When CRT Advocates Expect Relief Legislation

By Liz Carey

(May 10, 2018)—Applying steady pressure to pass two pieces of targeted legislation, complex rehab technology stakeholders joined recently for the 2018 National CRT Leadership and Advocacy Conference in Washington. In the days ahead, they’ll be following up on their Capitol Hill visits and looking for their priorities to pass either in forthcoming opioid legislation sooner, or upcoming Medicare legislation later this fall.

People with disabilities depend on complex rehabilitative equipment (CRT) to manage their medical needs, minimize their medical complications and health care costs and maximize their independence. Equipment and accessories that are tailored and available to meet individual needs can help prevent discomfort, pain and injury and maximize function.

“This is a small group of specialized products, and the people that use CRT rely on it for their livelihood, for their school, for their work, and if they don’t have this equipment, they’re sitting at home in bed,” said Don Clayback, executive director of the National Coalition for Assistive and Rehab Technology (NCART), which partnered with the National Registry of Rehabilitation Technology Suppliers (NRRTS) to host the annual conference. “With all the activity going on in Congress, we want to make sure the CRT legislation does not get lost in larger issues.”

Initial reports are positive and indicate strong Congressional awareness and bipartisan support for the pending CRT legislation, Clayback said.

CRT includes specialized wheelchairs, seating systems and other adaptive equipment such as standing devices and gait trainers. These individually configured products are widely used by people with high-level disabilities such as ALS, cerebral palsy, multiple sclerosis, muscular dystrophy, spinal cord injury and traumatic brain injury.

Complex rehab technology wheelchairs differ from standard wheelchairs. Individually configured to meet the specific needs of people with permanent disabilities, they are also vital to a small segment of Medicare wheelchair users, according to NRRTS and NCART.

The associations declared as urgent two bills: the “Protecting Beneficiary Access to Complex Rehab Technology” (S 486 and HR 3730); and HR 750 which is known as the “Ensuring Access to Quality Complex Rehab Technology Act.”

Priority one, the Protecting Beneficiary Access to Complex Rehab Technology legislation intends to stop Medicare from inappropriately applying Competitive Bidding Program payments to CRT manual wheelchair accessories. “Accessories” is a Medicare policy term but refers to all the components on a wheelchair, such as pressure relieving cushions, seat and back cushions, an adjustable headrest and specialty controls. “These are critical components of the wheelchair,” Clayback said.

The competitive bidding exclusion has already been applied to power wheelchairs. Advocates say the cuts must be stopped to protect access for the people with significant disabilities who depend on these specialized manual wheelchair systems. This bill currently has 21 cosponsors in the Senate and 87 cosponsors in the House.

Priority two, the “Ensuring Access to Quality Complex Rehab Technology Act” will create a separate benefit category for CRT within the Medicare program and make needed changes to improve coverage policies and safeguards. This bill currently has 99 cosponsors.

“Only about 10 percent of the Medicare population requires this type of individualized technology, but both the population and the type of equipment can easily get lost in the broader policies and spending around other types of DME like hospital beds, commodes and walkers, which are important in the home but are not as service intensive or individually configured,” Clayback said.

Passage of this CRT legislation is supported by more than 50 national consumer, disability and medical professional organizations, according to NCART.

“It’s gratifying to see a large group of the CRT community coming together in one place to move the mission of protecting CRT access forward. We want this National CRT Leadership and Advocacy Conference to continue to serve as a catalyst for more effective information sharing, collaboration and advocacy,” said NRRTS Executive Director Weesie Walker. “We appreciate our sponsors for making it possible to bring CRT consumers to the Hill as they have the most powerful message.”

Some 160 attendees represented all sectors of the CRT community at the annual conference that kicked off April 26. Thirty of the attendees were CRT wheelchair users who came to personally share their stories to legislators and advocates that included providers, manufacturers, consumers and consumer organizations, clinicians and clinical organizations, family and caregivers, researchers, and others from 36 states.