Complex rehab: Regulatory, legislative priorities in flux 

WASHINGTON – When it comes to the CRT industry’s legislative priorities for 2025, including securing Medicare coverage for standing systems, it’s a bit of a hurry-up-and-wait scenario, at least in the first few months of the year, stakeholders say. 

The ITEM Coalition, for example, had an opportunity to meet with CMS to discuss the status of its request to open a National Coverage Analysis for Medicare coverage of standing systems in the waning days of the Biden administration but decided to allow the new administration to come in and get situated before scheduling a meeting. 

“This will be a top ITEM Coalition priority for 2025,” said Michael Barnett, director of government affairs for the Powers law firm, and co-coordinator for the ITEM Coalition. “We plan to renew our meeting request at the beginning of the Trump Administration and go from there.” 

The ITEM Coalition submitted its original request for Medicare coverage of both standing systems and seat elevation in September 2020, more than four years ago. CMS chose to split the request and issued a coverage determination for only seat elevation in May 2023.  The remainder of the request for standing systems has been deemed “complete,” but a public comment remains pending. 

Wayne Grau, executive director of NCART, also said stakeholders must “wait and see” who stays and goes at CMS under the new administration and see how anyone new at the agency feels about covering standing systems.  

“It continues to be a push for us,” he said. “We want an opportunity to make our case for the medical value of this incredible product.” 

For other priorities, like making more permanent telehealth flexibilities for physical therapists and occupational therapists who conduct wheelchair evaluations, there’s more urgency due to a March 31 deadline for an extension that Congress passed before the end of 2024. 

“We feel confident that Congress will get something done to address it and that PTs and OTs will be included, but we don’t know how long term it will be, because part of the issue is the cost,” Grau said. “But it’s too valuable not to allow, especially for people who are residing in medical deserts. In some cases, this is their only opportunity to engage with a therapist.” 

• Related: A bill was recently introduced in the Minnesota state legislature that would require coverage for power standing systems. 
• Related: In October, Reps. Debbie Dingell, D-Mich., and Brian Fitzpatrick, R-Pa., sent a letter signed by 22 representatives to CMS urging the agency to open a national coverage analysis for standing systems in power wheelchairs.