Each month "NCART News" delivers the latest Complex Rehab Technology (CRT) Medicare and Medicaid updates, advocacy opportunities, and event information all in one place. |
|
This Memorial Day we express our deepest gratitude to the servicemen and servicewomen who sacrificed their lives to protect our freedoms. We also thank the families and loved ones who carry on their legacy. Throughout this weekend, please take time to acknowledge and honor the memory of these courageous heroes.
|
|
Power Seat Elevation and Standing Systems Coverage |
|
Senators Tammy Duckworth (D-IL), Bob Casey (D-PA), Marsha Blackburn (R-TN) and Representative Jim Langevin (D-RI) have met directly with CMS Administrator Brooks-LaSure on moving the Medicare coverage request forward. As a result, the Administrator has committed to posting the reconsideration of the related National Coverage Determination for public comment no later than August. This 30-day public comment period is the next step in CMS’ process and will be held to gather feedback from stakeholders and other interested parties.
NCART continues to collaborate with the ITEM Coalition on preparing advocates for this next part of the process. A website dedicated to this issue will be available to act as a hub of resource materials, talking points, templates, and comment submissions. More details will be provided when they become available.
|
|
OIG Identifies Inappropriate Medicare Advantage Denials |
|
The Office of Inspector General (OIG) has issued a report entitled “Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically Necessary Care”. The Report contains the results of their claims review and identifies a key takeaway as MAOs are inappropriately denying prior authorization and payment requests that meet Medicare coverage rules.
The OIG attributes these issues to the MAOs: (1) using clinical criteria that are not contained in Medicare coverage rules; (2) requesting unnecessary documentation; and (3) making manual review and systems errors. As a result of their findings the OIG recommended that CMS take these actions: (1) issue new guidance on the appropriate use of MAO clinical criteria in medical necessity reviews; (2) update its audit protocols to address the issues identified in this report, such as MAO use of clinical criteria and/or examining particular service types; and (3) direct MAOs to take steps to identify and address vulnerabilities that can lead to manual review errors and system errors. CMS concurred with all three recommendations.
This OIG study draws attention to important issues (requesting of unnecessary information and inappropriate denials) that impact CRT funding on a national level with many payers. A copy of the full report can be found at www.oig.hhs.gov by searching OEI-09-18-00260.
|
|
September 14 Virtual CRT Congressional Fly-In |
|
NCART and NRRTS are proudly hosting the 2022 CRT Virtual CRT Congressional Fly-In on September 14. This important annual event allows CRT suppliers, manufacturers, clinicians, consumers, and others to meet directly with their Members of Congress. It's the ideal opportunity to educate Congress about CRT and share the actions needed to protect access for people with disabilities.
While we are eager to return to in-person events in the future, this year’s sessions and Congressional meetings will take place virtually via Zoom. This gives more people the opportunity to participate from their homes and offices. And this year there is NO COST to participants. Registration opens soon so mark your calendars, share the date with others, and plan to join us for a day of advocating for Complex Rehab Technology.
|
|
Upcoming CRT Awareness Week |
|
The option for Physical Therapists (PT) and Occupational Therapists (OT) to offer certain CRT-related services via telehealth is tied to the COVID-19 Public Health Emergency (PHE). Based on discussions in Congress and other factors being considered by HHS, the PHE is expected to extend beyond the current July 15 expiration date. Of note, Congress has passed legislation that extends PT/OT telehealth flexibilities another 151 days beyond the end of the PHE.
NCART continues to hold discussions with the APTA and AOTA regarding legislative language that would make these flexibilities permanent. To learn more about why telehealth options for CRT are important and to email your Members of Congress asking for support, advocates can visit www.protectmymobility.com.
|
|
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 regarding CRT 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:
|
|
California – A CRT provider workgroup is holding monthly meetings to carry out action on 2022 initiatives; a separate Cal-AIM workgroup has been developed and held an initial meeting on May 25 to identify opportunities for CRT within this initiative.
Illinois – An NCART workgroup met with both the Department and legislators to discuss needed action to protect access to CRT; additional information is being gathered and a June meeting with the Department is being requested.
