Page 8 - HME Business, August 2017

News / Trends / Analysis
CMS Exempts CRT Accessories from Bidding-Derived Pricing
Concerted advocacy push combined with sympathetic agency leadership and lawmaker involvement pays off with protection for CRT providers, patients.
In news that has relieved Complex Rehab Technology (CRT) providers and patients alike, CMS exempted accessories for powered CRT mobility devices from the application of competitive bidding- derived rates, as it had previously been doing for the national expansion of competitive bidding.
The news came after a frustrating fight by industry advocates to protect CRT accesso-
ries from the application of bidding rates, either directly or through rate structures derived from the bidding program.
Congress’s 2008 passage of Medicare Improvements for Patients and Providers Act (MIPPA) was supposed to protect CRT from competitive bidding. CRT was carved out of the program, and the lawmakers that passed it assumed that included all CRT items.
When CMS decided during the 2016 national expansion of competitive bidding that MIPPA didn’t apply to accessories, Congress followed with the CURES Act, which delayed the application of bidding-derived until July 1. The announcement from CMS extends that provision indefinitely.
“CMS is issuing a new policy on how adjust- ments to the fee schedule based on informa-
tion from competitive bidding programs apply to wheelchair accessories and back and seat cushions used with group 3 complex rehabilitative power wheelchairs,” the announcement stated. “Section 16005 of the 21st Century Cures Act currently
allows higher payments for these items but is
set to expire after June 30, 2017. By continuing these higher payments, this new action will help to protect access to complex rehabilitative power wheelchair accessories on which people with significant disabilities depend.”
That announcement is a “big win” for CRT providers, according to American Association for Homecare President and CEO Tom Ryan.
“CMS’s action ensures that individuals with significant disabilities will continue to have access to specialized technology that they depend on, which will also be welcome news for caregivers and medical professionals who support these individuals,” he said.
Ryan lauded HME providers, patients and advocacy groups for the hard work in convincing CMS that the change was needed.
“I’m especially appreciative of the terrific support that the National Coalition for Assistive and Rehab Technology, United Spinal Association and the ITEM Coalition lent to this effort, as well as the strong engagement from AAHomecare member companies that manufacture and provide mobility products,” he said. “When the HME industry and patient groups are strongly united on public policy initiatives, it sends a powerful message to regulatory agencies and Capitol Hill.”
Ryan also credited HHS Secretary Tom Price and CMS Administrator Seema Verma, as well
as lawmakers, for recognizing the seriousness of the issue. The House sign-on letter that attracted more than 150 signatures “helped send a strong message” that Congress considered protecting the items a priority.
“It’s clear that the new leadership at HHS and CMS understand the effectiveness of highly specialized CRT products and other essential HME products in meeting patient needs and reducing hospital stays and other costly clinical interven- tions,” he remarked. “We also appreciate the sustained advocacy of Senators Bob Casey (D-Pa.) and Rob Portman (R-Ohio), as well as Reps. Lee Zeldin (R-N.Y.) and John Larson (D-Conn.), who both helped secure the earlier legislative delays to bidding-derived cuts and also led Congressional efforts to secure a long-term solution on CRT.” n
Rural Relief Letter Garners Solid Support
As a follow-up to a siccessful House letter urging CMS and HHS to make regulatory changes, a Senate letter attracted signatures from nearly half the upper chamber.
Forty-six Senators committed to sign their names to a Congressional sign-on letter from Sens. John Thune (R-S.D.) and Heidi Heitkamp (D-N.D.) that urged HHS and CMS leadership to provide bidding relief for rural and non-bid area providers.
The American Association for Homecare initially reported the news that it had heard from its Capitol Hill sources that the lawmakers in the upper chamber would support the letter, which
was addressed to HHS and CMS leadership. The industry advocacy association made the the full text of the letter available online at bit.ly/2tPqGdX.
The letter is a follow-up to a similar letter
in the house co-authored by Reps. Cathy McMorris Rodgers (R-Wash.), Dave Loebsack (D-Iowa), Lee Zeldin (R-N.Y.) and Diana DeGette (D-Colo.). That letter received signatures from 154 lawmakers.
AAHomecare lauded Sens. Thun and
Heitkamp for spearheading the Senate letter, and also noted that credit was due to the VGM Group, the Midwest Association for Medical Equipment Services, and North Dakota and South Dakota providers for taking leader-
ship roles in this effort, as well the state and regional HME associations and industry advocates who asked their Senators to add their signatures. n
8 HMEBusiness | August 2017 | hme-business.com
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“CMS’s action ensures that individuals with significant disabilities will continue to have access to specialized technology that they depend on.”
— Tom Ryan,
American Association for Homecare