

Next week many of us will be in Washington for the National CRT Conference to carry the CRT message to Congress. Our conversations will focus on two areas: (a) the need for CMS to follow the Congressional request in the House letter, and (b) securing co-sponsors for the “Ensuring Access To Quality Complex Rehabilitation Act”.

We’re looking forward to a very productive week!


Don Clayback, Executive Director, NCART