House Passes 21st Century Cures Act

December 1, 2016

Good news! Last night the House of Representatives passed the 21st Century Cures Act, which includes our 6-month CRT power wheelchair accessories delay, by a vote of 392-26. This shows overwhelming support in the House and sends a strong message to the Senate.

The Senate will now take up the bill, likely next week. It may encounter some resistance there, but signs are positive for passage. In the meantime, reaching out to your Senators and encouraging them to vote yes will be helpful. The NCART Board of Directors will be in D.C. next week carrying that message.

We are halfway there. Let’s keep the momentum going and we will keep you updated.

Regards,

Don
Donald E. Clayback
Executive Director | NCART
Office 716-839-9728 | Cell 716-913-4754
dclayback@ncart.us |www.ncart.us

Extended Delay of CRT Accessories Cut in House Bill

November 28, 2016

CRT Stakeholders and Friends,

Language to extend the current delay in Medicare cuts to CRT power wheelchair accessories to July 1, 2017 has been added to legislation to be considered this week. The House of Representatives has included a 6-month extension in the “21st Century Cures Act”, a 996-page bill relating to medical/healthcare research, innovation, and treatment.

The Cures Act is expected to be voted on this week in the House of Representatives and once passed it will go to the Senate for their vote, likely next week. Should it be passed by both chambers, it would then go to the President for signing.

As we’ve reported, our challenge was to get attached to a larger bill. So it is good news we are in a bill that will be voted on in lame duck. The not-so-good news is it does not expand the delay to CRT manual wheelchair accessories.

The reality is, given the difficult and limited year-end legislative environment, our supporters worked hard to get the best relief achievable. The 6-month period kept the CRT legislation cost down and most importantly allows time for next year’s new Administration/Congress to pursue a permanent fix through policy or legislation.

The Cures Act also includes Competitive Bidding “rural relief” language that would retroactively rescind the broad DME July 1, 2016 Medicare cuts until January 1, 2017. Providers would be able to recoup CB payment reductions incurred for dates of service from July 1 to December 31, 2016. The rescinded payment cuts would go back into effect on January 1, 2017.

Getting a CRT delay included in the Cures Act is only the first step. Now the bill must be passed in the House and Senate, which is not an automatic process. We need to stay engaged as things move ahead.

We will provide further updates as we move through this week.

Regards,

Don
Donald E. Clayback
Executive Director | NCART
Office 716-839-9728 | Cell 716-913-4754
dclayback@ncart.us |www.ncart.us

Happy Thanksgiving

November 22, 2016

CRT Stakeholders and Friends,

As we prepare to celebrate this important holiday, we wanted to take a minute and wish you a sincere Happy Thanksgiving.

We are very thankful for all your support and assistance throughout the year collectively fighting to protect access to CRT.  It’s not easy finding time for advocacy, but your participation is critical and is paying off.

We also are very thankful to those Members of Congress, their staff, and other policy makers who are “getting the CRT message” and doing their part to help.

Of course we can’t pass up an opportunity to remind you to use www.protectmymobility.org to send your Members of Congress a Thanksgiving message to stop the January 1 cuts to CRT wheelchair accessories.

Please accept our warmest Happy Thanksgiving wishes and enjoy the time with your family and friends.

Regards,

Don

Donald E. Clayback

Executive Director | NCART
Office 716-839-9728 | Cell 716-913-4754

How an Accessible Playground Improves Your Community

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Playgrounds can provide more than just a break from class. They offer the chance to build friendships, develop teamwork, and create joyful memories. At NCART, we believe that every child, no matter their physical restrictions, should have the chance to enjoy the benefits every recess brings. Find out how accessible playgrounds can benefit your community and how you can help ensure that no child gets left behind.

Why do we need accessible playgrounds?

For children affected by spinal and nerve diseases, playgrounds provide potential problems. Loose rocks covering the ground makes it impossible to maneuver crutches and wheelchairs. Swings do not provide additional back support and can cause potential danger from falling. Jungle gym equipment is narrow and steps hinder children with disabilities. Due to this, playgrounds are no longer safe and fun but provide potential risk of injury.

How can an accessible playground benefit my community?

For parents of children with special needs, the start of school brings additional concern. Since many schools do not have accessible playgrounds, they not only worry about injury, but about their child being left out of the group. By incorporating an accessible playground, you are procuring inclusion for all children as well as installing the belief of teamwork in your community. Ensuring that everyone feels welcome in your neighborhood can strengthen the ties of your town.

How can I help build an accessible playground?

