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Issue Background

Quality Complex Rehab Technology

H.R. 1516 was introduced in the House on 03/19/2015

S. 1013 was introduced in the Senate on 04/20/2015

Ensuring Access to Quality Complex Rehabilitation Technology Act of 2015

Amends title XVIII (Medicare) of the Social Security Act to cover, as medical and other health services, complex rehabilitation technology (CRT) items designed or individually configured for a specific qualified individual to meet that individual's unique: (1) medical, physical, or functional needs related to a medical condition; and (2) capacities for basic activities of daily living (ADLs) or instrumental ADLs.

Directs the Secretary of Health and Human Services to: (1) designate CRT items (excluding adaptive equipment to operate motor vehicles or certain prosthetic devices and orthotics); and (2) establish eligibility criteria for them.

Prescribes requirements for payments for CRT items.

Directs the Secretary to establish standards for clinical conditions for CRT item payment as well as quality standards for suppliers of such items.

Directs the Secretary to establish a formal process to allow submission of CRT code set modification requests by stakeholder groups for comprehensive coding changes related to entire policy groups.

Requires payment for replacement of a CRT item (or any part of one), without regard to certain continuous use or useful lifetime restrictions established for items of durable medical equipment, if a qualified ordering practitioner determines that a replacement item (or part) is necessary.

AAHomecare Applauds Complex Rehab Bill Introduction

LEGISLATION WILL HELP PATIENTS ACCESS HIGHLY SPECIALIZED MEDICAL EQUIPMENT

MON, MARCH 23, 2015

WASHINGTON, DC

The American Association for Homecare (AAHomecare) today applauded the introduction of the Ensuring Access to Quality Complex Rehabilitation Technology Act, which would help patients with disabilities or severe medical conditions access much needed highly specialized medical equipment.

“AAHomecare thanks Congressmen Jim Sensenbrenner (R-Wis.) and Joe Crowley (D-N.Y.) for their leadership on this issue,” said Tom Ryan, president and CEO of AAHomecare. “This legislation will protect consumers, increase quality, improve oversight and help get this specialized equipment to those who need it the most. The AAHomecare Complex Rehabilitation and Mobility Council (CRMC) looks forward to working with Congress and the consumer community to pass this important bill.”

“Highly sophisticated CRT products require a commitment to provide advanced services, training and personnel to ensure appropriate use,” said Peter Rankin, assistant director of government affairs for AAHomecare.  “Creating a separate category for this type of highly specialized medical equipment will help meet the distinctive needs of the individuals that use it and the suppliers that assist them. Congress has previously recognized exceptional situations like this by creating a unique category for orthotics and prosthetics.”

The Ensuring Access to Quality Complex Rehabilitation Technology Act is supported by multiple patient, medical professional and supplier organizations, including: American Association for Homecare, American Physical Therapy Association, Brain Injury Association of America, Christopher and Dana Reeve Foundation, Easter Seals, National Association for Home Care & Hospice, National Coalition for Assistive and Rehab Technology, National Multiple Sclerosis Society, Paralyzed Veterans of America, and United Spinal Association.

The American Association for Homecare represents durable medical equipment providers, manufacturers, and others in the homecare community that serve the medical needs of millions of Americans who require oxygen systems, wheelchairs, medical supplies, inhalation drug therapy, and other medical equipment and services in their homes. Members operate more than 3,000 homecare locations in all 50 states. Visit www.aahomecare.org.