December may, once again, turn out to be a lucky month for complex rehab stakeholders.
Last week, industry champions in the House of Representatives were able to slide into a larger bill some language that requires CMS to stop applying competitive bidding pricing to accessories for complex rehab manual wheelchairs for 18 months, from Jan. 1, 2019, through June 30, 2020.
“We’re pleased with the 18 months,” said Seth Johnson, senior vice president of government affairs for Pride Mobility Products. “It provides necessary relief for these manual wheelchair accessories. It would be nice to have permanent relief, however, and once this legislation is passed, we’ll be working with the administration to get the same regulatory relief for manual wheelchair accessories as power wheelchair accessories.”
H.R. 7217, which focuses on improvements to the Medicaid program, was introduced in the House on Thursday afternoon. The House is expected to vote on the bill early this week. If passed, H.R. 7217 will then move to the Senate for a vote.
The bill also provides a permanent exemption from the competitive bidding program for complex rehab manual wheelchair bases. CMS hasn’t included these bases in the program or applied pricing from the program to them, but this would make that official.
“It’s not prohibited by legislation, so this really closes the loop and prevents any misunderstanding,” said Don Clayback, executive director of NCART. “This is particularly important now, with CMS making modifications to the bid program going forward.”
Having complex rehab manual wheelchair bases exempted from the bid program through legislation also builds on the case for also permanently exempting accessories.
“Exempting the bases get us 75% of the way for complex rehab manual wheelchairs and accessories,” Clayback said. “Then we have 18 months to get the other 25%.”
Even though H.R. 7217 reportedly has broad bi-partisan support and strong committee support, it is all hands on deck to call members in the House and Senate “to push the bill across the finish line,” Clayback said, because no one can predict what will happen in Congress.
“That’s the one thing we have control over—emailing and calling our members,” he said.
This latest development comes after years of hard work that began to pay off in December of 2015, when industry champions were able to stave off bid pricing for accessories for complex rehab power wheelchairs for a year. They were able to do that again in December 2016 for another six months.
CMS then decided not to apply the pricing for accessories for complex power wheelchairs starting July 1, 2017. Bid pricing for complex rehab manual wheelchairs, however, has been in place since Jan. 1, 2016.