September 2020
Each month "NCART News" delivers the latest Complex Rehab Technology (CRT) Medicare and Medicaid updates, advocacy opportunities, and event information all in one place.
Congressional CRT Sign On Letter On Its Way
A total of 41 members of the House of Representatives signed on to the Congressional CRT letter that was sent to CMS yesterday. The letter was led by Reps. John Larson (D-CT) and Lee Zeldin (R-NY). This was a great result for the CRT Community and the collective group of Members shows solid bipartisan support. The final list of signers can be viewed here.

As reported earlier this month, the letter urges the Centers for Medicare and Medicaid Services (CMS) to make the needed policy change to permanently stop applying Competitively Bid payment rates to “accessories” used with Complex Rehab Manual Wheelchairs. The temporary suspension currently in place expires June 30, 2021.

Our sincere thanks goes to Reps. Larson and Zeldin for their continued leadership in protecting access to CRT for people with disabilities and to their 39 colleagues. We also thank all the organizations and individuals who reached out to their Representatives asking them to add their signatures. If your Representative signed on, please thank them and give them a plug through social media.

Now that the letter has been delivered to CMS, we will be following up with Congressional Committee staff and the staff at CMS to secure the needed policy change.
CMS "Technology, Coding, and Pricing Group" Established
CMS is establishing a new "Technology, Coding, and Pricing Group". This group is tasked with developing, evaluating, and reviewing payment, benefits, policies, regulations, and instructions concerning DMEPOS items and services. This will include overseeing the data analysis used to monitor the Medicare Competitive Bidding Program.

The NCART Regulatory Committee is discussing the impacts and opportunities and will be communicating with the CMS staff assigned to this new group. More details will be shared in the weeks ahead. 
CRT Remote Services and Telehealth
The CRT Remote Services Consortium continues to meet regarding the application of remote and telehealth services in the provision CRT. The mission of the Consortium is to secure a permanent option for the use of remote and telehealth services when it allows better access for people with disabilities. As part of this work, recommended policy guidelines and safeguards are being developed.

The National Survey recently conducted produced responses from over 80 CRT clinicians and suppliers sharing their experiences and opinions on the application of telehealth and remote services. Those results are being analyzed and will be incorporated into the policy and advocacy work.

We have been holding conference calls with Congressional staff involved in the legislative discussions surrounding this topic. There is general support for the permanent expansion of telehealth with proper safeguards, but that will require appropriate action from Congress and CMS. With these types of initiatives, the devil is always in the details. We will be maintaining contact and reaching out to additional offices as things move ahead to advocate for the necessary language and legislation related to CRT.

This is an important initiative to protect access and requires activity on multiple fronts. Our work will continue at the federal, state, and commercial payer levels and we are appreciative of the stakeholder collaborations.
Coverage of Power Seat Elevation and Standing Systems
As reported, we have been actively working with the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition to secure Medicare coverage for power seat elevation and standing systems. On September 15 ITEM submitted a formal request for reconsideration of the Medicare National Coverage Determination (NCD) for Mobility Assistive Equipment (MAE) to ensure that beneficiaries with mobility impairments have access to power seat elevation and standing systems in CRT power wheelchairs. This was the major next step in this initiative.

ITEM convened dozens of experts, including power wheelchair users, clinicians, assistive technology professionals, and disability advocates to prepare a comprehensive NCD request for Medicare to cover these systems. NCART chaired the Reimbursement and Technology Group and provided significant resources and input in the multiple areas of the submission.

The request includes an exhaustive review of the clinical evidence, citing more than 120 peer-reviewed studies supporting the medical benefits for power seat elevation and power standing systems. 60 national organizations across the disability and rehabilitation spectrum provided written support of this request, believing coverage is long overdue to ensure that people with mobility impairments can live their lives as independently as possible and maintain and improve their health and function.

ITEM, NCART, and other stakeholder groups will be holding discussions with contacts at CMS and within Congress to provide any additional information needed to facilitate the acceptance of the reconsideration request and secure needed coverage.
Ongoing CRT Industry Webinars
Policies, procedures, and legislative action continue to change from day-to-day. To keep the CRT industry informed NCART, NRRTS, U.S. Rehab, and the Clinician Task Force are holding another no-cost CRT Industry Webinar this Thursday, October 1 at 4:00 PM ET.  

