AAHomecare members are experts in providing standard and power wheelchairs, mobility equipment, and complex power mobility devices designed to meet patient-specific needs. Our members focus on providing high-quality, personalized service and ensuring access to necessary accessories and equipment.
AAHomecare members can find more information and get involved in shaping policy for this issue through the Complex Rehab & Mobility Council. For in-depth commentary on pending legislation and regulations, go to Analysis and Comments, Testimony & Official Statements.
Key Issue - Proposed Cuts for CRT Accessories
Congress Must Act to Protect Access for People with Disabilities—Support H.R. 3229 & S. 2196
The Centers for Medicare and Medicaid Services (CMS) began applying Competitive Bid Program (CBP) pricing to Complex Rehab manual wheelchair accessories on January 1, 2016 and will begin applying CBP pricing to Complex Rehab power wheelchair accessories on January 1, 2107 after a one year statutory delay by Congress via S 2425 Patient Access & Medicare Protection Act of 2015.
Implementing these prices violate the intent of past Congressional legislation and will create significant access problems for Medicare beneficiaries and other people with disabilities. CMS has refused a formal Congressional request to rescind this policy; therefore, Congress must pass clarifying legislation to accomplish this because:
It violates Congressional intent. CMS’ policy violates Congress’ intent when it passed legislation requiring CMS to exempt Complex Rehab power wheelchairs and accessories from the CBP through the Medicare Improvements for Patients and Providers Act of 2008.
It conflicts with Medicare policies. It is contrary to current Medicare policies created by CMS following the legislation which stipulate that accessories used on Complex Rehab manual and power wheelchairs are to be paid at traditional fee schedule amounts.
It is based off pricing of dissimilar items. CMS is using information obtained through the bidding of accessories used on Standard wheelchairs and inappropriately applying that pricing to Complex Rehab accessories that were not part of the CBP. CMS elected to group heterogeneous products under the same HCPCS codes; as result, the same codes includes both Standard and Complex Rehab wheelchair accessories. Those products are fundamentally different, and bidding suppliers did not consider Complex Rehab accessories when submitting their bids as Complex Rehab wheelchairs and related accessories were not part of the CBP.
It is based off old, limited pricing information. CMS is using extremely limited information from a sample size of 174 power wheelchairs in nine cities in 2008. Moreover, the CBP worksheet provided to suppliers indicated usage for many of the accessories between only 1 unit and 5 units per year. CMS plans to apply this grossly inadequate, 8 year old data to Complex Rehab accessories used on a national universe of over 15,000 Complex Rehab power wheelchairs.
It detrimentally affects the disabled population. The negative consequences will not be limited to just the Medicare program but will extend to children and adults with disabilities covered by Medicaid and other health insurance plans since most other payers follow Medicare policies.
AAHomecare urges support for H.R. 3229 and S. 2196, legislation to confirm original Congressional intent to exempt CRT wheelchairs and accessories from the bidding program.
Lean more in our Issue Brief: Protect Complex Rehab Wheelchair Accessories from Competitive Bidding-derived Pricing
Send a message to Capitol Hill in support of this legislation.
News & Information
Legislation to Introduce Complex Rehab Accessories Introduced in Senate (October 22, 2015)
AAHomecare and NCART Applaud Rep. Zeldin for Legislation to Protect CRT Accessories (July 28, 2015)
CRT Sign On Letter List of Signatures (April 22, 2015)
CMS Repair Claim Guidance ( August 25, 2014)
AAHomecare Comments on Prior Authorization Proposed Rule (July 25, 2014)
CMS Notice of PMD Prior Authorization Expansion (July 28, 2014)
AAHomecare Letter to CMS on Wheelchair Repairs (November 20, 2013)
Separate Benefit Category for Complex Rehab Technology Legislation (H.R. 942 & S. 948)
AAHomecare Letter to the Associated Press (April 5, 2013)
Prior Authorization for Power Mobility Devices Demonstration Issue Brief (October 11, 2012)
Citing Lack of Information, Providers Seek 30-Day Delay in Medicare’s “Prior Authorization” Program for Wheelchairs (August 27, 2012)
Homecare Community Dismayed that Prior Authorization Demo for Wheelchairs Lacks Clinical Template (August 7, 2012)
Homecare Providers and Consumer Advocates Urge Congress to Stop Ineffective Medicare Payment Review Process for Mobility Equipment (December 8, 2011)
AAHomecare Says OIG Report on Power Wheelchairs Shows that CMS Must Do More to Educate Physicians (July 11, 2011)
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