LIVING WITH A DISABILITY BY JERRY LEVINSON
Rep. Zeldin says Congress must now act again to ensure that a more permanent fix is granted.
Congressman Lee Zeldin (R, NY-1) is spearheading an effort to protect people with disabilities by ensuring they have access to essential medical equipment, such as specialized power wheelchairs, seating systems, and other adaptive equipment (collectively called Complex Rehabilitation Technology or CRT). To this end, he has introduced legislation (H.R. 3229) that clarifies the 2008 Medicare Improvements for Patients and Providers Act (MIPPA) by prohibiting the application of Medicare competitive acquisition rates to complex rehabilitative wheelchairs and accessories. Zeldin is joined and “fully” supported in his efforts by the ALS Association, Muscular Dystrophy Association, National Multiple Sclerosis Society, the Paralyzed Veterans of America, VetsFirst and the United Spinal Association.
REHAB EQUIPMENT INITIALLY EXCLUDED FROM COMPETITIVE BIDDING
When the MIPPA was enacted into law, it provided that CRT devices would be excluded from the Centers for Medicare and Medicaid Services (CMMS) Competitive Bidding Program. Excluded devices include power wheelchairs and the related accessories, which are the fundamental parts of the products that make them useful and beneficial to people with progressed disabilities – such as recline/tilt systems, specialty controls and seat/back cushions.
In November 2014, CMMS ruled, contrary to MIPPA, that starting in January 2016, accessories that are used on complex rehabilitative wheelchairs would no longer be part of the fixed fee schedule, but would be subject to competitive bidding pricing. Rep. Zeldin said this ruling would be “devastating for the disabled community,” decreasing access to individually configured wheelchairs and accessories.
A TEMPORARY FIX
In December 2015, Congress passed the Patient Access and Medicare Protection Act (S.2425), which provided a one year delay in the application of Medicare competitive bid pricing for complex rehab power wheelchairs and accessories to keep fees from rising anywhere from at least 10% to 34%. Zeldin says Congress must now act again in 2016 to ensure that a more permanent fix is granted.
The Congressman’s legislation, H.R. 3229, which has companion legislation in the Senate (S.2196), has strong bipartisan support in Congress with already over 135 House cosponsors.
ADDITIONAL SUPPORTING INFORMATION
Rep. Zeldin says that additional information has been reported since the introduction of his bill which only further supports its purpose.
According to the Congressman, “an additional requirement of S. 2425’s passage was a report conducted by the Government Accountability Office, which detailed why costs would increase for consumers should they switch to the competitive bidding model. As a result of this report, new cost estimates are now being conducted to detail the significant sums of money that will be saved due to the implementation of this legislation. The GAO report highlighted that too much of the Competitive Bid Rate data is outdated, limited and insufficient for determining payment rates nationally. By applying Competitive Bid Pricing for accessories used with standard wheelchairs to those used with Complex Rehabilitative Technology wheelchairs, there will be misguided and massive payment reductions ranging from at least 10% to 34% as a result. The bill has been referred to the House Ways and Means and House Energy and Commerce Committees. Before this bill can be brought to the House floor, it must pass out of one of these committees. Both the House and Senate must pass this legislation in 2016 to protect Americans dealing with the challenges from disabilities such as ALS, cerebral palsy, multiple sclerosis, spinal cord injury, and many other debilitating illnesses. My bill is just one effort to help Americans with disabilities attain the self-sufficiency and independence we all cherish. I will continue working in Congress to provide support and care to help the many vulnerable adults and children living with disabilities.” •
LIVING WITH A DISABILITY
This column has a simple purpose, but a difficult goal: discuss issues that affect the lives, well being and state of mind of those who must live and cope with a disability and do so in a humorous way whenever possible. This isn’t an easy thing to do, since there’s certainly nothing funny or humorous about being disabled, or in the difficulties and obstacles that those with chronic disabilities encounter daily. However, I’ve personally found that humor has to a great extent helped me cope with my disability (I’ve had Multiple Sclerosis for 47 years and use a wheelchair), and I hope this column helps others in the disability community do so as well.