GAO Study Foreshadows July 1 Cuts’ Impact on CRT

New report shows that the vast majority of wheelchair accessory spending goes to needed supplies for complex rehab patients.

A new study from the Government Accounting Office shows that the upcoming bidding expansion cuts, which CMS will implement on July 1, will sharply reduce funding for needed complex rehab wheelchair accessories.

The data provides a strong argument for supporting H.R. 3229 and S. 2196, bills that would prevent CMS from applying competitive bidding pricing to CRT wheelchair accessories, according to the American Association for Homecare and the National Coalition for Assistive Rehab Technology, which are working to advance the legislation.

The report, Medicare: Utilization and Expenditures for Complex Wheelchair Accessories,” showed that accessories for Group 3 CRT chairs, which are needed by those patients in order to properly use the chair and function, accounted for an outsized amount of wheelchair spending, and would be greatly cut by the July 1 cuts.

Of the 603,000 wheelchairs CMS supplied in 2014, 13,000 of those chairs were Group 3 wheelchairs. This accounted for approximately 2 percent of the total number of wheelchairs purchased, but accounted for 22 percent of total wheelchair expenditures — approximately $69 million of the $620 million CMS spent on wheelchairs.

Furthermore, accessories used with those Group 3 accounted for 18 percent of all accessories provisioned and 51 percent of all accessory expenditures — roughly $159 million) of all accessory expenditures.

Also, Medicare expenditures on accessories used with Group 3 chairs were concentrated in a small number of accessories, with the top accessory being a combination tilt and recline power seating system. That single accessory accounted for an estimated $56 million, or 35 percent of total expenditures on Group 3 accessories.

But, while the data shows that the majority of Group 3 patients need these accessories, it is estimated that reimbursement for them will be cut by 10 percent to 34 percent the full competitive bidding adjusted rates are implemented on July 1, according to analysis by AAHomecare.

Detailed analysis of the GEO report is available from NCART and a summary of the report is available from AAHomecare. Both organizations stress that the HME industry must get behind H.R. 3229 and S. 2196 and urge lawmakers to support the legislation. The bills currently have 117 and 18 cosponsors, respectively.

“We need action from Congress before these cuts limit access and options for some of our most vulnerable patient groups,” AAHomecare President and CEO Tom Ryan said. “What’s more, the negative consequences will not be limited to just the Medicare program, since most other payers follow Medicare policies. 

“This harmful program could potentially extend to children and adults with disabilities covered by Medicaid and other health insurance plans,” Ryan continued. “Passage of H.R. 3229 and S. 2196 will ensure access to this complex rehab equipment for Medicare beneficiaries and other people with disabilities.”

“This GAO Report is good news and enables our push for passage of our CRT legislation to move forward,” said Donald Clayback, executive director of the NCART. “Our CRT Legislative Group is currently reviewing the report and legislative impact with our Congressional champions to determine next steps. We will be providing additional information and advocacy details in the near future.”

About the Author

David Kopf is the Publisher and Executive Editor of HME Business and DME Pharmacy magazines. Follow him on Twitter at @postacutenews.

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