December 2022
Each month "NCART News" delivers the latest Complex Rehab Technology (CRT) Medicare and Medicaid updates, advocacy opportunities, and event information all in one place.
Focusing on the Future of CRT in 2023
Throughout 2022, NCART focused on a wide variety of priorities to address challenges faced by the Complex Rehab Technology (CRT) community. These included coordinating the coverage determination process for power seat elevation and power standing systems, along with pursuing solutions to multiple CRT coverage and payment issues at the federal and state levels. It has been a very busy year. We thank all our NCART Members and our advocacy partners for the contributions they made in these efforts.

The work accomplished this year sets the stage for more progress in 2023. 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 2023 CRT initiatives include:

  • Establishing Medicare coverage of power seat elevation and power standing systems (along with appropriate coding and payment rates).
  • Obtaining fee schedule relief to address increased operating costs that manufacturers and providers are fighting through to supply their products and services.
  • Securing needed reform 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 and look forward to working with all of you in 2023. Thanks for all that you do to support CRT access and best wishes for a very healthy and Happy New Year!
Reimbursement Relief is Needed
CRT providers and manufacturers are committed to supplying important CRT products and supporting services to individuals with disabilities. However, these companies and their staff continue to face significant challenges that must be addressed:

  • Increased payroll expenses due to the need to retain qualified staff.
  • Increased freight charges.
  • Difficulties in obtaining products and supplies in a timely manner.
  • Increased raw material costs, product costs, and surcharges.
  • Increased distribution and delivery expenses.

We will continue to work alongside other industry organizations to push this message on the federal and state level in 2023. Our goal will be to seek the needed support and relief that CRT providers and manufacturers require to provide timely access to their customers.
Wins for the CRT Industry in Omnibus Bill
Last week, Omnibus legislation was passed that secures several wins for CRT and DME providers. The President is expected to sign the legislation into law this week.

The new Government spending bill defers scheduled Medicare pay-as-you-go, or PAYGO, cuts that would have implemented a 4% cut to providers effective 1/1/2023. Those reductions will now be delayed until 2025. The bill also extends the blended 75/25 Medicare rates through the end of the Public Health Emergency or December 2023; whichever is sooner.

Additionally, the bill extended current COVID-19 telehealth flexibilities through December 2024. That means that Physical and Occupational Therapists will be able to utilize telehealth with individuals who utilize CRT when getting to a clinic isn’t an available option.

Thanks to all the organizations who weighed in and communicated stakeholder needs, and to Congress and the President for making this happen. Advocacy work will continue in 2023 to see these provisions become permanent for NCART providers. 
Medicare CPI-U Adjustments are 8.7 - 9.1% Increase for CRT
On December 1, the Centers for Medicare and Medicaid Services (CMS) released the quarterly fee schedule update for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS), which includes Complex Rehab Technology equipment and services. The update included the 2023 Medicare CPI-U adjustments, which is an inflation factor that is determined annually and applied to DMEPOS effective January 1. The 2023 adjustments are listed below:

  • Competitive Bidding Program items in former Competitive Bid Areas: +6.4%
  • Competitive Bidding Program items in non-Competitive Bid Areas: +9.1%
  • Non-Competitive Bidding Program items (this includes CRT): +8.7%

These adjustments were considered a positive development by some CRT providers; however, much work still remains to address the increased costs of doing business that the CRT industry has been experiencing. 
State CRT Work
The Local Fight for Improved Coverage and Funding
Coverage and funding at the state level play a key role in the availability and provision of CRT products and supporting services. NCART offers providers, manufacturers, associations, and policy makers strategic advice and direct advocacy on state issues to protect and improve access to CRT.

When a significant access issue is identified within a state, NCART's Payer Relations Committee and our state workgroups convene to review the problem, identify needed solutions, and implement the necessary advocacy plans. Below is a summary of some of our ongoing work:
Alaska – An NCART provider workgroup has made requests that include changes to reimbursement and administrative simplification. NCART has provided supporting information to the Department and the most recent meeting was held on 11/30; Department feedback is anticipated in late December.

