Higgins & local advocates detail bipartisan bill to help individuals with severe medical needs

Higgins, Sensenbrenner introduce Ensuring Access to Quality Complex Rehabilitation Technology Act

Congressman Brian Higgins was joined Monday by representatives from People Inc., Western New York Independent Living and the National Coalition for Assistive & Rehab Technology to announce federal legislation to make it easier for individuals with significant disabilities and chronic medical conditions to access specialized wheelchairs and adaptive equipment technology. Reps. Higgins and Jim Sensenbrenner have introduced H.R. 2408, the Ensuring Access to Quality Complex Rehabilitation Technology Act. The bipartisan bill creates a separate benefit category under Medicare to cover complex wheelchair and other adaptive equipment for people with severe medical needs.

Higgins said, “The reimbursement criteria for many of the devices used today was developed a generation ago, before some of this technology was available. This bipartisan legislation is an effort to remove bureaucratic barriers that create unnecessary challenges for families and provide easier access to services and complex medically necessary equipment for those with severe disabilities.”

Sensenbrenner said, “Individuals with significant medical conditions like cerebral palsy, muscular dystrophy, multiple sclerosis, and spinal cord injuries face unique physical and functional challenges. Many of these individuals rely on complex rehabilitation technology products to meet their medical needs and function on a daily basis. I’m proud to reintroduce this bipartisan legislation that would allow for targeted coverage and payment policies that address the unique situations of people with severe medical needs.”

"We are so grateful to Congressmember Higgins for sponsoring this important legislation for people with disabilities," said Rhonda Frederick, president and CEO of People Inc., and president of the Development Disabilities Alliance of WNY. "This bill will allow people with disabilities to obtain higher-end medical equipment, so they can have the most independent life possible versus nursing home care or hospitalization.”

“As systems to promote the health and independence of persons with disabilities change, complex rehabilitation technology is, more than ever, a critical part of maintaining our involvement and integration within our communities,” said Todd G Vaarwerk, chief policy officer for Western New York Independent Living Center. “However, the current system does not recognize that importance, and as a result, the people that can benefit from CRT the most go without, with results that are both negative to us as citizens, but potentially raising long-term medical costs. I thank Congressman Higgins and Sensenbrenner for continuing to support the full inclusion of people with disabilities by sponsoring this legislation.”

Donald E. Clayback, executive director of the National Coalition for Assistive and Rehab Technology, said, “We are very grateful to Congressman Higgins for taking up this important issue and championing the need for people with disabilities to get the specialized equipment they need. These individually configured products and supporting services are critical to allow people to be independent as possible and also play a big role in keeping down the costs of health care. The passage of this bill will have significant benefits to the children and adults with disabilities in Western New York along with their families and caregivers.”

Higgins’ press release noted, “Currently, Medicare includes complex rehabilitation equipment in the same category as standard durable medical equipment – i.e., traditional manual wheelchairs. However, individuals who use complex rehabilitation technology (CRT) products tend to differ from the traditional Medicare population and have vastly different needs. These products include specialized power wheelchairs, highly configurable manual wheelchairs, seating and positioning systems, and other adaptive equipment. Furthermore, these complex and often customizable products require a broader range of services and specialized personnel, as well as much more training and education for suppliers to ensure appropriate use.”

Under H.R. 2408, Medicare would cover complex rehabilitation technology under a separate benefit category. This separate category would allow for targeted coverage and payment policies that address the unique situations of this specialized subset of durable medical equipment and the people with disabilities it serves.

Additionally, to help prevent fraud and abuse, the legislation would establish clinical conditions for coverage that ensure these items are prescribed appropriately. Whenever prescribed, a licensed physical or occupational therapist with no financial relationship to the supplier would have to conduct an evaluation. This would ensure program safeguards by increasing quality standards for suppliers of these items.

H.R. 2408 is supported by the American Association for Homecare, American Physical Therapy Association, Brain Injury Association of America, Christopher and Dana Reeve Foundation, Easter Seals, National Association for Home Care & Hospice, National Coalition for Assistive and Rehab Technology, National Council on Independent Living, National Multiple Sclerosis Society, National Registry of Rehabilitation Technology Suppliers, Paralyzed Veterans of America and United Spinal Association.