Ohio – An NCART and OAMES workgroup met on May 25 to review data analysis regarding coding and reimbursement for ancillary CRT items; the data will be finalized and provided to the Department as part of a June meeting.
Pennsylvania – An NCART workgroup met to review the “Wheelchair Quality Assurance Act” (HB-2522) which was introduced in the state legislature and requires certain health insurance plans to cover semi-annual wheelchair preventative maintenance visits; the workgroup will be coordinating with PAMS and other stakeholders to hold additional meetings and connect with legislators.
Utah – An NCART workgroup met with the Department on May 17 regarding reimbursement and coverage for certain CRT items and services; a subsequent meeting is scheduled on June 9 and NCART will present FY 2023 budget recommendations for CRT during a Medical Care Advisory Committee meeting on June 16.
|
|
Cosponsors Needed for H.R. 6641 |
|
Earlier this year Representatives Paul Tonko (D- NY) and Markwayne Mullin (R- OK) introduced legislation that would provide a much-needed adjustment to Medicare reimbursement rates for certain Home Medical Equipment (HME). These adjustments are critically necessary to address the increased operational expenses and product costs that are being incurred by providers nationwide.
H.R. 6641 would establish a 90/10 blended Medicare reimbursement rate (90% competitive bid rate and 10% traditional rate) for items included in 13 HME product categories. This would positively impact Medicare rates for standard manual and power wheelchairs, accessories, and seating items. The increased rates would be effective retroactively to January 1, 2022 and would remain in place until December 31, 2023.
We ask for your help in adding cosponsors to the bill in the House of Representatives to move it forward. Advocates can visit the American Association for Homecare webpage to send an email to their Members to share the impacts of rising costs and to ask for support of the bill.
|
|
Home Modification Bill Introduced - H.R. 7676 |
|
Representatives Charlie Crist (D-FL) and Tom Suozzi (D-NY) have introduced H.R. 7676, the “Home Modification for Accessibility Act of 2022”, to provide tax incentives to homeowners to proactively update their houses for aging in place. This bill amends current Internal Revenue Code to promote the use of modifications to a person’s primary residence that improve the accessibility, security, or safety of the home. Being able to safely stay at home is a right all Americans should have.
The passage of this bill will support that right and bring much needed assistance and benefits to senior citizens and people with disabilities. It will not only improve a person’s quality of life and independence, it will also help reduce healthcare costs through decreasing home injuries, hospitalizations, and caregiver needs. NCART will be posting advocacy messaging that supports and urges the passage of this legislation and will be sharing shortly.
|
|
New NCART Manufacturer Member |
|
NCART is pleased to welcome another new Manufacturer to our membership roster. Seating Dynamics has a decades-long history of providing quality innovative products to the CRT community. We thank them for their support and look forward to having them join us to advocate for appropriate access to CRT equipment and services.
There is no shortage of advocacy work to be done and the CRT Community has proven that working together with purpose and determination produces positive results! If you are a CRT provider or manufacturer and aren’t already an NCART member, please click the button below to read more and consider joining us to protect the future of CRT access.
|
|
June 30 CRT Industry Webinar |
|
We’ve got updates! Another informative CRT Industry Webinar is being held on June 30 at 4:00 PM ET. Join NCART, NRRTS, U.S. Rehab, and the Clinician Task Force at no cost for the latest news relevant to the CRT community and to ask questions about policy and advocacy action. Click the button below to register today!
|
|
Upcoming CRT-Related Events |
|
NCART welcomes opportunities to support events that promote CRT education and advocacy. Here are some of the events that we're proud to help publicize:
|
|
Monthly Motivation
"While We Can Never Do Enough, We Can Always Do a Little More."
|
|
The Gary Sinise Foundation has spent the past 10 years pursuing ways to honor and serve our nation’s defenders, veterans, first responders, their families, and those in need. Hundreds of events have been held, 70 accessible homes have been constructed, 10 traumatic brain injury treatment sites have been developed, and the foundation is just getting started. Watch the video below to discover all that the Gary Sinise Foundation is doing to provide to support our nation’s heroes. |
|
NCART | info@ncart.us | 716-839-9728 | www.ncart.us |
|
|
|
|
|
|
