Last Friday, CMS published the final rule CMS-1526-F that includes reclassification of
certain DME items from the routinely purchased payment category to the capped rental
This includes tilt-in-space manual wheelchairs, pediatric manual wheelchairs and
manual wheelchair power-assists. By reclassifying these items, CMS will severely limit access to
Medicare beneficiaries who truly need the complex rehab seating and positioning that can only
be provided with this type of equipment. Suppliers will not be prepared to provide this
equipment to individuals on a capped rental basis because of the high level of expertise
required. CMS itself requires an evaluation by an ATP and a therapist for this level of need,
which is complex and typically lifetime. This is not a product that should be considered as a
U.S. Rehab, represents more than 1,200 member locations, and we were one of 172
organizations and individuals who submitted comments about CMS’s proposal several months
ago. For CMS to completely ignore any guidance from the sector that will be forced to say no
to Medicare beneficiaries because of payment structure flaws is very disturbing. It’s also
disturbing that the final rule was issued at 5:30 p.m. on Friday just before the week of
Thanksgiving when all governmental officials will be on break from Washington, DC.
The way to address this ruling now is through legislation. The bill to separate complex
rehab technology within the DMEPOS benefit category does just that. This law would clearly
define CRT products and protect them from capped rental issues. It is very important that you
take the time to contact your congressional offices and express your support for the Ensuring
Access to Complex Rehabilitation Technology Act (H.R. 942 and S. 948).
Please take the time to read and understand what CMS has done to the process of
providing this complex rehab equipment that is individually considered for each person. They
have re-categorized this equipment as commodities and put the individual’s health and wellbeing
at risk. They have also affected the scope and practice of the ATP, PT and OT
communities because potentially needed equipment will be difficult, if not impossible, to
provide as capped rental items.
You can find a copy of the CMS-1526-F on our website, along with a chart of affected
products, including complex rehab products that will now be capped rental and no longer
U.S. Rehab will continue our efforts to make everyone aware of the effect this will have
on patient access. We urge you to take the time to contact your congressional members and
discuss your support for the Separate Benefit Category for CRT.