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With just days to go before the implementation of a change that would have opened the door for cuts to payment for complex rehabilitation technology (CRT), including specialized wheelchairs and components, the US Centers for Medicare and Medicaid Services (CMS) has taken steps to ensure that the reductions won't happen after all.

The June 26 CMS decision manages to avert a planned July 1 change that would have affected payment for wheelchair accessories and back and seat cushions used with group 3 complex rehabilitative power wheelchairs. The looming cuts were related to a 2014 CMS decision to subject CRT to competitive bidding pricing, an approach associated with reduced payments from Medicare.

After CMS made the 2014 decision, legislators enacted short-term fixes to delay the cuts. The change to competitive bidding was supposed to have been implemented on January 1, 2017; the 21st Century Cures Act signed into law in December 2016 moved startup back to July 1. In January, Congress asked that the Trump administration review the impending change before it took effect.

The recent announcement from CMS puts the issue to rest. "CMS has reconsidered its policy on adjusting fee schedule amounts using information from the competitive bidding program for these items," CMS states in a guidance resource. "As a result, effective July 1, 2017, payment for these items will be based on the standard unadjusted fee schedule amounts."

APTA has been a strong supporter of efforts to remove CRT wheelchairs and components from competitive bidding pricing, and is a member of the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition. In a March letter to legislators, the ITEM coalition advocated for a permanent fix to the competitive bidding threat, writing that "regardless of injury, illness, disability, or chronic condition, all Medicare beneficiaries should be eligible for the same access to medically necessary mobility devices, services, and accessories."


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