December 2021
Each month "NCART News" delivers the latest Complex Rehab Technology (CRT) Medicare and Medicaid updates, advocacy opportunities, and event information all in one place.
Goodbye 2021, Hello 2022
Hard to believe we have come to the end of 2021. It has certainly been another challenging year for our country and ourselves dealing with the COVID-19 pandemic and many other issues.
 
Throughout the year there was no shortage of work to be done to protect and improve CRT access for people with disabilities. But thankfully once again the CRT community came together with determination and dedication to produce positive results that we can celebrate and build on.
 
The CRT community’s targeted multi-year work finally paid off in getting CRT manual wheelchair accessories PERMANENTLY protected from Medicare’s Competitive Bidding Program (CBP) pricing in July and excluded from any future CBPs. This was a major win for people who depend on CRT manual wheelchairs and we thank all our advocates, organizations, Congressional champions, and CMS for making this a reality.
 
We have made significant progress with the ITEM Coalition and others in pursuing Medicare coverage of power seat elevation and standing systems. We have continued to keep the importance of CRT access included in Congressional discussions regarding Telehealth flexibilities and needed COVID-19 relief to enable the CRT industry to continue to supply its important products and services.
 
We have also made progress on state Medicaid issues and legislation, increased policymakers’ understanding of CRT, added to our advocacy resources, held a successful and first-ever virtual CRT Congressional Fly-In in partnership with NRRTS, and saw increased engagement from individual consumers and national organizations throughout the year.
 
The collective work in 2021 sets the stage for more progress (and work) in 2022. As we enter the new year, there remains much to be done to continue to protect and improve access to CRT for people with disabilities. Our 2022 CRT initiatives include:

  • Obtaining Medicare coverage of power seat elevation and power standing systems (along with appropriate coding and payment rates).
  • Obtaining relief/assistance for COVID-19 impacts such as supply chain issues and increased operating challenges/costs that manufacturers and providers are fighting through to supply their products and services.
  • Obtaining permanent availability of CRT Telehealth services (PT/OT) to ensure remote access beyond the expiration of the Public Health Emergency.
  • Obtaining needed changes in the area of CRT wheelchair service and repairs to improve coverage, funding, and response time.
  • Building on current state advocacy and increasing activities and tools to prevent Medicaid payment cuts, enforce adherence to federal access regulations and policies, and communicate the benefits and cost-savings that access to CRT brings.

We hope everyone has had time to enjoy the holidays this month. Thanks for all that you do to support CRT access and best wishes for a very Healthy and Happy New Year!
Medicare DME Final Rule
As reported earlier this month, CMS has released the long-awaited Medicare DMEPOS Final Rule (CMS-1738-F, CMS-1687-F, and CMS-5531-F). You can read the Final Rule here and reference the Fact Sheet here.

This includes provisions regarding the application of Medicare Competitive Bidding Program (CBP) payment rates that will go into effect at the end of the COVID-19 Public Health Emergency (PHE):

  • For rural and non-contiguous areas, CMS will continue paying suppliers the 50/50 blend of adjusted and unadjusted fee schedule rates.
  • For contiguous, non-rural areas, CMS will change to paying suppliers at 100 percent of the CBP adjusted fee schedule rates.
  • For the former Competitive Bid Areas (CBAs), CMS will change to paying suppliers the single payment amounts (SPAs) established during the DMEPOS CBP updated by an inflation adjustment factor on an annual basis.

While this provided some relief to rural areas, it did not provide the full payment relief that was requested in other areas. It does make permanent the 50/50 blended payment rate for rural and non-contiguous areas. However, it fails to address the needs in other areas of the country by not continuing the current 75/25 blended payment rate for non-rural areas beyond the end of the COVID-19 PHE. It also does not adjust payment rates in former CBAs to reflect the significant increases in product and operational costs for suppliers since the last completed CBP round in 2015.

The final rule also discloses that CMS has decided to hold off on finalizing any changes to the HCPCS Code Application process. For now, they will continue to review the current system and consider changes in the future.
Medicare Seat Elevation and Standing Coverage
NCART participated in a December 22 meeting on this initiative with CMS leadership as part of the ITEM Coalition Workgroup. The purpose of the meeting was to present Dr. Meena Seshamani, CMS Deputy Administrator and Director of the Center for Medicare, an overview of the request for Medicare coverage of power seat elevation and standing systems and, most importantly, discuss overdue needed CMS action.

The discussion allowed for another review of the medical need and basis for Medicare to cover this important technology. ITEM Workgroup speakers included both consumers and clinicians who were able to highlight the needs of and benefits for people with disabilities. We also stressed the fact that this application was submitted in September 2020, accepted as complete in November 2020, but over a year has gone by and CMS has not yet moved to the next step in the formal review process.

The CMS team acknowledged they understand this is an important request and it has support from the CRT community and Congress. They shared there have been multiple internal meetings on the topic. While they could not commit to any specific timing on next actions at this time, they said they will continue their internal review and keep us updated.

The next step in formal process is for CMS to announce the reopening of the National Coverage Determination (NCD) Reconsideration and allow for organizations and individuals to submit input during a 30-day public comment period. We will continue to urge CMS to move ahead expeditiously and will share updates on progress.
Continued COVID-19 Challenges
CRT providers and manufacturers are committed to getting people with disabilities access to the important CRT products and supporting services they need to maintain their independence and health. However, the companies and staff continue to face significant COVID-19 related challenges including the following:

  • Increased payroll expenses due to the need to retain qualified staff.
  • Increased freight charges.
  • Difficulties in obtaining products and supplies in a timely manner due to supply chain challenges.
  • Increased raw material costs, product costs, and related surcharges.
  • Increased distribution and delivery expenses related to higher gas prices.
  • Increased costs related to Personal Protective Equipment and other safeguards provided to both employees and customers.

