Each month "NCART News" delivers the latest Complex Rehab Technology (CRT) Medicare and Medicaid updates, advocacy opportunities, and event information all in one place. |
|
CMS Releases DME Proposed Rule |
|
On October 27 CMS issued Proposed Rule CMS-1738-P relating to Durable Medical Equipment (DME) that includes proposals regarding payment rates, coding, and other matters. The announcement is packed with information and here’s our initial overview:
- Manual CRT Wheelchairs- The proposed rule formally incorporates the CRT federal legislation passed in 2019, recognizing that CRT manual wheelchairs and accessories have a permanent exemption from inclusion in any future Medicare Competitive Bidding Program (CBP). It also incorporates details about the 18-month suspension of CMS using CBP information to set payment rates for CRT manual wheelchair accessories (which expires on June 30, 2021). It’s good to see these items officially included in the CMS proposed rule, but advocates need to continue to push CMS to “make permanent” the temporary Medicare CRT manual wheelchair accessory policy.
- Payment Rates for DME Items- The proposed rule continues current relief for DME provided in rural areas at the 50/50 blended rate while other non-bid areas will be paid at 100% of the adjusted fee schedule. For DME items that were included in Round 2021 but which have essentially been removed, CMS is considering extending the current fee schedule adjustment rules “until new SPAs are calculated for the items once competitive bidding of the items has been resumed”.
- HCPCS Coding- The proposed rule includes changes designed to make coding applications, reviews, and modifications easier and more transparent.
- Benefit Category and Payment Determinations for New DME- The proposed rule includes changes to increase inclusivity and transparency in the processing of benefit category determinations and payment determinations for new DME.
NCART is conducting a more in-depth review and will be carrying out further analysis before submitting formal comments on these proposals by the late-December due date. To see the full CMS Fact Sheet, click the button below.
|
|
Major Changes in Medicare
Competitive Bidding Program Implementation
|
|
On October 27 CMS made a major announcement regarding implementing its Medicare DME Competitive Bidding Program (CBP). CMS notified the public that they will not be moving forward with implementing Competitive Bidding in 13 of the 15 product categories that had been included in the request for bids. The only two categories in which CBP contracts will be awarded and effective on January 1, 2021 are: (a) Off-The-Shelf Back Braces and (b) Off-The-Shelf Knee Braces. Additional details are being sought. The DME industry will continue to work with CMS to ensure Medicare DME payment rates are set at sustainable levels to allow beneficiaries to obtain needed products and services. |
|
CMS recently issued proposed rule CMS-1734-P regarding Medicare payment policies for the physician fee schedule which included proposals relating to continuing the expanded telehealth policies once the Public Health Emergency (PHE) expires. Unfortunately it did not include physical therapy and occupational therapy in the recommendations for permanency, but they did ask for public input on this area. To address that flawed plan, NCART submitted comments in support of permanently authorizing physical and occupational therapists as telehealth practitioners and including the related physical and occupational therapy codes as authorized telehealth services. For a copy of the NCART letter to CMS, click the button below.
The CRT Remote Services Consortium continues to meet in developing guidelines and advocacy documents. NCART is also continuing to hold discussions with Congressional offices regarding the importance of a permanent telehealth option, how it applies to people with disabilities who require CRT, and the need for legislation to give CMS the authority to take the necessary actions.
|
|
November 12 CRT Industry Webinar |
|
|
|
Stay informed on post-election changes and what it all means for the CRT industry along with other important updates. This month’s CRT Industry Webinar, hosted by NCART, NRRTS, U.S. Rehab, and the Clinician Task Force, is scheduled for November 12 at 4:00 PM ET. Get registered today by clicking the button below. |
|
State Association Conference CRT Track |
|
State Associations play an important role in advocacy and rely on successful annual conferences for membership engagement and financial resources. With that in mind, NCART is partnering with U.S. Rehab to provide support by offering an educational track of CRT courses specifically for associations who are transitioning to virtual conferences. The track includes presentations by NCART and NCART manufacturer members and offers a broad selection of topics for attendees. We look forward to coordinating this program with State Association Executive Directors to help further advocacy at the state level. |
|
CRT Medicaid Work in October |
|
NCART continues its work on state-level issues that impact access to CRT. If you are currently dealing with a CRT issue within the Medicaid program please send us an email using the button below. Here is a summary of some of our October activity:
-
California – The state CRT workgroup continues to monitor state budget developments; discussions were held with the NCART lobbyist regarding state-related CRT payment issues and plans for 2021.
-
Illinois – The Illinois Department of Health and Family Services published and implemented a standing device coverage policy on September 17 that included recommendations made by the NCART workgroup; work is being done in conjunction with the Clinician Task Force on a draft Medicaid wheelchair coverage policy; a position paper has been developed for the NCART lobbyist to communicate with state legislators the need to avoid any Medicaid payment cuts to CRT.
-
New York – NCART is working with NEMEP and AAHomecare on policy changes being proposed by the New York State Department of Health relating to CRT evaluations and services; recommended changes to the proposal will be communicated to the Department.
-
Nevada – NCART attended a virtual Medical Care Advisory Committee Hearing on October 13; communication with the Nevada Division of Health Care Financing and Policy and the Lt. Governor’s office is ongoing regarding the 6% across-the-board rate reductions for all Medicaid providers.
-
Ohio – In response to public comments submitted by OAMES, NCART, and AA Homecare regarding state telehealth policy, the Ohio Department of Health announced that they will be adding the "wheelchair management" CPT code 97542 to their list of approved telehealth codes; discussions will continue during the implementation process.
-
Oklahoma – NCART submitted comments to the Oklahoma Health Care Authority MMCO Contracting Department regarding their Request for Proposal (RFP) to Medicaid Managed Care Organizations who will be contracted to manage the SoonerCare program; discussions are ongoing.
|
|
United Spinal Association's Tech Access Initiative |
|
NCART is proud to be involved in United Spinal Association’s Tech Access Initiative. The initiative brings together members and community partners to ensure accessible technology is inclusive to everyone, including wheelchair users.
Through active discussion, participation, and training with tech giants like Facebook, Verizon, Google, Microsoft, Teledoc, and Waymo, the Tech Access Initiative and its team of consumer advocates provides critical perspectives and insight to enhance cutting-edge technology so that is accessible to all. For more details, visit United Spinal’s site by clicking the button below.
|
|
NCART Welcomes New Members |
|
The NCART roster is growing which is great news for CRT advocacy! This month we proudly welcome both Laurel Medical Solutions (Ebensburg, PA) and People First Mobility (Buffalo, NY) as new NCART provider members. Both companies have a stellar history of not only providing quality CRT equipment and services to their communities, but also advocating for access at the federal and state levels. We’re thankful for their support and look forward to their participation in NCART initiatives.
If your company is not an NCART member, please consider joining before the year ends. The CRT industry needs a strong national association with unified involvement and support to help fight the ongoing negative trends in CRT coverage and payment. Your membership will enable us to continue advocating aggressively on behalf of you and your customers. For more information on becoming an NCART member, click the button below.
|
|
Monthly Motivation
"Make-Believe Made for Everyone"
|
|
Whether you're headed out for some safe and socially-distanced trick-or-treating or just getting dressed up for some Halloween fun at home this year, Target has some great costume options for everyone. Watch the video below to meet the designers and families who helped launch these creative costumes! |
|
NCART | info@ncart.us | 716-839-9728 | www.ncart.us
|
|
Follow us on social media: |
|
|
|
|
|
|
