Lawmakers call on Medicare to cover preventative maintenance for CRT

WASHINGTON – U.S. Reps. Debbie Dingell, D-Mich., Brian Fitzpatrick, R-Pa., and colleagues have called on the Centers for Medicare & Medicaid Services (CMS) to cover preventative maintenance for complex rehab technology (CRT).

The lawmakers, in a letter to CMS Administrator Dr. Mehmet Oz, also ask the agency to drop a prescription renewal requirement for repairs of this equipment.

“Each year, tens of thousands of Medicare beneficiaries depend on CRT systems and equipment to maintain their mobility and independence,” they state. “Removing the prescription renewal barrier and providing coverage for preventative maintenance are targeted, achievable steps that would meaningfully improve care for this vulnerable population. We encourage CMS to prioritize both reforms and welcome the opportunity to discuss them further.”

Read the full letter here.

Current Medicare rules require that a component part must have already failed or malfunctioned before Medicare will cover any servicing – meaning that routine, scheduled maintenance designed to prevent failure is categorically excluded from reimbursement, the lawmakers point out.

“This framework is counterproductive in two respects,” they write. “First, it drives avoidable equipment failures: Problems that could be identified and corrected through routine maintenance instead go unaddressed until they become acute. Second, it undermines beneficiaries’ ability to plan.”

Current Medicare rules also require having a valid prescription on file dated within the prior 12 months for repairs.

“For beneficiaries who depend on power wheelchairs and similar equipment, this requirement, they say, creates an unnecessary and potentially harmful administrative obstacle,” they write.

The lawmakers believe CMS has the regulatory authority to allow for coverage of preventative maintenance and to waive or modify the requirement for prescription renewal.

Related reading:

• New York updates CRT maintenance, repair policies.
• ITEM Coalition presses policymakers to address repair issues.