September 2023

Seat Elevation and Power Standing Systems Update

As we've shared, CMS is in the process of determining coding for power seat elevation systems used with complex power wheelchairs. They are also working to establish appropriate reimbursement to ensure access. To provide CMS with additional data that supports access to this important technology, NCART workgroup submitted coding applications in July and collected non-Medicare pricing data to gauge existing payer structures.

Both the coding and national fee schedule amounts will be addressed as part of an upcoming HCPCS public meeting later this fall. Final implementation of coverage is anticipated in early 2024. In the interim, the DME MACs will continue to determine reasonable and necessary coverage as they work to develop local coverage determinations that are in line with the national coverage determination.

CRT advocates also continue to pursue establishing Medicare coverage for power standing systems used with complex power wheelchairs. The recent NCART/NRRTS Virtual CRT Congressional Fly-In asked Members of Congress to urge CMS to take needed action. The ITEM Coalition also held a September meeting with CMS leadership to continue the dialogue and supply additional clinical and consumer feedback regarding these systems. NCART was pleased to participate in that discussion and offer CRT perspectives that support coverage. CMS did not indicate a timeline for next steps, but additional data is being provided and additional meetings will be scheduled.

NCART will be providing additional guidance and updates as the information becomes available. 

October 12 Seat Elevation Documentation Webinar

This session, geared toward providers, billing staff, and clinicians, will include instruction from a PT and an OT and will outline how to properly document medical necessity in the wheelchair evaluation to ensure those that qualify will receive this life-changing technology.

This session will also assist providers in determining coverage prior to delivery since the seat elevation is not yet eligible for prior authorization with Medicare. This will include the documentation requirements for seat elevation on a new chair as well as retrofitting seat elevation on existing chairs that were received prior to May 16, 2023. And if there is any new information regarding billing (coding, modifiers and allowables) we will address that as well. There will be adequate time for Q and A!

0.1  CEU available at a cost of $10 (CEU registration link provided at the end of the webinar)

A Successful Summer of CRT Advocacy

The recent CRT Virtual Congressional Fly-In and CRT Product Expo were a great success and it would not have been possible without the support from our sponsors and the amazing advocates in the CRT community. A HUGE thank you to everyone who planned, participated, and supported these events!

Our collective advocacy brought the CRT message directly into over 220 Congressional offices representing 40 states. We were able to provide education and insight to policy influencers and communicated the need for support to enhance and ensure access to CRT for individuals with disabilities.

We all know that CRT advocacy is a marathon, not a sprint. Positive outcomes require consistent outreach and these events continued to strengthen important relationships with Members of Congress and their staff. We will need those types of connections as we continue to pursue meaningful change. We look forward to continuing to work together to create lasting improvements for CRT access!

Thank You Sponsors!

This summer's advocacy would not be possible without the generous support of our sponsors. We are grateful for their financial assistance that allows CRT advocates to connect with Members of Congress to advance the actions needed to safeguard access to CRT.

Complex Rehab Industry Cost Study

NCART is partnering with Strategic Marketing Services (SMS) at the University of Northern Iowa to conduct an updated, independent third-party analysis of the business and operating performance of CRT providers. This data will be used in advocacy discussions to illustrate the current operating and reimbursement challenges of CRT providers that negatively impact access to CRT for individuals with disabilities.

“By assessing the current situation and identifying areas of concern, the data collected will enable a clearer understanding of the challenges faced by industry stakeholders. Armed with this information, the industry can work collaboratively with policymakers and lawmakers to advocate for the necessary support and strategies needed to navigate through these turbulent times.”, said SMS Director Christy Ryken.

The survey is available online through the end of September and a final report will be shared with participants in the fall. The report will be provided at no charge for NCART members and any CRT company that participates in the survey. For more details, please contact NCART Executive Director Wayne Grau at wgrau@ncart.us.

