To Enrich Lives

NCART Members and Friends,

As part of our National CRT Conference next week in Washington, DC over 180 CRT stakeholders will be visiting the offices of their Members of Congress.  The purpose is to push for additional co-sponsors and passage of our CRT legislation.

For those stakeholders (consumers, clinicians, suppliers, manufacturers, others) who cannot be in Washington with us, we are asking that they call their Members of Congress on Tuesday April 29th in advance of the Congressional visits on Thursday May 1st.  To facilitate this effort we have developed the attached flyer for you to circulate within your own organization and share with other individuals and groups who can add their voices.  The flyer provides an overview, the specific steps to be taken, and the request that should be made.

We want Congress to get thousands of calls next week letting Members know that passing HR-942/S-948 is important to people back in their states.  They need to get that message!

Also attached is the list of current co-sponsors and the updated CRT Legislation Information Pack.  These are also available for viewing and downloading at www.access2crt.org.

Thanks for your participation and for spreading the word to other CRT stakeholders.

Don

Donald E. Clayback

Executive Director | N.C.A.R.T.

NCART Members and Friends,

As we have reported, problems continue with Medicare beneficiaries having access to wheelchair repairs. This problem impacts both Competitive Bidding Areas and non-CB areas. In an effort to get needed changes made we have been meeting/communicating with CMS as part of a national Work Group which includes United Spinal Association, the ITEM Coalition, AA Homecare, and others.

According to CMS they are “not aware of any access problems” regarding Medicare beneficiaries getting wheelchair repairs. We have an in-person meeting with CMS on May 15 and in advance of that we are looking to gather data that will illustrate the problems beneficiaries are having.

To help gather that data, two new tools have been developed by the Work Group. We are asking consumer groups, clinicians, providers, and manufacturers to get Medicare beneficiaries and other wheelchair users to make use of them:

1.) A website has been established that allows a Medicare beneficiary to send an email directly to their members of Congress asking them to “Fix Access To Medicare Wheelchair Repairs”. The email can be accessed at  http://action.savemymedicalsupplies.org/issue/wheechair-repair/.

2.) A “Wheelchair Repair Survey” has been developed through United Spinal and ITEM. This will help gather real data from both Medicare and other beneficiaries on accessibility to timely and professional wheelchair repairs. This survey can be accessed from the email website above or directly at  https://www.surveymonkey.com/s/wheelchair-repair.

Note, this does not replace the need for Medicare beneficiaries to call and share their wheelchair repair problems at 1-800-MEDICARE. They should still do that so CMS is hearing about problems through their internal reporting system.

Please share this information with anyone who has concerns/problems relating to wheelchair repairs. Particularly providers—be sure your customer service and repair staff have this information to point your customers to.

Thanks for spreading the word and encouraging Medicare beneficiaries who depend on their wheelchairs to let their voices be heard.

According to the American Association for Respiratory Care (AARC) Times – a journal for respiratory therapists-

by: Stephen F. Jencks

The Patient Protection and Affordable Care Act (PPACA) created the Medicare Readmissions Reduction Program (MRRP), under which hospitals are penalized for “excess” readmissions for certain diagnoses or procedures. “Excess” means that all readmissions within 30 days after discharge (except those likely to have been planned) exceeded an expected number. As of Oct. 1, 2014, chronic obstructive pulmonary disease (COPD) is one of the conditions for which readmissions are counted, and the penalty is up to 3% of Medicare revenues.

The MRRP can be seen as just another effort to reduce Medicare payments, but it is a paradigm shift in two ways. Holding a hospital accountable for readmissions within 30 days after discharge makes it accountable for the effectiveness of the care to which it discharges the patient and creates a substantial incentive for the hospital to work closely with other providers in the community. Possibly even more portentous, penalizing “excess readmissions” reverses a fundamental premise of hospital management: that an admission is a source of revenue.
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American Association for Respiratory Care (AARC) Times – a journal on all things respiratory related

Here is a question: Are you a hospital-based or a home-care based RT? If you work for a durable medical equipment (DME) supplier, you are fully aware of the challenges you face. Though you are very familiar with LTOT delivery devices and patient education in their use, you (and your DME employer) realize that payors for DME will not reimburse for patient clinical education, monitoring, and management that you have been trained to provide. You can’t function in your role as a respiratory disease manager. Job security is threatened as DME reimbursement continues to decline, especially due to Medicare capped rental and competitive bidding regulations. The AARC is trying to help watch your back, but it is a tough situation. Health care reform needs to position you to be valued for the care of the respiratory patient that you can bring into the home, and not just the equipment.

If you are a hospital-based RT and are unaware of the dilemma your colleagues face, you should be. At least for now, much of the weight they are not allowed to carry must fall upon you. Hopefully, your medical director, prescribing physicians, and administrators have given you a substantial role in identifying and documenting hypoxemia and qualifying patients for home oxygen therapy prior to discharge. With the shrinking workforce of DME provider-based RTs, you may need to play a major role in both selecting the appropriate LTOT system to address overall patient needs and documenting that the system meets SpO2 requirements during prescribed use (e.g., rest, exertion, sleep). Finally, as a respiratory disease manager, you should ensure that the patient understands hypoxemia and the importance of correcting it. You have an opportunity to initiate the process of patient self-empowerment in their care.
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According to HME NEWS:
by:  Leah Hoenen
Friday, March 14, 2014

WASHINGTON – A group of lawmakers has asked CMS to delay the transition of certain complex rehab items to capped-rental status on April 1.

In a March 6 letter to CMS Administrator Marilyn Tavenner, two senators and two representatives ask the agency to delay the transition until at least July 1 “to allow for the development of appropriate classification policies that provide patients with medically-necessary CRT equipment in a reasonable and cost-effective way.”

CMS has based its decision to change the status of the codes “on Medicare claims data that is more than 27 years old and fundamentally flawed,” wrote Sen. Thad Cochran, R-Miss., Sen. Charles Schumer, D-N.Y., Rep. Jim Sensenbrenner, R-Wis., and Rep. Joseph Crowley, D–N.Y.

Stakeholders have requested claims data from the Pricing, Data Analysis and Coding contractor (PDAC) to show that, had CMS used currently available claims data for items that did not exist in 1986, it would have placed the codes in question in the routinely purchased category. They expect to receive the data by the end of March.

At the same time that they’re fighting to delay the transition, stakeholders are also crafting a Plan B if it goes into effect as scheduled.

“I think the strategy will be to share what the impact will be on the marketplace, and if people are having difficulty getting equipment, those are stories we’ll share with Congress,” said Don Clayback, executive director of NCART.

All efforts have targeted not only delaying the change, but also eliminating it.

“One of the things we saw with the K9 issue last year is we focused a lot on delay, but there wasn’t as much talk about just getting it eliminated,” said Doug Westerdahl, secretary/treasurer of NCART. “So now we’re really focusing on delay and getting the whole thing removed altogether.”