We will continue to work with other industry organizations to push this message with Congress and policymakers as we move into 2022. Our goal will be to seek the needed support and relief that CRT providers and manufacturers require to provide timely access to their customers.
CRT Telehealth After the PHE
Congress continues to deliberate which of the current COVID-19 related telehealth flexibilities will be made permanent following the Public Health Emergency (PHE). CRT stakeholders have been communicating to their Members of Congress that telehealth flexibilities for CRT must be made permanent beyond the PHE to continue to offer needed CRT options and important benefits to individuals with disabilities.

The CRT Telehealth Position Paper can be found at www.protectmymobility.org. We are asking all CRT advocates to use the link at this website to send a pre-written email to their Members of Congress asking for support. Please click the button below and take three minutes to send your message to help ensure continued access.
Medicare Cuts Partially Halted
In December, legislation was passed and signed that will minimize/defer scheduled 2022 Medicare cuts that would have severely impacted the ability of CRT providers to supply the specialized technology and supporting services that people with disabilities and chronic medical conditions depend on.

There were two Medicare payment cuts scheduled for implementation in 2022. A reinstatement of the 2% Medicare sequestration reduction (tied to a budget bill passed in 2011) and a 4% PAYGO reduction (tied to increased spending for COVID-19). The 2% Medicare sequestration reduction will be gradually reinstated in 2022: 1% as of April 1 and the full 2% as of July 1. The 4% PAYGO reduction will be deferred until at least 2023.

While this did not provide complete relief, it helped to minimize the negative impacts. Thanks to everyone for taking action to protect access, to all the other organizations who weighed in, and to Congress and the President for making this happen.
NCART State CRT Work
State coverage and funding play a key role in the availability and provision of CRT products and supporting services. NCART places a priority on this area and offers providers and policymakers strategic advice and assistance on state issues relating to the coverage, funding, and provision of CRT.

When a significant access issue regarding CRT is identified, NCART's Payor Relations Committee and state workgroups convene to assist providers, manufacturers, state associations, and others in reviewing the problem, identifying potential resolutions, developing related resources, and taking action.

In 2021, NCART and the Payor Relations Committee worked to protect critical access in over 20 states. 2022 plans to request state payment increases where appropriate, exclude CRT from any reimbursement cuts, and improve service and repair access have already begun.

There are a number of helpful materials on our educational materials page, or you can click the button below to request NCART assistance.
December CRT Industry Webinar Recording
On December 14 NCART, NRRTS, U.S. Rehab, and the Clinician Task Force hosted the final CRT Industry Webinar of 2021. Panelists presented key CRT industry and advocacy information to prepare attendees for the year ahead. Topics included CPI-U payment adjustment details, advocacy updates, new resources from the Clinician Task Force, upcoming education from NRRTS, and a presentation from the ITEM Coalition.

You can view the recording of December's presentation here and download a copy of the handout here. We are currently planning our 2022 CRT Industry Webinars and will share those details in January. Be sure to watch for updates and stay informed about matters that impact CRT access!
HME Woman of the Year: Katie Stevens
NCART extends hearty congratulations to the VGM Group’s 2021 HME Woman of the Year, Katie Stevens. She is the CEO of Reliable Medical, headquartered in Brooklyn Park, MN.

Katie began her industry career in 2006 and has dedicated her time to improving outcomes for the industry and for individuals with complex medical equipment needs. As CEO, she is steering the full-line HME/CRT company toward continued growth and success.

Reliable Medical is a longstanding member of NCART and we are grateful for their support and partnership as we advocate to protect access to the critical equipment and services they provide.

We also want to recognize all of this year’s other nominees for their leadership and contributions to the industry. Congratulations to Trisha Bailey, CEO at Medical Hotspots Inc./Bailey’s Medical; Neidi Mack, Vice President for Ancillary Services at Prism Health Care Services/The Alden Network; and Victoria Peterson, Administrator at RespMed. Thanks for all that you do.
Start 2022 with NCART Membership
Christmas came early for NCART in the form of two new members before the close of 2021. We are proud to announce the addition of new supplier member, Alpine Home Medical, and new manufacturer member, Matia Robotics.

Alpine Home Medical has ten locations across Utah and Idaho and has been providing excellent CRT products and services to their community for many years.

Matia Robotics, a global manufacturer dedicated to providing innovative solutions for individuals with disabilities, has been engineering across the globe since 2006.

Thank you to both organizations for adding their support to CRT advocacy work. We couldn’t be prouder to be working alongside each of our member companies to protect access to CRT and want to continue to expand our advocacy reach.

The financial support of dedicated CRT providers and manufacturers is the foundation that enables NCART to carry out our important advocacy work. If your company provides or manufactures CRT and you aren’t yet an NCART member, please consider joining other dedicated CRT companies to help fight the negative trends in coverage and payment. Learn more by clicking the button below.
Register for ISS 2022
The International Seating Symposium (ISS) is the world's leading educational conference and exhibition on the topic of Wheelchair Seating, Mobility, and Associated Assistive Technologies. Attendees include clinicians, consumers, advocates, researchers, providers, manufacturers, and policymakers from over 30 nations. 

The ISS is being held as a hybrid event on January 31-February 2. This offers both a traditional in-person conference as well as a virtual conference with live-streamed courses through the attendee hub. Click below to visit the ISS website and get registered today!
Monthly Motivation
A Fresh Start
A new year is always a great time for fresh starts and adventures. In the video below, world-renown disability advocate Judy Huemann shares details about her own start in the world of fighting for disability rights. Click below to lear how she began her journey, why advocacy is so important, and how it does make a difference!

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