EAST AMHERST, NY – As reported last month, the advocacy work of the Complex Rehab Technology (CRT) Community resulted in significant protections for access to CRT manual wheelchairs being included in year-end legislation H.R. 7217 (“Improve Act”), introduced in the House of Representatives on Dec 5.
In addition to the CRT provisions, H.R. 7217 also contained several improvements to the Medicaid program for children and adults with disabilities which had broad bipartisan Congressional support.
The CRT access protections provided (a) a permanent exemption from the Medicare Competitive Bidding Program for CRT manual wheelchair bases (just like CRT power wheelchairs); and (b) an 18-month “suspension” in Medicare’s current inappropriate application of Competitive Bidding Program payment rates to CRT manual wheelchair accessories so that these accessories would go back to being paid at the traditional Medicare rates (just like CRT power wheelchair accessories).
We were very encouraged on December 11 when the House of Representative overwhelmingly passed H.R. 7217 by a vote of 400 to 11. This was a great show of the support in the House.
The bill then moved to the Senate to be acted on under their “Unanimous Consent” process, which is an expedited system meant for broadly supported bills when there is an expectation that no Senator will object to its passage. While this process can be quick, the downside is it can stall a bill if any individual Senator puts a “hold” on the legislation which prevents it from moving forward until the hold is removed.
Unfortunately upon arrival in the Senate it stalled based on holds from a very small number of Senators. Their concerns did not relate to the CRT language but were about other provisions regarding Medicaid services for children with complex needs. We continued to advocate in the Senate right through the holidays, but all the attention around resolving the government shutdown was the primary focus and made things much more challenging.
It’s obviously disappointing that H.R. 7217 was not passed by the Senate before the end of the 115th Congressional Session last Thursday. But getting the bill passed by such a majority in the House and then not encountering any Senate objections to the CRT provisions of H.R. 7217 in the Senate is great progress to build on in 2019.
With the start of the new Congress we are working with our House CRT champions Representatives Lee Zeldin (R-NY) and John Larson (D-CT) and to Senate CRT Champions Senators Bob Casey (D-PA) and Rob Portman (R-OH) to review next steps, including upcoming legislative options. We thank them for all their work in 2018 and for their continued support and leadership.
Thanks also goes to all the consumer, disability, and medical professional organizations who invested their time in educating and advocating. And thanks to our industry partners NRRTS, AAHomecare, the VGM Group, the MED Group, and the state associations for their contributions.
Getting legislation and policies to protect access to CRT for people with disabilities is not a sprint, it’s a marathon. The progress we made in 2018 increased CRT awareness and support and puts us in a strong position for 2019 as we work to resolve the CRT manual wheelchair issues and secure needed comprehensive improvements through establishing a Separate Benefit Category for CRT.
Don Clayback is executive director of the National Coalition for Assistive & Rehab Technology, East Amherst, NY.