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Complex rehab: Lead the charge for comprehensive changes

Complex rehab: Lead the charge for comprehensive changes

Rita StanleyQ. What does access to CRT mean? 

A. Access to complex rehab technology (CRT) has been the mantra of stakeholders. While that mantra has been consistent, the issue at the center of each initiative has been different. Initiatives have included attempts to prevent inclusion of CRT items in Medicare’s competitive bidding program, improve HCPCS coding, obtain adequate payment rates, improve processes for obtaining new HCPCS codes, and modify methodologies for developing payment. 

Each time stakeholders have come together to fight for positive change, it has been to maintain access to technology that could improve the function and quality of life of people with disabilities. There have been important successes along the way where access, but people with disabilities who count on assistive and rehabilitative technologies to improve function and independence, to access their communities, to improve quality of life – essentially to level the playing field – have experienced a decline in access to certain technologies and significant decline in access to innovation.  

It isn’t difficult to identify the barriers to access; the difficult part is identifying solutions. It isn’t as simple as obtaining new HCPCS codes or higher reimbursement. The needs of payers must be considered when seeking solutions. Finding the right balance between policies that promote appropriate access to meet the needs of people with disabilities and safeguard program integrity and avoid abuse of funding sources is essential.  

Comprehensive changes are needed, like HCPCS coding processes that are reasonable and predicable; investment in research; collaboration between manufacturers and policy makers regarding affordable, reliable and adequate evidence to demonstrate the medical value of devices and transparency regarding costs within the entire service delivery of technology; standards that promote professionalism; and product reliability. These are all necessary for sustainable access to technology. 

Rita Stanley is principal and policy consultant at Merriman Innovation Consulting. Reach her at


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