Manual CRT Protections Stall Out in Senate

Despite last-minute legislative wrangling, a Medicaid bill that included provisions to protect reimbursement for manual CRT chair accessories lapses with the close of the 115th Congress.

Despite a cliffhanger effort on Capitol Hill by complex rehab industry advocates, the Senate did not pass legislation that included protections for manual CRT wheelchairs before the 115th Congress lapsed.

In a 400-to-11 vote, the House of Representatives passed H.R. 7217, the Improving Medicaid Programs and Opportunities for Eligible Beneficiaries Act (aka, the IMPROVE Act), which provisions originating from H.R. 3730, a bill that protected funding for manual CRT accessories from competitive bidding.

That Medicaid legislation then went to the Senate, where it was to be passed through the unanimous consent process, wherein a bill is passed without a vote as long as no lawmaker objects.

However, the bill stalled out due to some Senators having concerns over provisions regarding Medicaid services for children with complex needs, according to a statement from the National Coalition for Assistive and Rehab Technology (NCART). To complicate matters, larger political events made addressing those concerns even more difficult.

“… While we continued to advocate in the Senate through the holidays, resolving the government shutdown was the primary focus and made things more challenging,” said NCART Executive Director Don Clayback.

If passed, the bill would have provided:

  • A permanent exemption for CRT manual wheelchair bases from competitive bidding.
  • An 18-month suspension to the application of competitive bidding payment rates for CRT manual wheelchair accessories, just like the CRT power wheelchair accessories. Accessories would go back to being paid at the traditional Medicare rates (in the same way as CRT power wheelchair accessories). The 18-month suspension would have run from Jan. 1, 2019 to June 30, 2020, and would have allowed time for the needed discussion to make a permanent policy change.

NCART's Clayback thanked HME and CRT industry advocates and stakeholders in a public statement for their efforts on behalf of H.R. 3730, as well as Reps. Lee Zeldin (R-N.Y.) and John Larson (D-Conn.) and Sens. Bob Casey (D-Pa.) and Rob Portman (R-Ohio) for their work to get the H.R. 3730’s provisions incorporated into the year-end bill. 

“Getting legislation and policies to protect access to CRT for people with disabilities is not a sprint, it's a marathon,” he said. “While we did not get final Senate passage this year, the significant progress we made puts us in a strong position for 2019 and served to build up CRT awareness and support that will help us as we work to get a Separate Benefit Category for CRT.”

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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