Getting an accessible playground built can seem like an overwhelming endeavor. To ease this concern, start by forming a committee within your community. Make sure to include individuals that can further help your cause such as lawyers, accountants, caregivers, and construction project managers. Speak with local businesses to expand your team. Create a separate committee for fundraising and keep your community involved throughout the process. Once you have your team, start planning tactics to raise awareness of your efforts. Continue to partner with companies across the state to aid in your fundraising events. Doing so will help spread out your workload and ensure maximum exposure. For more information on starting an accessible playground visit www.unlimitedplay.org to find out the steps you can take to help make your community stronger.

Accessible playgrounds are just one way to ensure that children with special needs are included in their community. At NCART, our members help make these ideas possible. Learn more on how your business can become a member today and the benefits our team can provide.

 

3 Ways to Show Support for Loved Ones with Spina Bifida

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This past October was National Spina Bifida Month, recognizing the 1,500 babies born each year with Spina Bifida. The leading neural tube defect in the United States, an estimated 166,000 people are affected with this condition each day. However, at NCART, we know that individuals with Spina Bifida have long demonstrated the strength and resilience required to conquer the world. By showing your support, you can provide additional help to spread awareness and assistance year-round.

What is Spina Bifida?

The most common permanently disabling birth defect in the United States, Spina Bifida literally means ‘split spine’. It occurs when a baby is in the womb and the spinal column does not close all the way. Scientists have not determined the cause of the defect, however, they believe that genetic and environmental factors act together to cause the condition.

How You Can Help

  • Become a respite provider

For families with Spina Bifida, there is little time to rest. Specialized doctors’ visits must be scheduled months in advance and usually require a full day of dedication. Equipment that provides assistance such as braces, crutches, and wheelchairs must be maintained to ensure that they are in proper working order. Respite providers give temporary relief care to aid in these responsibilities. They also provide support so that family caregivers can accomplish their day-to-day tasks.  Learn more about becoming a respite provider and the lasting difference you can make in a families’ life.

 

  • Volunteer at an adaptive sports camp.

For individuals with Spina Bifida, life does not slow down. Each year, adaptive sports camps offer the chance to show off their athletic prowess, determination, and spirit. From archery and skiing to rafting and kayaking, there is literally no boundaries to what individuals with Spina Bifida can accomplish. By volunteering at an adaptive sports camp, you are aiding in asserting their independence and health as well as creating new lifelong friendships. To get involved, visit http://www.disabledsportsusa.org/ and find out how you can help this important program.

 

  • Participate in a Walk-N-Roll.

Each year, funds are raised to support local community programs and services for those affected by Spina Bifida through family-friendly Walk-N-Roll events. These non-competitive one mile walks include educational resource fairs and are free of charge for the public. Find out when a Walk-N-Roll will hit your town and get involved today.

Families that are affected by Spina Bifida face challenges each day but, by offering support, you can make a difference. At NCART, we strive to ensure that all people with disabilities get the care they require. That’s why we are working to stop Medicare cuts threatening specialized wheelchair systems needed by family with spinal cord injuries. Help our mission by emailing your Members of Congress today to ask for their support.

CRT Wheelchair Accessories Legislation Update

October 6, 2016

CRT Wheelchair Accessories Legislation Update

Can December 31 major Medicare payment cuts to Complex Rehab wheelchair accessories be stopped?  The solution rests in getting Congress to pass needed legislation before year-end.

While Congress is currently in recess for the elections, they return on November 14 for the “lame duck” session.  This year-end session will be a hectic time, but it’s the opportunity for passage of House bill H.R. 3229 and companion Senate bill S. 2196 to stop these cuts.

To help publicize the issue and get more folks to reach out to Congress an ad was placed in an Assistive Technology Insert published last Friday in USA Today in the cities of Chicago, Dallas, Los Angeles, and New York City.  Share the ad with others in your circle of friends, associates, and organizations to get them to let Congress know this legislation MUST get passed this year.

The legislation also received a boost from a September 28 letter to Congress from the National Disability Leadership Alliance. Sincere thanks goes to them for their support.

As we look toward year-end we have a solid base of support from 145 Representatives on H. R. 3229 and 25 Senators on S. 2196.  The co-sponsor list can be found here.  But getting significant support is not the same as getting a bill passed.  We need to leverage our progress and get Congress to pass the legislation before they adjourn in December.

To make that happen Members of Congress must continue to hear from their constituents over the next several weeks as they discuss priorities and plans for the lame duck session.  The message to them is the Complex Rehab wheelchair accessories bill is “must pass” legislation.

With that in mind, please reconnect with your Members using the email here or by calling them through the Congressional switchboard at 202-224-3121.  If they are already a co-sponsor, thank them and emphasize the need to pass this legislation when they come back after elections.  If they are not signed on yet, make that request and stress the need for passage.

