CRT Stakeholders and Friends,

Your help is needed to stop the application of Competitive Bid pricing to Complex Rehab wheelchair accessories in 2016.  We need you to get your member in the House of Representatives to sign on to a BIPARTISAN Congressional letter that will be sent to CMS on this issue. The deadline to add their signature is 5:00 pm on April 15th, 2015. Below are more details.

As we’ve reported, CMS has indicated that effective January 1, 2016 they intend to apply Medicare Competitive Bid pricing to wheelchair accessories used on Complex Rehab wheelchairs. This is in violation of specific Congressional legislation and subsequent Medicare policy decisions that excluded Complex Rehab wheelchairs and related accessories from the Competitive Bid Program. This policy change would negatively impact up to 171 HCPCS billing codes and result in payment cuts ranging from 20% to 50%.

The attached NCART Position Paper provides more information. These cuts will create major access problems (or the elimination of access) for people with disabilities who rely on this specialized equipment. The negative consequences will extend beyond Medicare beneficiaries to other children and adults with disabilities covered by Medicaid and private health insurance plans since many other payers follow Medicare policy.

NCART Postition Paper

The only way CMS will change this policy is if Congress intervenes and compels them to. 

Thankfully 6 well respected members of the House of Representatives (Representatives Bill Johnson R-OH, Diana DeGette D-CO, Mike Kelly R-PA, David Loebsack D-IA, John Larson D-CT, and Devin Nunes R-CA) have co-authored a bipartisan Congressional letter to CMS. These individuals serve on either the Energy & Commerce or Ways & Means Committee, the committees having jurisdiction over the Medicare program. Their letter points out the problems and asks CMS to issue a rescission and maintain the current payment policy.

Here’s where your help is needed. Prior to sending this letter to CMS, the authors have sent a copy to their fellow Representatives asking them to add their names. This is referred to as a “sign on letter”. Our job is to get as many other Representatives as possible to “sign on” by  5:00 pm on April 15th. The more signatures, the more weight the letter will be given.

Attached is a copy of the letter to CMS with instructions as to how additional Representatives can sign on. This is the key document to share with your Representative.

CMS Complex Wheelchair Sign-on lettter

Attached is a “Call To Action” to get more CRT stakeholders informed and engaged. Please distribute this Call To Action to other groups and individuals that can be of help.

CRT Call to Action

This is an extremely serious threat to CRT access for both Medicare beneficiaries and for individuals enrolled in Medicaid and other health insurance plans. We need as many Representatives as possible to sign on to this letter to CMS by 5:00 pm on April 15th.  Without Congressional intervention, pricing for Complex Rehab wheelchair accessories will be reduced by 20% to 50% come January 1st.

Thanks for your immediate attention to this request.  Let us know if you have any questions or need additional information.

Regards,

Don Clayback, Executive Director, NCART