Today, Reps. Joe Crowley (NY-14) and Jim Sensenbrenner (WI-5) announced the reintroduction of the Ensuring Access to Quality Complex Rehabilitation Technology Act (H.R. 942), legislation that helps ensure patients with disabilities or severe medical conditions are able to access the highly specialized medical equipment that meets their needs and helps improve their day-to-day lives. Specifically, the bill establishes a distinct Medicare benefit category for complex rehabilitation technology products (CRT), such as specialized power wheelchairs and adaptive seating systems. This would allow the Centers for Medicare & Medicaid Services (CMS) to better target their payment and coverage policies to this unique type of equipment, by adopting higher quality standards for suppliers, improving oversight to prevent fraud and abuse, and expanding eligibility criteria for beneficiaries to access these products.
"For people with disabilities or other medical conditions, complex rehabilitation technology products aren't a luxury, they're a necessity," said Rep. Crowley. "Our legislation will help ensure more patients can access the high-quality products and services they need to help them lead a better, more independent life. And, it puts forward much-needed quality standards and consumer protections, making the Medicare program stronger for individuals and suppliers as a result."
"As someone who has been a leader in the past, fighting for the rights of the disabled, I want to ensure that all Americans have full access to the best tools available, giving them the ability to live each day to the fullest," said Rep. Sensenbrenner. "Disabled Americans should not be denied the benefits of proper rehabilitation or medical equipment that can provide them the opportunity to live and work freely and independently. With increased flexibility and proper oversight, we can ensure help for those in need while inhibiting fraud and abuse."
Currently, the Medicare program includes CRT products in the same category as standard durable medical equipment, like traditional manual wheelchairs, which limits access and product choice, as individuals that use CRT products differ from the traditional Medicare population. These individuals experience physical, functional and cognitive challenges every day as a result of significant disabilities or other medical conditions, such as cerebral palsy, muscular dystrophy, multiple sclerosis, and spinal cord injuries. Grouping CRT products with other durable medical equipment doesn't allow CMS the flexibility to address the distinctive needs of the individuals that use these products or the suppliers that assist them. Furthermore, these complex and often customizable CRT products require a broader range of services and specialized personnel, as well as much more training and education for suppliers to ensure appropriate use. Congress has previously recognized unique situations like this one by creating a separate benefit category for orthotics and prosthetics, another highly specialized medical equipment category, which has its own medical policies, accreditation standards, and payment calculations.
In addition, the bill includes provisions to ensure these items are being prescribed appropriately to prevent fraud and abuse, including requiring that a licensed physical or occupational therapist evaluate the patient, increased quality standards for suppliers of these products, and a supplier accreditation process to ensure compliance with these enhanced quality standards. The bill will also remove barriers that beneficiaries currently face in obtaining this equipment; for example, by making it easier for patients in skilled nursing facilities to transition to home or community care.
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.
"I am so happy that Representatives Crowley and Sensenbrenner have reintroduced this important bill, HR 942, Ensuring Access To Quality Complex Rehabilitation Technology Act of 2013, which creates a separate benefit under Medicare for customized wheelchairs that will ensure our members with spinal cord injury and disorders living with significant disabilities such as multiple sclerosis, spina bifida or amyotrophic lateral sclerosis (Lou Gehrig's disease) obtain the medical equipment they need to live independent, fully-functioning lives, as is their right," said Paul Tobin, President and CEO of the United Spinal Association, a nationally-recognized organization based in Queens, N.Y. that works to improve the quality of life of all people living with a spinal cord injury or disease.