Rehab stakeholders succeed with last-minute bill

Still need more permanent fix and greater coverage for accessories
Tuesday, December 22, 2015

WASHINGTON – Rehab stakeholders applaud the recent passing of a bill that delays CMS’s plans to apply competitive bid pricing to accessories for complex power wheelchairs for one year, but they’re ready to get back to work. 

In addition to getting a more permanent fix, the bill, S. 2425, only applies to Group 3 power wheelchairs. That means accessories for Group 2 and complex rehab manual wheelchairs will shift to bid pricing on Jan. 1.

Still, “something is better than nothing,” said Cara Bachenheimer, senior vice president of government relations for Invacare.

Stakeholders had been trying to push through Congress before the end of the year two bills, H.R. 3229 and S. 2196, that would have provided a technical correction preventing CMS from applying bid pricing to accessories used on complex rehab wheelchairs on the grounds that these products are exempted from the program by the language and Congressional intent of the Medicare Improvements for Patients and Providers Act. In addition, they believe CMS did not have the authority to do this as part of the policy expanding competitive bidding to non-bid areas. 

But lawmakers struggled with which complex rehab wheelchairs are and aren’t exempted from the program and, therefore, should be exempted from the pricing change.

“So they weren’t willing to pass H.R. 3229 as it stands, but they were willing to delay for one year,” said Don Clayback, executive director of NCART. 

The message that stakeholders will continue to hit home with lawmakers: When MIPPA was passed in 2008, the intent was to protect access to complex rehab wheelchairs and related accessories for people with disabilities. 

S. 2425 also calls for the Government Accountability Office to publish a report by June 1, 2016, that outlines accessory code item descriptions, breaks down utilization and expenditures, and compares competitive bidding payment amounts to current payment amounts.

“Hopefully it will provide us more ammunition and increase our chances of getting a more permanent fix next year,” said Bachenheimer. 

Once Congress reconvenes in January, stakeholders are eager to get the ball rolling. 

“We’re hearing that there’s going to be a Medicare bill developed and we’re going to do everything we can to get H.R. 3229 and S. 2196 included in that broader bill, whether the GAO report has been released or not,” said Seth Johnson, vice president of government affairs for Pride Mobility Products.