There’s a great deal at stake.  People with disabilities continued access to needed Complex Rehab wheelchairs and accessories depends on Congress passing H.R. 3229 and S. 2196 this year.  It’s up to us to help Congress do the right thing.

Thanks for taking the time to reconnect with your Members and being part of the year-end push.  Let us know if we can be of assistance and we’ll keep you posted as we move ahead.

Regards,

Don
Donald E. Clayback
Executive Director | NCART
Office 716-839-9728 | Cell 716-913-4754
dclayback@ncart.us |www.ncart.us

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.

Why CRT Needs to Be a Separate Category

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When it comes to healthcare, the last thing most people think of are billing categories.  Unfortunately, something as mundane as a billing category could be the deciding factor in obtaining appropriate equipment for those who use complex rehab technology (CRT). Currently, CRT is categorized in Medicare under the heading of “durable medical equipment”, or DME. Here’s why that’s a problem:

  • This category was originally created for an elderly population.

 

The designation of DME was first established in the 1960s to cover the type of equipment used by people as they advance in age—such as walkers, wheelchairs and bath safety equipment. CRT users are enrolled in the Medicare program not because of their age, but because of chronic and complex disabilities. Furthermore, their equipment is far more advanced technologically than what is typically used by an elderly patient. The conditions that apply to individuals utilizing CRT every day are not the same for DME users.

 

  • Obtaining CRT equipment is much more involved than obtaining DME

 

Typically, an elderly patient receives their DME products after a trip to the doctor and a trip to the DME supplier. Someone who uses CRT, however, must have carefully documented trips to the doctor, physical therapist or occupational therapist, an assistive technology professional (ATP), and a CRT provider. Additionally, the complexity of the equipment means the user will need ongoing training, support, and maintenance.

 

  • Medicare has more requirements for CRT

 

Obtaining DME is often as simple as visiting a medical equipment supplier with a doctor’s order in hand and leaving with equipment that same day.  There are far more requirements a person must go through to obtain CRT. Complex Rehab Technology is provided through an interdisciplinary team consisting of, at a minimum, a physician, a physical therapist or occupational therapist, and credentialed personnel from an accredited Complex Rehab Technology company.  The process of assessing, measuring, ordering, building, delivering, fitting, modifying, and training often takes three months or more.

 

  • Congress has changed other categories before

 

What we’re asking for is nothing new. In the past, Congress has recognized that other special medical needs don’t fall under the DME category. Orthotics and Prosthetics is one such example. It has its own separate set of rules for standards, accreditation and billing categories. We’re asking the same thing be done for CRT users.

 

Help NCART convince Congress that these changes need to be made.  Make a phone call to your Congressional representatives, write letters and emails to them, or the next time your representative gives a town hall meeting in your city attend it and speak up about CRT needs. Encourage your friends and family to do the same.  Together, we can make a difference!

Celebrate National Rehab Week by Advocating for Those Who Use Complex Rehab Technology

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The week of September 18-24 marks National Rehab Week, and NCART urges you to celebrate it by bringing attention to those who use Complex Rehab Technology. With your help, we can make sure that Washington hears the voices of those who most need this lifesaving equipment. Here are just a few ways you can do that:

Bring Attention to It at the Grassroots Level

Changes in our political landscape start at home. Those who are federal and state legislators now often start off as members of the city council or board of supervisors. Contact the mayor or board secretary and ask to be added to the next meeting’s agenda. Speak about the issues facing those who use CRT, and what problems the disabled community is facing on a locally. Don’t get discouraged if nothing happens right away. Often, you need to speak up regularly at local meetings before you start seeing change. Use the Tools for Telling the CRT Story on our website as a start.

Make Sure Your State Legislators Are Aware of the Issues

The next step is to contact your legislators at the state level. Many times, state-level coverage and funding dictate the availability of CRT products and supporting services. We’ve included links to the Medicaid policy in each state here. If you need help understanding what the issues are in your individual state, you can visit the Kaiser Family Foundation or contact NCART directly.

State legislators are usually more attentive than those at the federal level. Because they remain in the state where they are elected, they are more connected with their electoral base. Often, they will base their vote off of how many constituents they hear from on a given issue. Even if only one person speaks up to them, it will be enough to sway their vote!

Write to Your Federal Legislator

Just like with state legislators, a legislator at the federal level will sometimes vote according to what he or she hears from their constituents. Often, an overwhelming amount of letters on a given issue will be their deciding factor. The key is to keep letting our voices be heard! Like at the grassroots level, we need to be patient and continue to speak up until change happens.