We'll be providing valuable information on topics including: 

• What Clinicians Want CRT Suppliers to Know 
• What Lies Ahead for COVID-19 Relief
• Supplier Resources for Natural Disasters
• State Work Being Done to Protect CRT
• Current Challenges from the CRT User Perspective

Register now and join us on Thursday for a quick and reliable update on what's happening in the world of CRT!
CRT Medicaid Work in September
NCART continues its work on state-level issues that impact access to CRT. If you are currently dealing with a CRT issue within the Medicaid program please send us an email using the button below. Here is a summary of some of our September activity:

  • California - The state CRT Workgroup met to review a variety of issues including the budget outlook, Medi-Cal organizational leadership changes, state telehealth policies, CRT payment rates, and Managed Care contract revisions; an introductory call was held with the new DHCS Deputy Director.
  • Illinois - The state CRT Workgroup is: monitoring possible across-the-board rate reductions for state agencies; NCART met with Access Living (state disability advocacy group) and state lobbyists to discuss Medicaid outlook; the Department has confirmed that a formal standing equipment coverage policy is expected to be published next month.
  • Indiana - NCART submitted written comments expressing concerns regarding proposed CRT and DME rate changes; continuing to work in conjunction with the Great Lakes Association, AA Homecare, and VGM.
  • Michigan - State CRT bill passed unanimously in the Senate; the bill will now move to the House floor for a vote; NCART continues to work with the Michigan Homecare and Hospice Association and the University of Michigan Wheelchair Seating Service; if you are a Michigan resident, please use the link at www.protectcrt.org to get additional details and email your legislators.
  • New York - NCART participated in group call with NEMEP and AA Homecare to discuss planned policy changes and potential advocacy projects impacting CRT and DME.
  • Ohio - NCART joined the Ohio Association of Medical Equipment Services and AA Homecare in the submission of written comments on state telehealth policies.
  • Oklahoma - NCART submitted written comments on CRT concerns with proposed State Plan Amendment; held call with the Department to confirm proposed rate calculations for CRT Power Wheelchairs; provider discussions are scheduled to address other ongoing CRT policy issues.
  • Texas - The state CRT Workgroup met to discuss state policy and coverage for CRT and related services; documentation being developed and meetings with department being pursued; working with AA Homecare on Medicaid Managed Care recognition of CRT.
  • Washington - NCART joining state association and others in proposing standing device coverage policies; monitoring possible across-the-board cuts to the Medicaid program; outreach to Department contacts ongoing.
Talk Rehab Podcast Hosts NCART
This month NCART was pleased to spend some time catching up with Bill Noelting on Talk Rehab, the seating and mobility focused podcast making a splash within the CRT industry.

Discussing NCART's history, achievements, and future initiatives, the podcast featuring Mickae Lee and Don Clayback is available on the Talk Rehab Website, Facebook, and LinkedIn platforms.

In addition to the NCART podcast, Talk Rehab has an extensive library of information-packed discussions with well-known CRT clinicians, consultants, and others that can be accessed by clicking below!
Election of NCART Officers and Board Members

We are pleased to announce the results of the elections of our officers and Board of Directors for the 2020-2022 term. The officers are President- Chris Yule of Travis Medical, Vice President- Greg Packer of U.S. Rehab, Treasurer- Seth Johnson of Quantum Rehab, and Secretary- Alexis Ward of National Seating & Mobility. Doug Westerdahl of Numotion, immediate past president, will continue to serve on the Executive Committee. 

NCART operates under the direction of a 15-member Board of Directors with representatives from a cross section of small, medium, and large CRT providers and manufacturers. The Directors serve 2-year terms with staggered elections.

Newly elected Board members for the 2020-2022 term are: Mike Barner, University of Michigan Wheelchair Seating Service, Administrative Director; Kevin Gearheart, Rehab Medical, President; Seth Johnson, Quantum Rehab, Senior Vice President Government Affairs; Debra Kalk, Reliable Medical Supply, CEO/President; Doug Munsey, Ki Mobility, President; Greg Packer, U.S. Rehab, President; Gretchen Schuler, Invacare, Vice President Insurance Risk Management; Alexis Ward, National Seating & Mobility, Vice President Payer Relations; Doug Westerdahl, Numotion, Vice President; and Chris Yule, Travis Medical, President. For a full list of Board Members currently serving, click below.

We sincerely thank these industry leaders for their leadership and service to support NCART’s mission to protect access to CRT for people with disabilities.
Why CRT Companies Join NCART
With the policy and reimbursement landscape for CRT changing from day to day it is critical, now more than ever, for all CRT providers and manufacturers to unite around protecting access. NCART is the strong national association our industry needs, acting to unify involvement and support to fight the ongoing negative trends impacting CRT access.

If your company manufactures or supplies CRT and you haven’t joined other dedicated stakeholders as NCART members, please consider joining this month. Your membership will enable us to continue advocating aggressively on behalf of you and your customers to secure the future of CRT access. For more information on becoming an NCART member, click below or email mlee@ncart.us.
Monthly Motivation
"Her First Thought Was How She Could Help Others"
Andrea Dalzell is no stranger to the CRT Community. She's a powerhouse advocate who has been to Capitol Hill countless times and has decimated boundaries time and again. Most recently Andrea showcased her grit as a frontline nurse in New York City during the pandemic. Good Morning America and the Craig H. Neilson Foundation surprised her with a gift she never imagined. Her first thought? How she could use it to help others, of course. Stay tuned through the end of the video below for the big announcement!

NCART | info@ncart.us | 716-839-9728 | www.ncart.us