Page 8 - HME Business, Jan/Feb 2019

News / Trends / Analysis
CMS Might Add Ventilators, Braces to Bidding
H.R. 3730
Provisions Added
to Lame Duck
Medicaid Bill
The effort to protect accessories for manual CRT chairs sees a nail-biting legislative effort at the end of the 115th Congress.
In a last-minute legislative move made as this issue was going to press, the language of H.R. 3730, a
bill that would stop CMS from using competitive bidding-derived reimbursement for accessories used with manual CRT wheelchairs, was added to House Medicaid legislation that was up for a vote.
The Medicaid bill, H.R. 7217, the Improving Medicaid Programs and Opportunities for Eligible Beneficiaries Act (aka, the IMPROVE Act) was poised for a vote in the very final days of the 115th Congress. A vote was possible as part of “lame duck” legislative activity just before the Congress adjourned. If passed, the bill would move up to the Senate.
The two provisions in the Medicaid legislation salient to the CRT accessories are that:
• It permanently exempts CRT manual wheel- chair bases from competitive bidding.
•It provides an 18-month suspension to the application of competitive bidding payment rates for CRT manual wheelchair accessories, just like the CRT power wheelchair accessories. Accessories would go back to being paid at the traditional Medicare rates (in the same way as CRT power wheelchair accessories). The 18-month suspension runs from Jan. 1, 2019
to June 30, 2020, and would allow time for discussion to make a permanent policy change.
As this issue was going to press, Don Clayback, executive director of The National Coalition for Assistive & Rehab Technology (NCART), as well as representatives of the ITEM Coalition, the American Association for Homecare and VGM Government Relations were urging providers to impress upon lawmakers the need to approve these provisions.
This is great progress, but it still needs to get passed,” Clayback said. “... The House and Senate must hear from their constituents that this legis- lation needs to be passed this year [2018]. This would be a major win for access to CRT for people with disabilities.” n
Agency solicited public comments on the expansion; MedPAC had earlier identified comparatively high reimbursement for ventilators under Medicare.
CMS is planning on adding ventilators and back and knee braces to the next round of competitive bidding and is seeking public comments on that plan.
Readers might recall that in June The Medicare Payment Advisory Commission’s (MedPAC) iden- tified ventilators as among the non-competitively bid products that Medicare spends the most on, and recommended expanding the program.
In its announcement, CMS listed the various codes it was considering:
• Ventilators: E0465, E0466, E0467
• Off-The-Shelf Back Braces: L0450, L0455, L0457,
L0467, L0469, L0621, L0623, L0625, L0628, L0641,
L0642, L0643, L0648, L0649, L0650, L0651
• Off-The-Shelf Knee Braces: L1812, L1830, L1833,
L1836, L1848, L1850, L1851, L1852
“These new product categories will be phased-
in under all competitive bidding areas in the next round of the DMEPOS Competitive Bidding Program,” the announcement read.
CMS took public comments until Dec. 17, and providers were urged to send in their thoughts on the program given that ventilators are highly special- ized and serve patients with severe conditions.
Both the American Association for Homecare and VGM Government Relations said they were opposed to adding any of the products, and underscored the
need to protect ventilators in particular. “The thought of bidding such vital, life-
sustaining equipment such as an invasive ventilator is extremely concerning given the fact that there is a small provider population serving that venerable market,” a statement from VGM read.
“The prospect of adding ventilators to the bidding program should worry patients who depend on these highly specialized and service- intensive products, as well as clinicians and other caregivers who support this often-vulnerable patient population,” added AAHomecare.
“Ventilators are literally life support systems for the individuals who use them,” noted Tom Vorhees, CEO of PromptCare, which serves adult and pedi- atric ventilator patients in the Mid-Atlantic and Northeast regions. Sharing his comments in a state- ment from the American Association for Homecare, Vorhees added that “Including these products in the bidding program is guaranteed to reduce the number of companies with the experience and clinical expertise needed to serve this vulnerable patient cohort. If CMS’ decision to include venti- lators in competitive bidding results in a lack of access to these critically important products, the impacts on Medicare and Medicaid beneficiaries and their caregivers will be devastating.” n
Harmar Mobility Acquires Pride Mobility’s Lifts and Ramps Division
The acquisition will let Pride focus on its scooter and chair lines while allowing Harmar to bolster its vehicle lifts.
Pride Mobility Products Corp. has sold its Lifts and Ramps Division to Harmar Mobility LLC, a transaction will benefit both mobility companies.
Regarding the sale to Harmar, Pride Mobility Chairman and CEO, Scott Meuser, said “Our business
is about our consumers, and this change allows us to give consumers more of what they desire in our mobility products. We know that Harmar will continue to offer the same quality and support for our lifts and ramps, providing a seamless transition for our customers.”
While this arrangement allows Pride Mobility to focus their R&D on further innovation with their scooters, power chair and lift chair products, it also shores up Harmar’s line of vehicle lifts.
Steve Dawson, CEO of Harmar Mobility, notes, “The acquisition of the Pride Vehicle Lifts and Ramps division is consistent with our strategy to build on our leadership position in vehicle lifts. The Pride team has built an impressive product line and we are excited to continue to develop and grow these products alongside the Harmar brand.” n
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