CRT UPDATE

THE LATEST ON CRT ISSUES AND ACTIVITIES

Written by: DON CLAYBACK, EXECUTIVE DIRECTOR OF NCART

PREVENTING MEDICAID PAYMENT CUTS TO CRT

The potential of Medicaid payment cuts was identified as a2021 risk to Complex Rehab Technology (CRT) access given the financial impact that the COVID-19 pandemic was projected to have on state budgets. Accordingly, we have been monitoring state budget announcements and working with state associations and other stakeholders to minimize this threat.

To strengthen these efforts, we have developed a “No Cutsto CRT” tool kit for communicating with state legislatures and health departments. The tool kit includes a position paper with key CRT talking points, infographics with state Medicaid information, a summary of the CRT delivery process, and other information supporting the need to protect CRT from rate reductions that would reduce access. For more details, or torequest the tool kit for use in your state, email Mickae Lee atmlee@ncart.us.

STOPPING JULY 1 CUTS TO CRT MANUAL WHEELCHAIR ACCESSORIES

As we enter the month of April, the prospect of July 1 Medicare payment cuts to CRT manual wheelchair accessories looms as a threat to reduce access for those individuals who depend on this technology.

We are continuing the dialogue with the Centers for Medicare and Medicaid Services (CMS) to “make permanent” the Congressionally mandated 18-month suspension which stopped CMS from inappropriately applying Medicare Competitive Bid Program payment rates for “standard DME” items to set payment rates for the more specialized items used with CRT manual wheelchairs. To make this suspension permanent, CMS action is needed before the expiration on June 30.

NCART and other CRT industry stakeholders have provided analysis and recommendations to CMS as to the pathway to implement a permanent policy change. Unfortunately, CMS has yet to come to a decision if and when they will take the necessary action. This process has been complicated by the change in administration and the fact that a new Secretary of Health and Human Services and a new CMS administrator (the key decision-makers) have not yet been seated.

As soon as the new secretary and administrator are in place, we will be emphasizing the need for quick CMS action and engaging our Congressional champions to reinforce that request. We will keep the CRT community updated as we move ahead and seek grassroots engagement as needed.

PERMANENT CRT TELEHEALTH SERVICES

On the legislative front, the topic of telehealth is again generating much discussion in the first weeks of the new session of Congress. Of particular significance, on March 2 the House Committee on Energy and Commerce’s Subcommittee on Health held an over four-hour hearing entitled, “The Future of Telehealth: How COVID-19 Is Changing the Delivery of Virtual Care.” The hearing presented a robust discussion from committee members and invited witnesses regarding making telehealth options permanent beyond the public health emergency (PHE).

Several pieces of telehealth legislation have already been introduced this year. It is expected that a key bill impacting CRT access, the “Expanded Telehealth Access Act (ETAA),” will be reintroduced shortly by Reps. Mikie Sherrill, D-NJ, and David McKinley, R-WVa. This legislation gives CMS specific direction to authorize physical therapists, occupational therapists and speech language pathologists as permanent telehealth practitioners once the PHE expires — a key provision for the CRT provision process.

NCART and other CRT stakeholders continue to meet with Congressional staff to discuss the benefits of telehealth for individuals using CRT and requesting that any final Congressional legislation include language directing CMS to include physical therapists and occupational therapists as permanent authorized telehealth practitioners.

Here is some homework. Congress needs to hear from their constituents. CRT stakeholders are encouraged to use the links at www.protectmymobility.org to email their Members and request that any new legislation include the provisions that are important to maintain CRT access.

On the clinical practice front, new CRT telehealth information is available. Under the umbrella of the CRT Remote Services Consortium, the Clinician Task Force worked diligently to develop a document that offers guidance to clinicians considering telehealth for clients using CRT. We are happy to report the “Clinician’s Guide to Use of Telehealth for CRT Service Provision” has been released.

The guide offers a variety of information on determining when telehealth is an appropriate option for CRT. It includes a decision tree, tips for preparing for telehealth visits, sample case studies of the application in the CRT provision process, and other advice for those exploring telehealth.

Special thanks go to the Clinician Task Force for their leadership and development of this document and to the others in the CRT Remote Services Consortium who provided input. The guide can be downloaded at www.cliniciantaskforce.us or www.ncart.us.

ESTABLISHING COVERAGE OF POWER SEAT ELEVATION AND STANDING SYSTEMS

Our work with the Item Coalition led work group continues in engaging with CMS regarding the submitted request for Medicare coverage of power seat elevation and standing systems. We have had group discussions with CMS on the detailed information presented and those conversations will continue.

One of the next steps in the process will be CMS publishing a notice that the related National Coverage Determination (NCD) has been opened for reconsideration and seeking public comments. Upon this notice, there will be a 30-day public comment period during which organizations and individuals can provide responses to CMS in support of establishing Medicare coverage.

In addition to encouraging the submission of supportive publiccomments, the work ahead will involve further dialogue with the CMS review team, responding to questions or requests for additional information.

MONTHLY CRT INDUSTRY WEBINARS

It is important that CRT industry folks stay currenton news that impacts the coverage and provision ofCRT at the federal and state level. With that in mind, NCART, NRRTS, the Clinician Task Force and U.S.Rehab are continuing their monthly Industry Webinar series that began last year.

Topics are wide ranging, and presenters share timely information on important CRT matters. These webinars are offered at no cost and are recorded to enable the widest distribution. Recordings of past presentations can be found at www.ncart.us or www.nrrts.org. Watch for the monthly announcements or contact one of the organizations to get signed up.

BECOME AN NCART MEMBER

The need for a strong national CRT advocacy association focused on protecting CRT access has never been greater. NCART fills that need. A huge thank you goes out to our supplier and manufacturer members. It is their financial investment that enables us to fight the good fight, but we need others to add their support to meet the growing challenges.

Our mission is laser focused on promoting access to CRT. If you are a CRT supplier or manufacturer, that equates to protecting YOUR business and YOUR ability to serve YOUR customers. For information on becoming an NCART member, please visit the membership area at www.ncart.us

CONTACT THE AUTHOR Don may be reached at DCLAYBACK@NCART.US

Don Clayback is executive director of the National Coalition for Assistive and Rehab Technology (NCART). NCART is a national organization of Complex Rehab Technology (CRT) suppliers and manufacturers focused on ensuring individuals with disabilities have appropriate access to these products and services. In this role, he has responsibility for monitoring, analyzing, reporting and influencing legislative and regulatory activities. Clayback has more than 30 years of experience in the CRT and Home Medical Equipment industry as a supplier, consultant and advocate. He is actively involved in industry issues and a frequent speaker at state and national conferences.