As Congress has reconvened in our nation’s capital, there are several items on the agenda that must be quickly addressed. Among them, preventing a government shutdown, immigration, and several health care-related items. With a massive hurdle of tax reform completed in 2017, members of Congress are likely going to look to small, effective health care reforms going into the 2018 elections. This will provide a great opportunity for complex rehab and mobility policy items to get through Congress and onto the president’s desk.
Looking back to 2017, one of the highlights at the federal level was the Centers for Medicare and Medicaid Services (CMS) changing their position on accessories for power wheelchairs being included in the competitive bidding program. Pressure coming from Congress along with grassroots providers remaining engaged was arguably much of the reason why CMS changed its position on this issue.
The initial focus for U.S. Rehab during the 2018 session will be to see passage of H.R. 3730, which would direct Medicare to halt the application of competitive bidding prices to CRT manual wheelchair accessories. The bill has strong bipartisan support with more than 80 cosponsors. Click here to view the latest sponsor list. With large pieces of legislation moving early in the session, there will be some opportunities to be a part of larger pieces of legislation.
In addition to the manual accessories bill, U.S. Rehab will continue to advocate for a separate benefit category within Medicare to distinguish CRT from durable medical equipment. H.R. 750 has been introduced by Rep. James Sensenbrenner (R-Wisc.), which has nearly 100 cosponsors.
At the state level, there are several reimbursement threats to complex rehab providers across the board. As federal funds to the state Medicaid programs will be reduced stemming from the 21st Century Cures Act, states will need to ensure reimbursements are sustainable to prevent patient accessibility issues to this effective, cost-saving equipment. At the end of December, CMS notified state Medicaid directors that they must be in compliance with the federal allowable for Medicaid reimbursements by the end of 2017. This unreasonable deadline gave states two business days to change processes at the end of the year. In a letter released on Jan. 4, CMS revised their guidance to states, giving them more flexibility to meet these new requirements.
Medicaid directors were scrambling to become compliant with these requirements at the end of 2017, but after a lot of industry pressure, CMS relaxed their requirements in order to give states more time to evaluate their own programs. States will likely look to tighten their belts when it comes to their budgets, which means that effective grassroots advocacy with state policy makers will be crucial to maintain quality reimbursements.
With a number of challenges in 2018 and a constantly evolving business environment, U.S. Rehab will remain highly engaged at the state and federal levels of government. Serving our valued members in order for them to continue providing vital care to patients will always remain our number one priority.