CMS Halts Applying Bid Pricing to Manual CRT Accessories

After extending a temporary suspension of any cuts until Sept. 30, CMS has released a final rule stating it will permanently stop applying bid-derived pricing to manual CRT accessory reimbursement.

In a move that essentially severs the last bond between competitive bidding and complex rehab technology (CRT), CMS has stopped applying competitive bidding-derived reimbursement rates to accessories for complex rehab technology (CRT) Wheelchairs.

In June, CMS extended its suspension of applying the rates to manual CRT accessories rates for another until Sept. 30 after lawmakers backed a House sign-on letter from Rep. John Larson (D-Conn.) urging the agency to protect beneficiary access to the accessories.

Now, CMS’s newly issued final rule on the matter not only makes the policy permanent but ends the last remaining link between competitive bidding and CRT — and a very long legislative and regulatory fight on behalf of CRT accessories.

When Congress passed the Medicare Improvements for Patients and Providers Act (MIPPA) in 2008, the primary purpose of the law was to delay Round One of competitive bidding, but it also carved out CRT from the competitive bidding program.

However, in 2015, CMS expanded competitive bidding nationally, and in so doing, announced it would also apply its bid pricing scheme to CRT accessories. Its argument was that, while MIPPA carved out the chairs from bidding, it didn’t remove the accessories.

Congress subsequently twice passed legislation delaying the application of the pricing. Then, in June 2017, CMS announced policy that indefinitely delayed applying the prices for accessories on power CRT chairs.

From that point forward, mobility stakeholders and industry advocates, led by the National Coalition of Assistive & Rehab Technology (NCART), concentrated their efforts on protecting manual CRT accessories.

Now, four years later, it looks as though the fight is finally over.

“We are sincerely grateful to CMS for making today’s policy decision and protecting access for people with disabilities who depend on these individually configured CRT wheelchairs and seating systems,” NCART Executive Director Don Clayback said. “This outcome was the result of several years of collaborative advocacy within the CRT Community to ensure these damaging cuts did not go into effect.

“We want to thank Reps. John Larson (D-CT) and Lee Zeldin (R-NY), and Sens. Bob Casey (D-PA) and Rob Portman (R-OH), for their ongoing leadership and support,” he continued. “We also extend thanks to their Congressional colleagues and Committee staff.”

Clayback also thanked consumers, clinicians, providers, manufacturers and organizations for working together. Consumer and clinician groups Clayback highlighted included the ITEM Coalition, United Spinal Association, Christopher and Dana Reeve Foundation, ALS Association, Spina Bifida Association, Paralyzed Veterans of America, Center for Medicare Advocacy, and Clinician Task Force. He also thanked NRRTS, U.S. Rehab, the American Association for Homecare, and RESNA. 

“And finally, sincere thanks to our NCART provider and manufacturer members,” he added. “Their financial support and active engagement make meaningful advocacy wins like this possible. We appreciate everyone’s commitment to protecting access and look forward to working together to make continued progress for people who depend on CRT.”

About the Author

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

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