Tomorrow (Wednesday) is National Call In Day for Complex Rehab

[Tom Borcherding]

Call your members of Congress and join with many others who want to preserve access to complex rehab equipment! The call to action only takes a couple of minutes.

http://www.nrrts.org/announcements/CRTCall-inDay

Thank you!

Tom Borcherding

[MSspouse]

I don't think that would help as much as requiring them to participate in the entire duration of treatment for a stage IV pressure sore and then seeing the amount billed to Medicare. Next best would be to force them to watch a graphic documentary of a few typical cases.

That said, I am dismayed by the narrow scope of the resolution. It reads as written by and for the wheelchair industry. Bedding, bathing, toileting, and transferring are equally important.

[cheesecake]

Medicare's Homebound rule prevents the purchase for equipement for outside of the home. My private insurance follows the homebound rule. Because of that I cant get the wheelchair I need and was prescribed. Three bad falls in the last two months cost thousands in care and missed time from work.

Since when is work a convenience? My salary covers my insurance and DME.

PLEASE call in tomorrow.

[Tom Borcherding]

Originally Posted by MSspouse

I don't think that would help as much as requiring them to participate in the entire duration of treatment for a stage IV pressure sore and then seeing the amount billed to Medicare. Next best would be to force them to watch a graphic documentary of a few typical cases.

That said, I am dismayed by the narrow scope of the resolution. It reads as written by and for the wheelchair industry. Bedding, bathing, toileting, and transferring are equally important.

MSspouse,

I hear what you are saying! Unfortunately, the reality as it relates to Congress and legislation is that to try and gain Congress' support for a total overhaul to the Medicare DME benefit is just too big of a bite out of the apple. This is an election year, and Congress won't tackle huge projects not already on their radar screen. By focusing on a smaller bite (specifically the benefit around complex rehab equipment such as speciality power wheelchairs, ultralight rigid chairs, speciality seating, standing frames, etc.) we hope to gain enough Congressional support that this request for a Separate Benefit for Complex Rehab equipment gets included as a part of a bigger healthcare bill later this year. But for that to happen, Members of Congress needs to hear from their constituents that this issue is both important and urgent.

[wheeliecoach]

My husband and I were filmed for the video that is being shown to Congress. We did mention the fact that my husband, due to being in a chair that was not fit to him, had incurred (at that time) $150,000 in treatment for a stage IV pressure sore that went septic. This point was covered then after we talked about it. Regardless...call...if we can win this battle, we may be able to win other battles downstream.

[cheesecake]

Today is a National Call-In Day for Complex Rehab Technology (CRT). Have you called your Senators or Congressional office? I called during my lunch break and asked my member of Congress to support legislation to establish a separate benefit category for CRT under Medicare Durable Medical Equipment (DME) benefit.

Medicare’s DME benefit was drafted over 40 years ago, well before the advances in technology. Over the years, durable medical equipment (DME) has become customized and unique to the user and specific disability. The Medicare guidelines have not changed with technology. Currently CRT falls into the same category as crutches, canes, and walkers. By creating a separate category under Medicare for CRT, the specific and unique equipment needs of individuals with disabilities can be met. This will account for only 7% of all equipment needs.

Why should you call? The reasons are numerous. Medicare guidelines apply to most private insurance companies as well as Medicaid, not just to Medicare beneficiaries.
Currently complex rehab technology (CRT) falls under Medicare’s “In the home” restriction. “In the home” restrictions means that the equipment needs to be for use and benefit in your home. If a particular piece of equipment would allow you to go to school, work or function independently in the community—it is NOT covered. I had power assist wheels denied because Medicare guidelines say I must “be unsuccessful” for one year with a standard manual chair. My seating clinic documented how the wheels assisted me with my employment and my insurance called my employment a “convenience and not a necessity”.

What should you ask for? Request that your Senators and Congressional member support a separate category for Complex Medical Technology (CMT). Let them know what equipment you use, need and any obstacles you have had in getting it funded. If you have private insurance, let them know that your insurance follows Medicare’s antiquated guidelines. Before you hang up, please be sure to give your full name, address and stress that you are a constituent.

Is today the last day to call? No, you can call at any time but this week is important. Other disability advocates are personally visiting their Congressional offices on Thursday, April 19th to meet with Congressional staff. Please call and let your voice be heard. I know I was told today that others had called.

Lend your voice and make a difference.

[Belaattal]

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