We Still Need your Help to Make a Change in CRT- HR 942

I am sitting here on the first day of June, thinking of how far we have come in our quest to change Complex Rehab Technology.  CRT is a relatively new term, which covers custom configured equipment including ultra light weight wheelchairs, powered mobility and seating and positioning equipment. 

It is mostly understood that, CRT is not a order and drop equipment, and requires skilled staff to help with the evaluation and assessment, the gathering and submission of paperwork to insurance funding, the ordering, assembly, delivery and fitting of this specialty equipment. 

Unfortunately our industry has not done enough to police itself and has a black eye, as it is lumped in with DME.  Every month you can see in the news DME suppliers investigated for fraud and abuse.  It is unfortunate that instead of CMS doing a better job screening their suppliers, they have placed higher and higher requirements which are negatively affecting the beneficiaries. What CMS/Medicare does, is adopted by all other insurance carriers.

I am excited to tell you at this moment we have 130 House Co-signers and 15 Senators who have Co-Signed on to this Legislation. This is a great start but we need more to make this legislation to be important enough for Congress to move on this.

None of us know if/when we may need these products and services; and there is a real concern that if things do not change, then this industry will certainly change; and possibly disappear.

A friend of mine reminded me that, Orthotics and Prosthetics went through this Journey several years ago, and it took them over a decade to be recognized and have their products/services separated from basic DME and are understood that it takes a special group of people to take care of those with special needs.

Take a moment to sign on to the petition to separate CRT. If you want to be move involved please contact me and I can put you in touch with several groups who are leading the charge to change CRT.

This Article was written by Carey Britton, ATP/SMS, CRTS for Active Mobility Center. He can be reached for comment at (954) 946-5793 or at cbritton@wheelchairguys.com.

What is Complex Rehab Technology ?

CRT (Complex Rehab Technology) is the newest term, developed over the last few years to describe specialty equipment that which is more involved than basic  DME (Durable Medical Equipment). As you may know DME encompasses everything from disposables  to custom wheelchairs and Orthotics/Prosthetics. You may wonder why a new term was created if it is part of DME? 

Invacare Rear Drive Powerchair

For years, DME vendors have been given a bad name, with a few bad companies taken advantage of the system and many times committing fraud.  CRT was born, when Medicare created the Competitive bidding process and they didn't understand the level of involvement with Specialty Seating and Equipment. After much work from the Rehab industry, some specialty equipment was exempt from the competitive program; including ultra light weight wheelchairs, tilt in space wheelchairs, and group 3 powered wheelchairs.  Medicare, who sets precedent for Medical Equipment to all funding sources, accepted that the skill level and expertise in providing this level equipment was above the typical DME provider.

Since that time, NRRTS ( National Registry of Rehab Technology Suppliers ) and NCART ( National Coalition of Assistive and Rehab Technology ), has been lobbying Congress to further separate Complex Rehab equipment from DME.  It is understood that there is a value for this equipment provided and that there needs to be increased safeguards, and education from individuals providing this level of equipment. If  this industry is not protected, and the value shown, it will disappear in the upcoming years.  The average age of Rehab Technicians are late 30's, with most over 40, and few new people learning this trade.

Carey Britton

 With the baby boomers aging, we will need more specialists  involved; helping match proper equipment for seating and mobility needs.  A further issue causing challenge, is that there are fewer physician and therapists specializing in this field; leaving more pressure and expectations on the Seating and Mobility Specialists.   Although the Seating and Mobility Specialist is a critical component in the team that provides and supports these services; the clinician is  the gatekeeper, and we need more clinicians  to step up become community leaders. 

In order to ensure  good outcomes, we continue to progress in this industry with increased credentials, increased education, and increased safeguards to protect patients.  Our industry needs to continue to educate the allied services to become more involved in the team that is required to improve seating, function and overall satisfaction.

This article was written by Carey Britton, Seating and Mobility Specialist at Active Mobility Center. He can be reached for comment at 954-946-5793 or at cbritton@wheelchairguys.com  .

