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High-tech wheelchairs: AAH pivots strategy on bill, plans blitz on Capitol Hill

High-tech wheelchairs: AAH pivots strategy on bill, plans blitz on Capitol Hill

Alexis WardWASHINGTON – AAHomecare and its champions in the House of Representatives have modified the language of a bill to improve access to titanium and carbon fiber wheelchairs for Medicare beneficiaries and will make it the focus of a new congressional fly-in scheduled for September. 

H.R. 5371, the “Choices for Increased Mobility Act,” would now establish two or more HCPCS codes for the base of an ultralightweight manual wheelchair depending on the construction material used, with one code used to identify a base with titanium or carbon fiber materials and one to identify a base without these materials. 

“The bill is still in effect and it’s still H.R. 5371, but the language and the way it achieves what we wanted it to do is different,” said Alexis Ward, senior director of payer relations for AAHomecare. “We pivoted how we open up access.” 

H.R. 5371 was introduced in mid-September by Rep. John Joyce, R-Pa., with Rep. Michelle Steel, R-Calif., joining as an original co-sponsor. 

There is precedent for treating upgrades like this, points out Dan Fedor, director of reimbursement and education for U.S. Rehab.  

“The way I interpret it in the proposed bill is we will keep the K0005 code for ultralight manual wheelchairs and if the wheelchair includes titanium or carbon fiber, there would be a different code used as the upgrade, much how it works currently from a Group 3 to a Group 4 power wheelchair,” he said. “There would be two different codes on two different lines, where the beneficiary would pay just the difference between them with an advance beneficiary notice (ABN).” 

If titanium and carbon fiber wheelchairs had a separate code, it would also make it easier for commercial insurers to follow Medicare’s lead, Ward says. 

“They look to Medicare coding and guidelines, but they don’t have a similar process of ABNs and non-assigned claims,” she said. “This would allow all payers to have this code that they can look to.” 

AAHomecare, with Jay Witter, senior vice president of public policy, leading the way, is working to get a companion bill introduced in the Senate prior to the fly-in, which will also include a mini-expo for equipment demos, Ward says. 

“It gives us an opportunity to meet and push this down the line this year,” she said. 


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