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Thread: National Call-In Day to Congress - Separate Benefit Category for Complex Rehab

  1. #1
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    National Call-In Day to Congress - Separate Benefit Category for Complex Rehab

    Get involved! It will only take 5 or 10 minutes from your day tomorrow! You can make a big difference for future access to top quality mobility and seating equipment. Thank you!

    National Call-in Day for Complex Rehab Technology
    February 16, 2011
    “We need Congress to introduce and pass legislation to create a Separate Benefit Category
    for Complex Rehab Technology within the Medicare program.”
    If you know the names of your Senators and/or Representative, you can reach them by calling the U.S. Capitol
    switchboard at (202) 224 ‐3121 and asking to be connected.
    If you need to look up the name(s) of your Members of Congress, please go to celaadvocacy.org and enter your zip
    code in the box at the lower left hand corner of the home page.
    What to say when you make the calls!
    Each of us is unique. No two of us communicate in exactly the same ‐ and that's how it should be.
    In order to help you make more unique and impactful calls to your Members of Congress, here is a "script" that
    you might incorporate into your conversation. Use all of it, part of it, or none of it. The important thing is that you
    make the calls.
    "Hello, my name is _____________________ and I am constituent of Senator or Congressman/woman
    ____________. I would like to speak with his or her Health Legislative Aide.
    NOTE: If the Health Legislative Aide is unavailable: Choice #1 ‐ Speak with any available legislative aide; Choice #2 ‐
    Leave a detailed message (as below) with the person answering the phone.
    I am calling the Senator or Congressman/woman to urge him/her to help introduce legislation to create
    a Separate Benefit Category for CRT ‐ Complex Rehab Technology ‐ within the Medicare program. CRT
    includes complex rehab power wheelchairs, highly configurable manual wheelchairs, adaptive seating
    and positioning systems, and other specialized equipment, such as standing frames and gait trainers.
    This equipment is used by people with complex disabilities such as Cerebral Palsy, Muscular Dystrophy,
    Multiple Sclerosis, Spinal Cord Injury, Amyotrophic Lateral Sclerosis (Lou Gehrig’s disease), and Spina
    Bifida.
    The current Medicare DME, Durable Medical Equipment, benefit does not adequately differentiate
    Complex Rehab Technology and the related services. A Separate Benefit Category is needed to
    distinguish and address the unique needs of individuals with disabilities and medical conditions who
    require these Complex Rehab Technology products and services.
    To create this Separate Benefit Category requires Congress to pass legislation. A national committee of
    consumer, clinical, and supplier groups has drafted the necessary legislative language. When this
    document crosses his/her desk, I ask that the Senator/Representative review it and consider sponsoring
    its introduction.
    Your office may have received a fax on Monday which included the position paper about the need for
    this legislation. If you haven't received it, I would be happy to e‐mail it you."
    NOTE: Be sure to get the person’s name and e‐mail address.
    If you need to send additional information to the Members ‐ or if they ask you questions that you're unable to
    answer ‐ please e‐mail us at smargolis@nrrts.org.

  2. #2
    Senior Member
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    Dec 2009
    Location
    St. Louis, Missouri
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    Separate Benefit for Complex Rehab - Support from ITEM Coalition

    ITEM Coalition Letter of Support
    November 30, 2010
    RE: Ensuring Medicare Patient Access to Complex Rehab Technology (CRT)
    Dear Senators and Representatives:
    The Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition
    requests that Congress establish a separate benefit category for complex rehab technology
    within Medicare to ensure beneficiary access to critical assistive devices for beneficiaries
    with disabling conditions. The current benefit structure presents serious and often
    insurmountable obstacles for individuals who need to access Complex Rehab Technology
    (CRT) to achieve high levels of function in order to achieve good health outcomes, live
    independently, be employed where possible, care for their loved ones, engage in civic
    functions, and perform everyday activities.
    CRT entails a broader baseline of services than those that are currently referred to under
    the Medicare program as “durable medical equipment” or “DME.” CRT is prescribed and
    customized to meet the specific medical and functional needs of individuals with
    disabilities and medical conditions such as, but not limited to, Cerebral Palsy, Muscular
    Dystrophy, Multiple Sclerosis, Spinal Cord Injury, Amyotrophic Lateral Sclerosis (Lou
    Gehrig’s disease), and Spina Bifida. However, because CRT is currently coupled with the
    more general DME benefit, these patients face a series of challenges trying to access the
    appropriate and necessary technologies and services. These challenges include:
     Hindrance of the pairing of an individual’s needs to the appropriate products and
    technology due to coverage policies that are based on diagnosis instead of a
    person’s functional needs;
     Severe limitations on devices to be used outside of the home and in the community,
    due to Medicare’s restrictive interpretation of the “in the home” requirement for
    DME;
     Threats to patient access by the inclusion of CRT products in Medicare’s DME
    Competitive Bidding program, a program that could threaten patient access to
    20
    specialized technology. (While Group 3 complex rehabilitation wheelchairs were
    exempt from competitive bidding, other items such as configurable manual
    wheelchairs, tilt-in-space wheelchairs and custom seating and positioning items are
    still at risk);
     Lack of access to local CRT suppliers and long delays for repairs and maintenance
    for CRT due to insufficient reimbursement for these specialized devices and
    services; and
     Reductions in coverage for CRT when State Medicaid programs cut DME benefits.
    Congress recognized the difference between DME and CRT when it exempted complex
    rehabilitation wheelchairs from DME competitive bidding in the Medicare Improvements
    for Patients and Providers Act (MIPPA). CRT was exempted from this program to
    preserve access to these specialized technologies for a patient population that is vulnerable
    and at-risk. Our proposal to break out a new CRT benefit from the existing DME benefit
    under the Medicare program would build on that Congressional recognition.
    The ITEM Coalition urges Congress to establish a new and separate benefit category for
    Complex Rehab Technology products and services that recognizes the customized nature
    of the technology and the range of services necessary to meet the unique medical and
    functional needs of people with disabilities and complex medical conditions. For more
    information, please contact Peter Thomas, ITEM Coalition Counsel, at (202) 466-6550.
    Sincerely,
    ACCSES
    American Academy of Physical Medicine and Rehabilitation
    American Association of People with Disabilities
    American Association on Health and Disability
    American Congress of Rehabilitative Medicine
    American Music Therapy Association
    American Therapeutic Recreation Association
    Amputee Coalition of America
    Association of Assistive Technology Act Programs
    Association of University Centers on Disabilities
    Blinded Veterans Association
    Brain Injury Association of America
    Christopher and Dana Reeve Foundation
    Disability Health Access, LLC
    Disability Rights Education and Defense Fund
    Easter Seals
    Harris Family Center for Disability and Health Policy
    Hearing Loss Association of America
    National Association of County Behavioral Health and Developmental Disability Directors
    21
    National Association of State Head Injury Administrators
    National Council on Independent Living
    National Disability Rights Network
    National Down Syndrome Society
    National Multiple Sclerosis Society
    National Rehabilitation Hospital
    National Spinal Cord Injury Association
    Paralyzed Veterans of America
    Rehabilitation Engineering and Assistive Technology Society of North America
    Spina Bifida Association
    TASH
    The Arc
    United Cerebral Palsy
    United Spinal Association
    VetsFirst

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