Remembering Simon Margolis

July 26, 2016

CRT Stakeholders and Friends,

It is with deep sadness we share the news that longtime leader and friend Simon Margolis passed away yesterday.

For those who didn’t know Simon, he spent his career as an Assistive Technology (AT) and Complex Rehab Technology (CRT) practitioner, industry leader, and advocate.

And even more important than that, he was a good man.

I knew and worked with Simon very closely in different capacities for over 30 years. And many others in the AT and CRT arena had that same honor. He was a great guy to have leading an initiative or as a member of your team.

When it came to CRT, Simon was all in. His many contributions to promoting access to the technology and services that improve the lives of people with disabilities are far too numerous to list.

As Gary Gilberti, past NCART President, said “As a clinician, provider, manufacturer, inventor, accreditation surveyor, or organizational leader Simon wore many hats and brought diverse perspectives to all his conversations”.

It is amazing when you look at the various roles and organizations Simon had a significant and positive influence on. During his career he was part of the leadership of all three major AT/CRT organizations. And he was part of the actual creation of two of them.

At RESNA, he served on the Board of Directors and as President. At NCART, he was one of our founders and served on our Board of Directors. And most importantly, at NRRTS he was one of the founders where he served on their Board, served as President, and then led NRRTS for seven years as Executive Director until his premature retirement in August 2013 due to health issues.

In all these positions, Simon’s passion and dedication had a common goal: protecting and improving access to high quality individually configured equipment that people with disabilities rely on and ensuring it was provided by qualified professionals and organizations.

Our heartfelt condolences go out to his wife Marcia, his daughter Erica Negrini and son-in-law Tyler. Marcia and Erica were the real stars in his life and his love for them was evident in his personal conversations.
You can convey your thoughts to the family at

Some people say when they die, they’d like their legacy to be that “I left the world a little better than it was when I came into it”. Simon can rest in peace knowing his dedicated contributions left the world much better for people with disabilities and for those of us who knew and worked with him.

Thank you Simon for the example you left us to follow. We will continue to advocate (fight) for access to CRT in your memory.



Donald E. Clayback
Executive Director | NCART
Office 716-839-9728 | Cell 716-913-4754 |

DME Rural Relief Legislation Did Not Pass

July 18, 2016

NCART Board and Supporters,

Unfortunately the Congressional legislation to impose a 3 month delay to the implementation of the July 1 DME cuts failed to pass the Senate on Friday.

Accordingly, the July 1 cuts will remain in effect unless Congress takes action when they return in September after their summer recess.

The 3 month delay legislation had passed in the House. But it failed to pass in the Senate on Friday due to a “hold” placed by an unidentified Senator as part of the Senate’s “hot line” process.

This further emphasizes the need to secure passage of H.R. 3229 and S. 2196 to stop the application of competitive bid rates to CRT power and manual wheelchair accessories.

We had a very good showing and discussions in Congress last week to secure passage of the CRT accessories legislation.

We will be sharing more details on that and on needed next steps shortly.


Donald E. Clayback
Executive Director | NCART
Office 716-839-9728 | Cell 716-913-4754 |

What do we mean by accessories?


The fight to protect access to CRT accessories has been at the forefront of our legislative discussion. From delaying the application of competitive bid rates to the CMS’ ruling on billing instructions that directly violates S-2425, it’s the issue that has garnered the most attention. But what exactly are we talking about when we refer to CRT accessories?

We’re not talking about frills. The term “accessory” can be deceptive, as it brings to mind items that are nice but not necessarily needed. When we’re talking CRT, accessories include items that are vital to the user’s life and health.

Cushions are not a luxury. In many cases, accessories include things such as seating and positioning cushions. Just like the word “accessory,” this can also bring to mind something that’s a luxury and not a necessity. For CRT users, however, it’s the exact opposite. These cushions and seating positions keep them from developing sores and placing stress on the wrong muscles. It keeps them healthy while using their wheelchair for everyday life.

They include things that are essential to operating the wheelchair. It would be impossible to operate a wheelchair without the wheels or joystick. Yet, all these things are included in the accessory category. They also include miscellaneous parts that keep the chair going. If one of those parts goes out, it can be impossible for CRT users to get it replaced due to the red-tape and lack of funding.

Getting the right accessories is more difficult than it seems. Because of how the system is currently set up, CRT users often end up having to search for a CRT provider who will still supply the equipment.  Or even worse, they’re being provided less-than-ideal equipment, which leaves them unable to lead independent lives.

NCART and other CRT stakeholders continue to fight to protect accessories used with Complex Rehab Technology by promoting our federal legislation related to the issue.  H.R. 3229 and S. 2196 would permanently prevent CMS from applying Competitive Bid pricing to these specialized accessories. Visit to learn more about how you can help join the fight!