 

It's Time to Advocate for the Future Access of Complex Rehab Equipment

Demand your Rights, Get out and Live !

For years, the DME (Durable Medical Equipment) and HME industries have given away too much in the attempt to best service our customers.  Our industry is comprised of caring individuals who want to make a difference in the lives of patient's we serve. What drives us is that we know at the end of each day, we made an impact, and improved the lives of the people we touched.

The DME and HME industries were created to help reduce the costs of Health Care. Research shows that getting a patient home from the hospital they heal and recover faster. Having a system where equipment and services are provided to the home reduces costly Hospital and Nursing Home Care. The DME industry is 1% of the Healthcare Budget, and saves a lot of money.

In the past few years, the pressures of insurance reductions, fraud and abuse, and increasing equipment costs have affective the way we conduct our service delivery.  What started out as a noble profession of helping, has become a business of becoming efficient.

Caring for our customers, we created networks and groups to lobby the state and federal governments trying to avoid further reduction in access to wheelchairs, scooters, powered wheelchairs, standers, gait trainers and seating and mobility equipment.

What happens at CMS/Medicare is adopted by all other insurance carriers; so those who don't care what happens with Medicare are fooling themselves. Many of our customers cannot speak, many fear that if they complain and lobby that they could lose more than they already have, and others don't know how. Many providers have continued to give away services and equipment and now are no longer able to.  We have failed to educate our customers, and now we are caught in an insurance system who isn't paying and customer's who are angry that they can't get what they used to.

Suppliers and Manufacturer's have commited time and resources to this battle; however since these groups profit from the provision of this equipment their voices are not heard as loudly as when it comes from the customers and beneficiaries of these insurances. Beneficaries will need to Advocate or Accept reduced access to quality equipment and services.

In the past few years, Medicare has instituted competitive bidding, where they forced providers to issue their lowest bid in order to stay in business. The first round of bidding caused hundreds of companies to go under, and 33% of the winning bidders closed within the first year.  This program is being launched nationwide this year, and will certainly cause havock on beneficaries.  As you may have seen the Scooter Store was raided and closed (for now), and all of their customers are stranded. Since they were investigated for fraud, providers are concerned. If a provider repairs and submits a claim for one of these customers, and that customer's paperwork is investigated and found that the Scooter Store did not complete their paperwork properly, that the funds for the chair and all services can be recooped by Medicare.

CMS/Medicare in the past two years had created a system where private companies are auditing providers in hopes to find missing or incomplete documentation so they can recoop money back to Medicare. These companies (bounty hunters) receive money based on this recoopment.  Generally these recoopments are not because the customer/beneficiary didn't need the equimpent, not because they didn't get the equipment; but because their was a T-not crossed or an I not dotted.

Major insurance companies are following Medicare's programs, and it is affecting everyone needing durable medical equipment (DME).  Many DME companies have stopped accepting Medicare as a payment sources as the risk of audits are too great.

There is still time to improve access to this life enhancing equipment.  There are several groups looking for your and your voice to send a message that will affect the future of Medical Equipiment. I encourage you to research these groups and commit to sending emails and making calls to help reduce the future pressure. We cannot afford to lose more companies with the baby boomer population retiring and who will need access to these services. With the pressures from Insurance, the risks are too great for any new companies to invest in the infrastructure of a company to provide these services.

Important Pending Legislation

HR-942- House Bill to Separate Complex Rehab Technlogy Equipmentt from DME, an important step in ensuring Access
S-948- Senate companion bill to separate Compex Rehab from DME

HR-1717- Bill to Stop Competitive Bidding


Get involved:
NRRTS- National Registry of Rehab Technlogy Suppliers
NCART- National Coalition for Assistive and Rehab Technlogy
USREHAB- a Division of VGM
Users First- Voice of Consumers using Equipment

Any questions or comments can be directed to Carey Britton with Active Mobility Center, located in Pompano Beach, Florida.