At NCART, we are dedicated to helping those who use CRT have their voices heard and ensuring that they have access to the equipment they need. Join us this September 18-24 in celebrating National Rehab Week by kicking off grassroots, state and national efforts to make sure the CRT story is heard!

Problems with Cost Plus Payment in CRT

United States Coins.

United States Coins.

Complex Rehab Technology (CRT) products are specialized and customized to fit each individual’s needs. These products are provided to individuals with significant disabilities in order to address their medical and functional needs.

When determining the cost of CRT products, the cost of the product, cost of the service, delivery and support system must be recognized. The cost of the product itself is only about half of the actual cost of providing the equipment. CRT studies have found that for every dollar of funding, product cost is approximately 49 cents and service cost is approximately 46 cents. To make sure that people with disabilities are able to access the CRT equipment they need, a funding system must incorporate the total costs of providing the product and the supporting services. Because of these operational and financial challenges, there are only a limited number of companies that will supply CRT and that number is decreasing.

Problems with Cost Plus Payment Methodology

  1. Unless the Cost Plus methodology incorporates all costs of products and services with an appropriate multiplier, it does not provide appropriate payment rates.
  2. A Cost Plus system is time consuming for the payer. Since CRT orders are so complex, there may be 20 to 30 invoice line items to review on each claim. This creates additional administrative burdens.
  3. A Cost Plus system penalizes CRT suppliers and rewards companies that don’t. Because dedicated suppliers buy more products, they will typically have a lower product cost compared to the company that buys fewer products. The result of this is a supplier getting paid less than a company that has made a smaller investment.
  4. A Cost Plus system reduces the supplier’s desire to negotiate better acquisition costs.

Alternative Payment Methodologies  

  1. Use published Medicare Fee Schedule to ensure that the most current fee schedules are in place.
  2. Use Manufacturer’s Suggested Retail Pricing (MSRP) to decrease the likelihood that a supplier will provide a low quality product.
  3. Use a combination of Medicare Fee Schedule and MSRP. Use the Medicare Fee Schedule for coded items and MSRP for non-coded items.

There are a number of problems with applying the Cost Plus payment methodology to CRT. The National Coalition for Assistive and Rehab Technology (NCART) works hard to make sure that individuals with disabilities have access to CRT products and services. Contact us to find out how you can help!

Wheelchair Accessories Legislation Gains Support

August 31, 2016

Wheelchair Accessories Legislation Gains Support

CRT Stakeholders and Friends,

Yesterday Representative Lee Zeldin (R-NY), the House sponsor of our complex wheelchair accessories bill H.R.3229, held a press conference at The Children’s Center at United Cerebral Palsy (UCP) of Long Island, a school for students with developmental disabilities. The purpose of the press conference was to call for Congress to pass H.R.3229 this year, legislation that he labeled as a “must pass” bill to protect access for people with disabilities.

Other CRT stakeholders in attendance also spoke in support. These included Stephen Friedman, President and CEO of UCP of Long Island; Rolf Walter, a 50 year client of UCP who uses a CRT power wheelchair; and Linda Bollinger-Lunger, a physical therapist with Long Island Select Healthcare who has been delivery CRT seating and mobility for 17 years. All three did a very good job in emphasizing the critical need to protect access to CRT and for Congress to pass this bill.

The press conference was well attended and Representative Zeldin was joined by local elected officials, staff of UCP of Long Island, residents from UCP of Long Island’s 31 homes, advocates for individuals with disabilities, and members of the community. You can view the 20 minute press conference here and the related press release can be found here.

In addition to the press conference, national consumer, patient, and clinician organizations have once again communicated in writing to Congress urging passage of H.R.3229/S.2196.

The Consortium for Citizens with Disabilities (CCD) sent a supporting letter signed by 26 national organizations to Congress on August 18th. The ITEM Coalition followed up with a similar letter signed by 37 national organizations on August 25th. Those letters can be found and downloaded here.

We sincerely thank Representative Zeldin and the members of the CCD and the ITEM Coalition for their continued leadership and support.

These positive developments come at an excellent time and let Congress know this legislation must be passed this year. The documents and information can be shared as part of your follow up with the offices of your Representative and Senators. We need all 3 of your Members signed on as co-sponsors to build on this momentum!

Congress will be back in session starting next Tuesday for most of September and next week is the ideal time for follow up. Use the resources at www.access2crt.org to see if your Members have signed on and to make additional outreach as needed.

Regards,

Don

Donald E. Clayback
Executive Director | NCART
Office 716-839-9728 | Cell 716-913-4754
dclayback@ncart.us |www.ncart.us

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