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Wheelchair Accessories used on Group 3 Power Wheelchairs will pay INCORRECTLY from Jan 1 – June 30, 2016

US Rehab logoWe are very sorry to report that CMS has officially announced that the implementation of Section 2 of the PAMPA, which exempted accessories used on group 3 power wheelchairs from the adjusted fee schedule amount based competitive bid pricing, will not be implemented until July 1, 2016. This means that accessories used on group 3 power wheelchairs will pay at a lower rate than what it should (fee schedule). The Act that included exempting accessories used on group 3 bases was passed on Dec. 28, 2015 and was effective Jan. 1, 2016.

Many providers have been holding claims in the hope that CMS would announce the system would be updated to pay these accessories accurately shortly after Jan. 1 (the effective date), however, with this delayed implementation it would be best to send the entire claim in and request a reopening adjustment for those accessories that paid incorrectly (competitive bid rate).

We realize this is a tremendous burden on the provider in having to track these incorrect payments and request a reopening at a later date due to the resources required to administer the adjustment. We will continue to work with legislators and CMS to stress the importance of having this implemented in a timelier manner. We will keep you posted.

NCART Release: CMS Issues Unreasonable Billing Instructions

Protect Access to Specialized Wheelchair Accessories

A Special Message from U.S. Rehab and NCART
CMS has announced that it intends to apply competitive bid pricing to wheelchair accessories used on complex rehab wheelchairs effective January 1, 2016. This will result in payment cuts of 20% to 50% and cause major decreases in the availability (or outright elimination) of individually configured wheelchair systems that people with disabilities rely on.

Representatives need to hear from people in their home districts that this is a problem that needs fixing. NCART has developed a website to provide information (including the Position Paper and copy of the letter) along with tools to assist you in getting your Representative to sign on to the bipartisan letter to CMS.

Please take action today! Go to http://cqrcengage.com/access2crt/CBpricing to email, call or tweet your house representative.