Complex rehab stakeholders 'pick up pace' for manuals

WASHINGTON - Complex rehab stakeholders scored a big win when CMS used its authority to stop reimbursement cuts for accessories for complex power wheelchairs, but their job is only half done.

Stakeholders are now aiming for legislation in the House of Representatives that would stop competitive bidding-related cuts for accessories for complex manual wheelchairs that went into effect on Jan. 1, 2016.

“We're picking up the pace on that issue,” said Don Clayback, executive director of NCART.

Legislation introduced in the House and Senate in 2016 sought to stop the cuts for accessories for both complex power and manual wheelchairs, but CMS included only power wheelchairs in its June 23 announcement.

The reason: It could have to do with a bill back in 2008 that exempted complex rehab from the bid program. At the time, only power wheelchairs, not manual wheelchairs, were set to be included in the program and, therefore, the bill provided protection only for those wheelchairs.

“Unfortunately, there has been an unintentional focus on power and once that ball started moving it has been difficult to stop,” Clayback said. “That's one reason why we said, 'Let's clarify that with the 2016 legislation and include both.'”

Stakeholders and their champions in Congress were able to stave off the cuts for accessories for complex power wheelchairs for a year in 2016 and six months in 2017. Not so for manual wheelchairs.

“We're going back to congressional leaders and saying, 'Thank you for championing this issue for power wheelchairs; now we're looking to complete the picture,'” Clayback said.

It doesn't make sense to protect access to accessories for one product category and not the other, as complex manual wheelchair users also need, for example, special cushions to protect them from pressure sores.

“Whether it's power or manual, they have a disability and they're sitting in a chair for 12 hours a day,” Clayback said. “They have the same need and should have the same access.”

This has been a major point of emphasis during meetings on Capitol Hill to discuss the need to stop the cuts.

“Equal access is vital,” said Laura Weidner, senior director of federal government relations for the National MS Society. “Legislation on this front is a heavy priority for us.”