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CMS Protects Access to Power Complex Rehabilitation Technology Accessories

June 23, 2017

The Centers for Medicare and Medicaid Services (CMS) issued a new guidance that protects access to complex rehabilitation technology (CRT) power wheelchair accessories by excluding them from Medicare’s Competitive Bidding Program. CRT refers to medically necessary products that require intricate programming, personalization, and evaluation, such as power wheelchairs and wheelchair accessories, which include head support systems, specialized seat cushions, and tilt-and-recline systems. CRT “accessories” are the fundamental components—such as tilt-and-recline systems and customized seat cushions—that make CRT usable and beneficial for people with significant disabilities. 

Under the durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) Competitive Bidding Program, CRT accessories would have been subject to lower rates that would have negatively impacted consumer access. Recognizing that these specialized products are vastly different from standard wheelchairs and accessories within DMEPOS, Congress had delayed this harmful policy twice—but CMS’s action permanently exempts CRT power accessories from this program and allows for much more open access to equipment that preserves independence and quality of life for people with significant disabilities. 

The guidance comes days before the July 1st deadline for CMS to reevaluate CRT fee schedule payments under Medicare, after which potential spending cuts to CRT providers and patients would go into effect. “This is a big win for disabled patients and their caregivers, who need these critically important products so they can live their lives to the fullest,” said Energy and Commerce Committee Chairman Greg Walden (R-OR). 

The Society applauds the Center for Medicare and Medicaid Services for clarifying that power CRT accessories are to be paid at traditional Medicare rates,” said Bari Talente, Executive Vice President for the National MS Society. “This will help ensure that people with progressed MS have access to fundamental components of wheelchairs like tilt-and-recline systems and customized seat cushions that keep them healthy and independent.” 

In addition to CMS for issuing this guidance, the Society thanks Congress for passing the previous delays in a bipartisan manner and coalition partners including the National Coalition for Assistive and Rehab Technology (NCART), the United Spinal Association and Paralyzed Veterans of America.

While we applaud the decision, the Society sees room for further improvement in access to CRT. Although CMS protected power CRT accessories from competitive bidding pricing, manual CRT accessories are still subject. The Society will continue working on protection for manual CRT accessories and another long-term solution—passage of H.R. 1361/S. 486, the Ensuring Access to Quality Complex Rehabilitation Technology Act. This bipartisan bill would streamline access to CRT by creating separate recognition under Medicare, enhancing quality standards for CRT suppliers, and clarifying coverage requirements for CRT. The bill would also exempt CRT products from Medicare’s “in-the-home” restriction, allowing beneficiaries to utilize their mobility devices to be active members of their community. 

Learn more about long term services and supports like complex rehabilitation technology. 

About Multiple Sclerosis

Multiple sclerosis is an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body. Symptoms range from numbness and tingling to blindness and paralysis. The progress, severity and specific symptoms of MS in any one person cannot yet be predicted, but advances in research and treatment are leading to better understanding and moving us closer to a world free of MS. Most people with MS are diagnosed between the ages of 20 and 50, with at least two to three times more women than men being diagnosed with the disease. MS affects more than 2.3 million people worldwide.

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