How to tell your CRT story to your legislator


If you’re lucky enough to attend the 2016 RESNA/NCART Conference, then you might be looking at the possibility of meeting with your legislator. While this may seem intimidating, it can actually be an excellent chance to tell your CRT story. Here are a few tips on how to make it successful:

  • Start with an introduction—who you are, where you live, what your connection is with the CRT world. If you use CRT, tell them for how long, even if it’s been your whole life.
  • Think of a specific personal incident that highlights why CRT is so important to you (if you use it) or to the people with whom you work. It doesn’t have to be dramatic or extreme to be impactful—just honest.
  • Talk about how current legislation impacts your or your clients’ access to CRT, and what changes need to be made.
  • Ask for a commitment to support legislation that will make access to CRT easier.
  • At the end of the meeting, remember to thank them for their time.

You can use these bullet points as a template to frame your story before you meet with legislators. The last thing you want is to walk out of the meeting thinking, “Oh, I should have said THIS!” Practice it several times beforehand. Legislators are pressed for time, so you don’t want to stumble as you try to find the word to convey what you want to say.

Remember to be real! This is your story, and you are the expert on this issue. It’s impossible for legislators to know everything about the topics they vote on, and they often rely on stories and input from their constituents before deciding how to vote. Your one visit can make all the difference.

If you find yourself stuck as you try to frame your story, our website has examples of other people telling their CRT story. Check out our video library for some inspiration.


CMS Releases July 1 Medicare DME Fee Schedules with Major Cut

June 24, 2016

CRT Stakeholders and Friends,

Late yesterday afternoon CMS finally released the July 1 Medicare DME Fee Schedules. A mere 5 business days before the reduced payment amounts go into effect!

As feared, the payment reductions due to the full application of Competitive Bid Program information, including new data from the recent Round 2 Recompete, are major.

Unfortunately HME legislation to delay these cuts was passed in the Senate on Tuesday, but a similar bill in the House that was scheduled for a vote Wednesday was never acted on due to the Congressional “sit-in” and the subsequent adjournment of the House until July 5.

The related CMS Fact Sheet can be found here. Based on that document, the July 1 payment amount cuts (from 2015 payment amounts) for DME items include: Oxygen Concentrator 56% cut; Nebulizer 68% cut; Hospital Bed 55% cut; Walker 58% cut; Commode 56% cut; Standard Manual Wheelchair 60% cut; and Standard Power Wheelchair 53% cut.

The detailed July 1 Fee Schedules can be found here.

We are in the process of analyzing the July 1 payment cuts that apply to wheelchair accessories and will report that information as soon as our analysis is complete.

These major reductions further underscore the need for us to push for passage of H.R. 3229 and S. 2196 this year to protect accessories used on complex rehab power and manual wheelchairs!

More also to follow on that.

CRT Education and Advocacy in Washington, DC July 12-14

CRT Education and Advocacy in Washington, DC July 12-14

CRT Stakeholders,

This is a critical year for taking the CRT message to Congress.

We need to build on the significant progress we have made and push for passage of legislation to prevent significant payment cuts to CRT wheelchair accessories on December 31 (H.R. 3229 and S. 2196) and to create a separate CRT benefit category (H.R. 1516 and S. 1013).

With that in mind, CRT stakeholders are encouraged to sign up for the “new and combined” 2016 Assistive Technology Conference being held July 12 to July 14 at the Hyatt Regency Crystal City in Arlington, Virginia being presented by RESNA, NCART, and NRRTS.

Attendees will benefit from a continuation of sessions covering business topics for the management teams of CRT providers and manufacturers plus funding and advocacy topics for all CRT stakeholders regarding the latest CRT Medicare and Medicaid trends, issues, and advocacy strategies.

In addition, the CRT “business” sessions are now supplemented by great CEU-earning seating and mobility workshops designed for the practicing Rehab Technology Professional.

Most importantly, July 14 will be Capitol Hill Day enabling everyone to take the CRT message directly to Congress. Providers, manufacturers, consumers, clinicians, and other advocates will spend the day making in-person visits to Members’ offices. Once you sign up, we’ll make the appointments for you.

So come join other CRT stakeholders for unparalleled continuing education, networking, and advocacy!

You can get more details and register online at

Get Excited! It’s almost time! Preview of the 2016 RESNA/NCART Conference, Part 2


In our previous blog, we highlighted some of the things we’re looking forward to during the 2016 RESNA/NCART conference. We would like to continue that preview for today’s blog:

CRT Legislative and Regulatory Update

The policy landscape for CRT is ever-changing, and this session’s aim is to keep attendees abreast of those changes. Industry experts will provide a comprehensive look at what’s going on at both the federal and state levels. Some of the things covered will include: Medicare Separate Benefit Category legislation, Medicare’s application of Competitive Bid pricing to CRT wheelchair accessories, other Medicare issues and state CRT legislation.

Seating, Mobility, and CRT Show and Tell

Just as the regulations surrounding CRT are constantly changing, so are the technologies going into them. This session will allow attendees to have a hands-on demonstration of recent emerging and innovative technologies for Complex Rehab Technology.

Capitol Hill Visits

If you have a stake at all in the world of Complex Rehab Technology, we would encourage you to attend this event! During this visit, you will have direct access to the policy makers who impact the legislation around CRT. Participants will be able to meet with both their senators and representatives in Congress. Those who do sign up for the Capitol Hill Visit will be required to attend the session titled “Congressional Prep for Capitol Hill Visits” The session will equip you with talking points about specific target issues, as well as familiarize you with the logistics of the visit.

