Background: Complex Rehabilitation Technology (CRT) includes the complex and individually configured wheelchairs and equipment used by people with paralysis and other mobility impairments. Unfortunately, CRT is provided under the Durable Medical Equipment benefit in Medicare. This has historically created problems, including rules that the equipment could only be useful “in the home,” and that CRT is not available to people transitioning from nursing facilities back home.
This problem got worse with the creation of the competitive bidding program. While Congress exempted CRT power chairs from the program, they did not exempt CRT manual chairs. The federal Medicare office has also expanded the program several times. Implementation of competitive bidding has already caused problems across the nation with access to CRT and appropriate chairs.
Most recently, Medicare announced that they would include in competitive bidding all “accessories” of manual and power chairs. This includes seating systems, head rests, tilt and lift, and more. This will take effect January 1, 2016. This change will exacerbate existing problems and further limit access to appropriate equipment.
Current Action: Disability advocates – including the Christopher & Dana Reeve Foundation, working closely with NCIL, the Multiple Sclerosis Society, United Spinal Association, and the CRT providers in the National Coalition for Assistive Rehab Technology (NCART) – are working to address this problem with a two-pronged approach.
The Ensuring Access to Complex Rehabilitation Technology Act (H.R. 1516 / S. 1013) was introduced by Representatives Crowley (D-NY) and Sensenbrenner (R-WY) in the House and Senators Cochran (R-MS) and Schumer (D-NY) in the Senate. It would not only end competitive bidding for CRT, but would remove CRT from durable medical equipment entirely and end the “in the home” restriction. It would create a new benefit in Medicare for CRT with quality controls and a new, independent pricing system based on ensuring access.
H.R. 3229 – is a much smaller bill introduced by Representative Zeldin (R-NY) that would only solve the competitive bidding program. We are hoping to pass H.R. 3229 by January 1 to keep the problem from getting worse, then work on passing the larger bill.
Advocacy Campaign: We are launching an advocacy campaign to get more members of Congress to commit to supporting this bill. We worked with a company called Postcard that create a platform to where advocates can upload pictures, write messages, and create physical postcards to share the importance of CRT with Congress. Make your own postcard showing the importance of your chair, especially the “accessories” that are really necessities!
