Protecting CRT state by state

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Friday, May 31, 2019

In the political process, complete bipartisan support is rare. But in March, both houses in the Tennessee legislature unanimously passed a bill establishing a separate benefit for complex rehab technology (CRT) products provided through Medicaid. 

CRT products—such as power wheelchairs—are designed to meet the unique needs of individuals with disabilities and profound healthcare challenges. In practical terms, the legislation designates CRT as its own category, protecting it from any future across-the-board budget cuts.

This protective language in the bill is important because over the past decade, Tennessee has passed numerous budget cuts to durable medical equipment, including CRT. Though seemingly minor, these cuts can be devastating to those who depend on power wheelchairs and other CRT products.

Now that the bill is signed by Governor Bill Lee, Tennessee will become the seventh state to pass such legislation which our company played a leading advocacy role. Our success in Tennessee represents a 10-month initiative driven by our policy team and an industry coalition that includes the American Association for Homecare (AAHomecare).

This accomplishment in Tennessee follows equally successful initiatives in Illinois and Wisconsin, where we led coalitions that worked with legislators until they unanimously passed similar bills. While in principle protecting people who use wheelchairs is a non-polarizing issue that enjoys widespread bipartisan support, in practice it takes a lot of negotiation to get laws passed.

While all lawmakers are supportive of mobility issues, each state’s legislation comes with its own unique set of circumstances. For example, some states have pre-existing laws that partially protect CRT benefits, and these need only to be amended or updated; others are starting from ground zero.

This is why our education and advocacy efforts are so vital, and why we invest both money and manpower in building collaborative relationships in statehouses across the country. With these networks in place, we are able to respond swiftly to any proposed or enacted budget changes. If a cut affecting CRT is made to a state’s budget, we’re on our horse galloping to the capitol to make sure those who are making the cut fully understand its implications.

In these situations, our first choice is always to make change by working through the regulatory process. We prefer to sit down with folks from the state Medicaid office, working with them and local legislators to remedy the situation. However, if we can’t reach a resolution and they give us no alternative, we seek legislation.

Our ultimate goal is federal legislation protecting CRT as a separate benefit. However, we’re now in our 11th year—and 6th Congress—and we’ve learned that passing legislation in Washington is a slow process. Rather than waiting, we’re continuing to build coalitions and work proactively where we see opportunities to pass legislation on a state-by-state basis.

A secondary benefit to this approach is that legislation can be tailored to meet each state’s needs and fiscal situation. For example, if the Centers for Medicare and Medicaid Services (CMS) issues a federal cut, each state may interpret it differently. Some might be able to absorb the cut (rather than pass it on to residents), while others might not be able to afford to do so.

Until we achieve federal legislation, passing state legislation that establishes CRT as a separate benefit ensures its protection in the face of federal CMS budget cuts.

We’re proud of our achievement in our home state of Tennessee, and we plan to build on the momentum by targeting other states where the political environment is favorable for positive movement. We look forward to working with their legislators and policymakers to carve out a separate benefit for CRT, and we invite others in the CRT community to join us.

Here are some ways you can get involved:

 ●      Get Educated: Access2CRT.org  was created to promote and protect access to CRT for people with disabilities.. The site allows users to learn about threats to access on both the federal and state levels. It also provides educational materials, resources and tools that explain what CRT is, how it is provided and its benefits.

●      Contact Your Representatives in Washington:

○      Congressional directory

○      Senate directory

●      Stay Informed: Sign up to receive updates from the National Coalition for Assistive and Rehab Technology (NCART), the national trade association for CRT. 

Bill Mixon is the CEO of National Seating and Mobility. He has 29 years of experience across the healthcare and professional services industries and more than 16 years of experience in general management, president and CEO roles.