Legislation to prevent the application of bidding-derived pricing for CRT accessories was introduced in the Senate and House last week. The legislation is needed due to CMS' attempt to apply competitive bid program pricing to CRT accessories effective January 1, 2016. Congress has twice passed legislation to delay this measure, most recently through provisions in the CURES bill that hold off bidding-derived rates until July 1, 2017.
The Senate bill, S. 486, introduced by lead sponsors Sens. Rob Portman (R-Ohio) and Bob Casey (D-Pa.), and its House companion, H.R. 1361, introduced by Reps. Lee Zeldin (R-N.Y.) and John Larson (D-Conn.) both show strong bipartisan support from initial co-sponsors.
“CRT providers need a permanent fix that will ensure that they can continue to support individuals with serious disabilities that depend on this specialized equipment,” said Tom Ryan, president and CEO of AAHomecare. “If bidding-derived pricing is allowed to slash reimbursement rates, these companies simply can’t provide the level of clinical care associated with CRT products and accessories, including patient evaluation, as well as configuration, fitting, and adjustments for the equipment.”
“After two timely delays, rehab providers are finally at a critical juncture where the ill-conceived proposed cuts to 171 CRT accessory codes can be put to rest," said Georgie Blackburn, vice president of government relations and legislative affairs for BLACKBURN’S. “Plain and simple, MIPPA 2008 exempted CRT power chairs and accessories from the bid program."
“I’m thrilled to see that we have congressional leadership recognizing this, resulting in S.486 and H.R. 1361, and that we now have Secretary Tom Price leading HHS,” added Blackburn, who also serves as a member of AAHomecare’s Complex Rehab & Mobility Council (CRMC). “I have never felt so optimistic that logic will prevail when it comes to public policy for CRT!”
“Without adequate funding, suppliers won’t be able to provide these very specialized products that are essential to allow patients to stay in their homes, which is both their preferred outcome as well the cost-effective place for them to be,” said Jody Wright, president of Rocky Mountain Medical Supply and CRMC member. “I hope that companies in the CRT space will reach out to their Senators and Representative and ask for their support for this much-needed legislation.”
In addition to showing bipartisan support, the committees of jurisdiction covering healthcare-related legislation are well-represented by current co-sponsors:
S. 486 – 5 Republican co-sponsors, 4 Democrat co-sponsors – 4 cosponsors are members of the Senate Finance Committee
H.R. 1361 – 12 Democrat co-sponsors, 10 Republican co-sponsors – 8 co-sponsors are members of the House Ways & Means Committee and 4 co-sponsors are members of the Energy & Commerce Committee.
Learn more with AAHomecare's issue brief on CRT accessories legislation.