Complex Rehabilitative Technologies (CRT) are medically necessary, individually configured products including wheelchairs and customized accessories that keep people with neuromuscular diseases healthy and independent. Access to complex rehabilitative technologies (CRT) and accessories is critical to many people living with muscular dystrophy, ALS, spinal muscular atrophy (SMA) and other neuromuscular diseases and includes devices such as customizable wheelchairs and accessories.
There are currently two legislative efforts impacting access to complex wheelchairs and accessories.
In 2015, the Centers for Medicare and Medicaid Services (CMS) announced that cuts would be put in place by applying competitive bid pricing to CRT, which would compromise access to those who most depend on this equipment. Application of competitive bidding to this CRT would change the way CRT has historically been covered since 2008, when CRT was not included in the category of items to be included in competitive bidding. After more than a year of coalition advocacy in objection to the changes, CMS announced that they will not apply competitive bid pricing to cut payments to CRT power wheelchair accessories. Instead, CMS is issuing a new policy on how adjustments to the fee schedule based on information from competitive bidding programs apply to wheelchair accessories and back and seat cushions used with complex rehabilitative power wheelchairs. Now, payment for these items will be based on the standard unadjusted fee schedule amounts. While this serves as a permanent fix for CRT power wheelchair accessories, it does not address the cuts to CRT manual wheelchair accessories and we will continue to update you as that issue progresses.
Currently, the Medicare program includes CRT in the same Medicare category as standard durable medical equipment, such as traditional manual wheelchairs, without regard to the realty that CRT items are used by people with significant disabilities and require a broader range of services and specialized personnel than what is required for standard durable medical equipment (DME).
Congress has made efforts to remove certain CRT from the current reimbursement category that is shared with all durable medical equipment (DME), and would establish specific criteria applicable to this specialized set of products and devices. This includes legislation that would ensure patients with who depend on CRT to live their day-to-day lives have access to the highly specialized medical equipment, as well as establish a distinct benefit category in Medicare for CRT products, such a specialized power wheelchairs and adaptive seating systems. Allowing for separate category gives CMS the ability to better target their payment and coverage policies for complex equipment. Currently, Medicare classifies these specialized products as standard durable medical equipment, which limits access and choice for those individuals who rely on CRT products.
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