California – An NCART stakeholder workgroup continues meeting monthly to actively pursue improving access to CRT through the Medi-Cal program and to identify opportunities for CRT within the Cal-AIM program. Meetings with both the Department and state legislators were held in November and December to discuss the upcoming session and opportunities for CRT legislation.

Maine – NCART met with HOMES and provider members regarding rate adjustments scheduled for 1/1/23 that will impact CRT codes; comments were submitted on 12/15 to convey concerns and recommendations.

Massachusetts – Legislation impacting CRT wheelchairs was unexpectedly passed out of committee and engrossed in the Senate during their informal session. NCART and an industry stakeholder workgroup have updated needed resources and conducted outreach to House leadership; NCART and others will be meeting with legislators throughout the remainder of the session, which ends on January 3.

Nevada – An NCART provider group summarized current challenges impacting access to care and has made initial requests to the Department; additional information has been submitted to the Department and NCART is meeting with Department leadership on 12/19 to continue discussing proposed solutions and an implementation timeline.
HME Woman of the Year - Sherry Krug
Congratulations to Sherry Krug, who was awarded VGM & Associates 2022 HME Woman of the Year during a special virtual ceremony held on December 15. Krug joined Binson’s Medical Equipment & Supplies in 2020 as their Vice President of Business Development and was applauded for her effectiveness and her leadership. VGM has posted a video of the award ceremony here.
Binson’s Medical Equipment & Supplies is a dedicated NCART supplier member and we are grateful for their support and partnership as we advocate to protect access to the critical equipment and services they provide.

Recognition is also given to this year’s other finalists: Dalia Morales, ATP, Director of Compliance, HR, and Complex Rehab Technology at Respiratory and Medical Homecare Unlimited Inc.; Sheila Roberson, Chief Compliance Officer of Great Elm Healthcare; and Erin Weiman, CEO and Owner/Operator of Nunn’s Home Medical Equipment.

Finalists are chosen based on their contributions to the industry, including advocacy, business processes, volunteering, and improving the lives of others. We thank all of this year’s nominees for their hard work and dedication to the industry. 
Year-End CRT Industry Webinar Recording
NCART, NRRTS, U.S. Rehab, and the Clinician Task Force hosted the LAST Complex Rehab Technology (CRT) Industry Webinar of 2022. Panelists presented key CRT industry and advocacy news including:

  • 2023 CRT Congressional Outlook
  • Ongoing CRT Advocacy Work
  • Medicare Repair Documentation Update
  • Updated ICD-10 Codes for Wheelchair Seating
  • NRRTS Updates
  • CRT Provider Benchmarking Survey Results

You can view the recording of this presentation here and download a copy of the handout here. Recordings from all 2022 webinars can be found here.

Our 2023 CRT Industry Webinar schedule will be announced in January. Stay tuned!
NCART Welcomes Two New Members
Christmas came early for NCART in the form of two new members before the close of 2022. We are proud to announce the addition of new supplier member, Eclipse Home Medical, and new manufacturer member, Tamarack Habilitation Technologies, Inc.

Based in Utah, the staff at Eclipse Home Medical is dedicated to supporting individuals by matching them with the CRT that best meets their unique mobility needs. You can learn more about them by visiting their website, http://eclipse.care/. 

Since 1990, Tamarack Habilitation Technologies has been trusted by healthcare professionals worldwide to help improve mobility and protect the skin. Their products can be found on their website, https://tamarackhti.com/. 

We thank both organizations for adding their support to CRT advocacy work. We couldn’t be prouder to be working alongside each and every one 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.
International Seating Symposium 2023
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 an in-person event April 13-15, 2023 at the David L. Lawrence Convention Center. Click below to visit the ISS website and get registered today!
Monthly Motivation
Wounded Hero U.S. Army SGT Bryan Anderson - Home Dedication
In November, U.S. Army SGT Bryan Anderson was handed the keys to a custom-built R.I.S.E smart technology home designed specifically for him by the Gary Sinise Foundation. Bryan is no stranger to the Complex Rehab Technology industry. He has been a dedicated advocate for access to CRT for many years and we join in honoring him for his service and his sacrifice. Thank you, Bryan. Enjoy your new home!
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