Protecting Access to CRT in the States

Alaska – An NCART and PAMES provider workgroup has been meeting with the Alaska Commissioner’s office to discuss reimbursement increases and needed CRT repair reform; additional meetings are being scheduled in October to identify opportunities for 2023-2024.

California – SB 271 is awaiting signature by Governor Newsom. The bill raises the Medi-Cal prior authorization cap from $250 to $1,250 and allows consumers to directly purchase certain wheelchair components that are non-clinical, do not require programming, and do not involve calibration. NCART will continue to pursue additional improvements for California NCART members in 2024. 

Connecticut – NCART continues to meet with consumers, State Agencies, legislators, and advocacy organizations to identify needed service and repair reform. The legislatively mandated working group will submit a joint report to the Connecticut legislature in February 2024

Colorado - NCART, CAMES, and other stakeholders submitted comments in response to CRT service and repair metrics proposed by the State; additional stakeholder discussions took place on 6/13 and NCART/CAMES met with the Department 6/21 to discuss continued feedback; further stakeholder discussion was held on 7/13. The final metrics underwent an emergency rules process via the Medical Services Board on 9/8; implementation begins on 10/1 and provider reporting begins in 2024.

Massachusetts – Wheelchair Warranty Protection legislation was reintroduced in the House and Senate; CRT repair reform language has also been introduced in the House; NCART, HOMES, and others are working with state lobbyists to advance legislation that addresses the needs of all stakeholders; NCART has testified at multiple hearings and has coordinated meetings with key legislators in August and September; October hearings are scheduled and NCART will be providing written and verbal testimony; other legislative and stakeholder discussions are ongoing.

Michigan – CRT state recognition legislation has been introduced in the Senate; NCART is communicating with the Michigan Healthcare and Hospice Association and lobbyist on needed next steps; committee hearings are scheduled in October; NCART will provide written and verbal testimony in support of the legislation.

Utah – NCART presented FY 2025 budget requests to the Medical Care Advisory Committee in June; ongoing efforts will require legislative action in 2023/2024; NCART has communicated with key legislative committees about these budget requests as well as actions urgently needed to improve claim processing delays; October meetings have been requested and discussions are ongoing.

September 28 CRT Industry Webinar Recording

The September 28th CRT Industry Webinar was packed with updates helpful to those involved in the provision of CRT. Among the topics covered were:

1. Congressional Activity and Outlook
2. NCART - CRT Legislative and Advocacy News
3. NRRTS – Educational Opportunities and Resources
4. Clinician Task Force – Recent and Upcoming Work  

You can view the recording of yesterday's presentation below and download a copy of the handout here.

The next CRT Industry Webinar will be offered on December 14 at 4:00 PM ET. Be sure save that date in your calendar, we’ll send reminders and registration information out soon!  

NCART Membership Secures the Future of CRT

NCART is the only national organization focused completely on representing suppliers and manufacturers of Complex Rehab Technology (CRT) products. NCART is strictly focused on working with policymakers, legislators, and others to establish and maintain appropriate coverage and funding to protect and improve CRT access.

If your company provides or manufactures CRT, help us fight the negative trends in coverage and payment that continue to mount. Your membership is crucial! Your support will enable us to continue to advocate aggressively on your behalf as we work to maintain and establish policies needed to ensure people with significant disabilities and chronic medical conditions can access the specialized equipment and services they require and you provide. 

You can easily and securely submit your application online by clicking the button below. For additional information or questions, please contact Wayne Grau, Executive Director, at wgrau@ncart.us or 570-902-9878.

NCART welcomes opportunities to support events that promote CRT education and advocacy. Here are some of the events that we're excited to share:

• CRT Repair and Service Reform Strategy Meeting – October 10
• NCART Board of Directors Planning Meeting – October 19-20
• Abilities Expo Ft. Lauderdale - October 13-15, 2023
• HOMES Winter Conference - November 2
• TexMEP Annual Conference – November 9-10
• Abilities Expo Dallas - December 1-3, 2023