The actual time that you visit with congressional members will vary. Since you will meet with the representatives from your area, everyone will meet with different legislators, and not all of them are on the same schedule. Remember, if you attend this session, you will need to dress appropriately! Dark suits for men, and pants or skirt suits for women.


We’re looking forward to seeing all of our supporters at this year’s conference! You can find full conference information here.

Get Excited! It’s almost time! Preview of the 2016 RESNA/NCART Conference, Part 1


The 2016 RESNA/NCART conference is coming up soon! We’re excited to gather together with like-minded individuals and talk about the issues that are impacting us. For today’s blog, we’re going to talk about some of the highlights from the conference we’re looking forward to:

CRT Industry Leader’s Panel

Those who provide complex rehab technology know that our industry is facing many changes. This session will feature a panel of industry leaders who will share their thoughts and perspectives about what’s happening. Those who attend this session can expect to walk away with both an overview of the industry changes, as well as suggestions as to what to do.

No More Addendums! Get it right the First Time when Documenting the Medical Necessity for Complex Rehab Technology

This interactive workshop will help attendees gain some insight into Medicare documentation requirements. All clinicians are familiar with the frustration of having a patient who clearly needs complex rehab technology, but then are told the documentation doesn’t reflect medical necessity. This session will present in an easy-to-understand manner what it is Medicare expects. Those in attendance will have the chance to review actual wheelchair evaluations, and report back to the rest of the group what they found.

CRT Town Hall

If you need to speak your mind about something, this is the place to do it! The CRT Town Hall offers an open forum for people to talk about the many topics surrounding the CRT industry, including its future. The actual topics will be based on attendee suggestions, although they must be suitable for group discussion.

Those are just a handful of the sessions that we’re most excited about. With the conference coming up fast, we would like encourage you to register, if you haven’t already done so. We hope to see you there!

GAO Report on CRT Wheelchair Accessories Released

June 2, 2016

CRT Stakeholders and Friends,

Yesterday afternoon the Government Accountability Office (GAO) released their report to Congress regarding Group 3 Complex Rehab Power wheelchair accessories.

This report was required as part of year end legislation that implemented a one year delay in the application of competitive bid pricing rates to accessories used with Group 3 Complex Rehab Power Wheelchairs.

The report focuses on (1) the utilization and expenditures for Medicare wheelchairs and accessories, in particular for Group 3 Complex Rehab Power Wheelchairs and the accessories used with them; and (2) how the 2016 Competitive Bidding Program adjusted payment rates for wheelchair accessories, in particular those furnished in connection with Group 3 Complex Rehab Power Wheelchairs, compare to the 2016 unadjusted fee schedule payment rates for the same items.

You can download a copy of the report at

Based on our initial review, the report is very data driven and validates the information CRT stakeholders have shared with Congress in support of passage of the CRT Wheelchair Accessory Legislation (H.R. 3229 and S. 2196).

We are in the process of fully analyzing the report and will be sharing more details shortly.


Donald E. Clayback
Executive Director | NCART
Office 716-839-9728 | Cell 716-913-4754 |

P.S. If you know of other CRT stakeholders who would like to receive these types of updates please have them sign up at the NCART website.

Etiquette to use when interacting with a wheelchair user


If you’re a wheelchair user, you have certain “pet peeves” when it comes to how people interacted with you. Among them may be how people interact with you. Today’s blog covers what is proper etiquette around a wheelchair user:

Don’t touch my wheelchair. In many ways, my wheelchair is an extension of my body. You wouldn’t touch a stranger on a random part of their body, so don’t do it to my chair.

Don’t talk slower to me. I can understand speech perfectly fine. Even if my condition prevents me from speaking clearly, I’m still able to comprehend what you’re saying.

Don’t pat me on the head. I’m not a little kid.

Don’t talk over my head like I’m not there. Even if I’m with my caretaker, I can still talk, make decisions and interact with other people. Similarly, if I was standing up next to you, you would never think to talk through me as if I’m invisible—yet, that’s exactly what you’re doing when you talk over me.

Don’t grab my wheelchair handles so I can’t move. You wouldn’t like it if someone kept you from moving freely.

Don’t make me strain my neck. Pull up a chair or sit down next to me if you want to have a long conversation. It can strain my neck if I’m looking up at you too long, and that’s just uncomfortable.

Don’t ask me what happened. For some wheelchair users, this is a personal and touchy subject. Just like anyone else, some of us are more private than others, and really don’t want to reveal parts of our lives to complete strangers.

Don’t assist me when I say no. I like to maintain my autonomy and independence. It’s condescending for you to assume I need help when I haven’t asked for it. Also, if you jump to the “rescue” without asking, you could throw me off balance.

At NCART, we believe education is the key when it comes to changing both society and governmental regulations when it comes to wheelchair users. We continue to fight for the rights of wheelchair users, and you can help us. Visit our website to learn how!

NCART - 54 Towhee Court - East Amherst, NY 14051 - Office: (716) 839-9728 - Fax: (716) 839-9624

Send us an email