Complex Rehab Technology Grassroots Advice

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Complex Rehab Technology 2016 Don Clayback, Executive Director, NCART 2016 Grassroots Advice Be informed know what the ask is and why it s needed Leverage our progress CRT awareness and support is high Make it personal develop a contact and let them know why this is important Be persistent get what we need and stay in contact throughout the year NCART 2 NCART 1

Thanks To All Who Are Working To Protect Access To CRT Consumers Family/Caregivers Clinicians Researchers Providers Manufacturers Advocacy Groups And Others NCART 3 Dedicated CRT Advocacy Website Headquartered at www.access2crt.org Sign-Up to receive CRT updates! Federal and State Issues Advocacy Tools- Email and Call links to Congress Position Papers Calls to Action CRT Videos Other helpful documents NCART 4 NCART 2

Year End 2015 Action S. 2425 - last bill passed in Congress in 2015 Captured misc. Medicare fixes that Congress agreed with before adjourning Included a 1 year delay in application of CB pricing to accessories used with Group 3 Complex Power Wheelchairs AND requires a GAO Report with recommendations Did not include a delay for accessories used with Complex Manual Wheelchairs NCART 5 2016 Medicare CRT Issues 1) CMS 6 month hold on implementing S. 2425 delay of payment cuts as of January 1, 2016 2) GAO study and report on accessories used with Complex Rehab Power Wheelchairs (S. 2425) 3) Application of DME Competitive Bid information to cut payment rates for accessories used on Complex Rehab Wheelchairs (H.R. 3229 and S. 2196) 4) Creation of Separate Benefit Category for CRT and implementation of needed improvements in coverage and standards (H.R. 1516 and S. 1013) NCART 6 NCART 3

CMS 6 Month Delay on Delay CMS announcement issued on January 22 that S. 2425 delay would not be implemented in their system until July 1 Goes against year-end directive and DOES NOT prevent cuts from impacting providers and beneficiaries There have been discussions with Congress leads and CMS, but no resolution yet Additional advocacy action may be required NCART 7 Required GAO Study Part of S. 2425 delay language for Group 3 Complex Rehab Power Wheelchair accessories Requires GAO to study accessories used with power wheelchairs and make administrative and legislative recommendations Stakeholder Work Group is developing material to assist GAO in study and will be offering input and assistance Report due by June 1 NCART 8 NCART 4

H.R. 3229 and S. 2196 Legislation to stop CMS from applying CB pricing to CRT wheelchair accessories Impacts 171 wheelchair accessory codes with payment reductions ranging from 10% to over 40% CMS does not have authority to do this; beyond scope of Final Rule, violates 2008 legislation (MIPPA) AND subsequent CMS policies MAJOR disruption in access to CRT manual and power wheelchairs with Medicare AND other payers NCART 9 Accessories Bill Co-Sponsors House bill H.R. 3229 has 89 Reps. signed on -- 62 Republicans and 27 Democrats -- 14 on Ways & Means Committee -- 14 on Energy & Commerce Committee Senate bill S. 2196 has 17 Sens. signed on -- 7 Republicans and 10 Democrats -- 7 on Finance Committee -- 4 on HELP Committee See list by state at www.access2crt.org NCART 10 NCART 5

H.R. 1516 and S. 1013 Ensuring Access to Quality CRT Act 1) Creates separate category for CRT within the Medicare DMEPOS benefit (similar to Orthotics & Prosthetics) 2) Designates HCPCS specific codes as CRT and allows for creation of NEW codes 3) Eliminates in-the-home restriction for CRT and adds functional considerations 4) Expands clinical evaluation to all CRT mobility bases 5) Increases supplier standards: enhanced ATP credential staff and requires repair capabilities 6) Allows nursing home residents to access CRT if part of move to community residence 7) Clarifies exemption of CRT from competitive bidding NCART 11 Sep. Category Bill Co-Sponsors House bill H.R. 1516 has 157 Reps. signed on -- 66 Republicans and 91 Democrats -- 22 on Ways & Means Committee -- 20 on Energy & Commerce Committee Senate bill S. 1013 has 15 Sens. signed on -- 6 Republicans and 9 Democrats -- 4 on Finance Committee -- 3 on HELP Committee See list by state at www.access2crt.org NCART 12 NCART 6

Advocacy - Polite Persistence Focus on specific ask -- Sign-on as co-sponsor -- Pass legislation this year to provide permanent protection to access Use email, but phone call is most effective -- www.protectmymobility.org Don t get sidetracked by blow off responses whether via email or in-person Hold site visits at your facility or make a visit to the local office NCART 13 CRT Expo on Capitol Hill Allowing Congressional Members and staff to see CRT in-person Repeat of last year s event Will be held in April, date to be announced Great opportunity to get your Congressional contacts to stop in and spend 15 minutes learning about CRT NCART 14 NCART 7

Upcoming 2016 National Conference Combining annual RESNA and CRT Conferences into one powerful event July 11 th to 14 th in Washington (Arlington, VA) -- July 14 th Capitol Hill Visit Day Assistive Technology community together for education, networking, and advocacy Save the dates registration information and additional details will be released shortly NCART 15 CRT Educational Materials Great advocacy information in the Education Materials section at www.ncart.us- Videos- Intro to CRT ; CRT and the ADA CRT Facts and Figures CRT Delivery Process CRT Mobility vs Standard Mobility Separate Benefit Category Information The CRT Company (narrative, workflow, finances) Many other helpful documents NCART 16 NCART 8

Our friend and dedicated advocate Finn Bullers passed away on January 31 at age 52. We will miss his passion, intelligence, and humor. In Memory of Finn Donations can be made to children s college fund: https://www.gofundme.com/ finnbullers NCART 17 Questions & Discussion Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead Don Clayback Executive Director, NCART 716-839-9728 dclayback@ncart.us www.ncart.us www.access2crt.org NCART 18 NCART 9