CRT wheelchair protection passes House Energy & Commerce Committee

UPDATE: July 18, 2019: The full House Energy & Commerce Committee advanced the bill Wednesday, which would exclude manual complex rehab technology wheelchairs from the CMS competitive bidding program.

Dive Brief:

The House Energy and Commerce Committee’s Health Subcommittee approved a bill with provisions its supporters argue will protect access to manual complex rehab technology (CRT) wheelchairs and their accessories for Medicare beneficiaries.
HR 2328, the Reauthorizing and Extending America's Community Health (REACH) Act, would permanently exclude manual CRT wheelchairs from the CMS competitive bidding program and exempt related accessories from bidding-derived pricing from Jan. 1 through Dec. 31, 2020.
Similar language was included in HR 2293, introduced in April, and HR 3429, the HEARTS and Rural Relief Act, which was approved by the House Ways and Means Committee in June. Companion legislation was introduced in the Senate in April.

Dive Insight:

The Centers for Medicare and Medicaid is moving to a new competitive bidding model for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS). The agency last year finalized a rule that shifts to a lead item pricing methodology in which suppliers submit only one bid for a product category instead of receiving reimbursement based on a median bid.

Industry and patient advocacy groups are concerned the program could force some suppliers out of business and create access problems for patients.

Complex rehab wheelchairs are used by patients with significant disabilities such as ALS, cerebral palsy, multiple sclerosis, muscular dystrophy and spinal cord injury. The specialized wheelchairs must be individually configured and can require extensive evaluation, fitting and adjustment by a clinical team.

The American Association for Homecare has been pushing for the establishment of a separate Medicare benefit category for CRT, in addition to its efforts to have manual CRT equipment excluded from the competitive bidding program.

In May, CMS announced a one-month delay in opening the bidding window for the competitive bidding program, rescheduling the start date to July 16. The agency said the new timeframe would give bidders more time to prepare. The bid window is set to close Sept. 18.

The Competitive Bidding Implementation Contractor Tuesday also released a 55-page guide and 18 additional fact sheets with instructions for the 2021 bidding round. In April, the American Association for Homecare, the Council for Quality Respiratory Care, VGM & Associates and the Healthcare Nutrition Council launched a website that provides a clearinghouse for information to help suppliers of durable medical equipment understand the impact of the new bidding program.

HR 2328, the Reauthorizing and Extending America's Community Health (REACH) Act, will move next to the full House Energy and Commerce Committee for consideration.