NCART Adds New Regulatory Updates to the Newsletter!

NCART will be providing regulatory updates to our members to help them understand how regulations may affect their business. Julie Piriano, NCART Senior Director of Payer Relations and Regulatory Affairs, participates with DME MACs, RESNA, PDAC, and other organizations to inform NCART members of any changes. Below is a recent update sent out to NCART members. If you are not receiving these updates, please get in touch with Julie at Julie.Piriano@Ncart.us

Update - Are you Still having trouble getting Expandable Electronics covered / paid for?

On May 30, 2024 CGS republished the Power Wheelchair Electronics Clarification document, available here, that reminds providers of the following:

When two power seating functions/actuators/motors are provided, one unit of E2311 (electronic connection between wheelchair controller and two or more power seating system motors) is allowed. An expandable controller (E2377) and harness (E2313) are not allowed in this situation unless a specialty interface is used.

When three or more power seating functions/actuators/motors are provided, one unit of E2311 (electronic connection between wheelchair controller and two or more power seating system motors), one unit of E2377 (expandable controller), and one unit of E2313 (harness for upgrade to expandable controller) are allowed.

An expandable controller (E2377) and the wiring harness (E2313) are also allowed when a specialty interface is required, i.e., head control interface (E2327, E2328, E2329, E2330), sip-n-puff interface (E2325), joystick other than a standard proportional joystick (E2312, E2321, E2373), or multi-switch hand control interface (E2322).

This same clarification document is also available on Noridian’s website here.

As a reminder – For traditional (Part B) Medicare beneficiaries the E2310, E2311, E2313, and E2377 HCPCS codes are all eligible for voluntary prior authorization and the DME MAC contractors are all following the above criteria when affirming prior authorization requests for expandable electronics. It should be noted that they are also denying requests for expandable electronics if:

a.    There are not 3 or more medically necessary actuator motors; or,

b.    There is not a specialty drive input device needed to operate the power wheelchair.

While all Medicare Advantage (MA) Plans should be following this same interpretation of the policy, we are still hearing of challenges being experienced by our members. Therefore, NCART, in collaboration with the Clinician Task Force, is continuing to gather information to help fight improper MA denials. If you are interested in participating in this study please visit https://tinyurl.com/3k5mrvmy and complete the simple, 6 item survey.

NCART IN ACTION

• NCART participated with the ITEM Coalition to discuss language around future

repair regulations and/or legislation.

• NCART held their monthly call with NRRTS to discuss better ways to coordinate

our efforts.

• NCART held a call with the Connecticut lobbyists to discuss the law requirements

that go into effect on July 1, 2024.

• NCART hosted their bi-weekly payer relations/regulatory committee call.

• NCART submitted comments to a request from the Federal Aviation Administration

on wheelchair repairs.

• NCART participated in the Disability and Rehabilitation Research Projects Program

monthly call.

• NCART held its monthly California provider call to discuss issues with the

Department of Healthcare Services.

• NCART held a call with the Rhode Island lobbyists to discuss the ongoing right to

repair legislation.

LIVE from Waterloo, Iowa - HEARTLAND Conference

NCART was proud to participate in this week's VGM/US Rehab conference in Waterloo, Iowa. Many CRT providers and manufacturers attended (please see video below). Wayne Grau, NCART's Executive Director, participated in two panels about seat elevation and the ATP Assessment. Thank you to VGM/US Rehab, a very valuable member and partner, for including NCART in this great event.

NCART & US Rehab Legislative Day-

SAVE THE DATE!

Advocacy Quotes

“True advocacy is born from culture, not from technology or marketing” Jay Baer

NCART is the only national organization dedicating every effort and resource entirely to representing suppliers and manufacturers of Complex Rehab Technology (CRT) products. NCART is strictly focused on working with policymakers, legislators, and others to establish and maintain appropriate coverage and funding to protect and improve CRT access.

If your company provides or manufactures CRT, help us fight the negative trends in coverage and payment that continue to mount by becoming an NCART member. Your support will enable us to continue to advocate aggressively as we work to ensure that individuals with disabilities have access to the specialized equipment and services you provide.

You can easily and securely submit your application online by clicking the button below. For additional information or questions, please contact Wayne Grau, Executive Director, at wgrau@ncart.us or 570-902-9878.

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