CMS Announces Manual Wheelchair Accessories are Permanently Exempt from the Competitive Bidding Program

Published in Government Relations on July 29, 2021

CMS announced today that manual wheelchair accessories will be permanently exempt from future competitive bidding programs.

As printed in the CMS fact sheet:

“CMS is finalizing an exclusion from fee schedule adjustments based on information from the DMEPOS Competitive Bidding Program (CBP) for wheelchair accessories (including seating systems) and seat and back cushions furnished in connection with group 3 or higher complex rehabilitative power wheelchairs. We are also extending this fee schedule adjustment exclusion to wheelchair accessories (including seating systems) and seat and back cushions furnished in connection with complex rehabilitative manual wheelchairs. Additionally, we are modifying the regulatory definition of “item” under the DMEPOS CBP at 42 CFR 414.402 to exclude complex rehabilitative manual wheelchairs and certain other manual wheelchairs and related accessories when furnished in connection with these wheelchairs from the DMEPOS CBP, as required by section 106(a) of the 2020 Further Consolidated Appropriations Act.”

https://www.cms.gov/newsroom/fact-sheets/fiscal-year-fy-2022-inpatient-rehabilitation-facility-irf-prospective-payment-system-pps-final-rule

“This is indeed good news for providers of complex rehab technology. While this is big win for Complex Rehab Technology providers, it is huge for end users. This will result in the overall reduction of healthcare cost with proper seating and positioning for beneficiaries,” said Greg Packer, president of U.S. Rehab.

In 2017, legislation passed omitting power wheelchair accessories from CMS’s competitive bid program. But manual wheelchair accessories were not included in this legislation and remained in the competitive bid program. 

To address this gap, in December of 2019, Congress passed language from H.R. 1865 to make clear the intent was for both power and manual wheelchair accessories to be treated the same. The legislation included a provision suspending CMS’s application of Medicare’s competitive bid program pricing until June 30, 2021, allowing time for CMS to take the same permanent action. It was then extended 90 days.

Many thanks to Rep. John Larson (D-CT) and Rep. Lee Zeldin (R-NY) who for years have been our primary supporters of this exemption with legislative efforts and letters to CMS. We also want to thank all who reached out asking their legislators to support these efforts.


TAGS

  1. competitive bidding
  2. complex rehab
  3. vgm government

From Our Experts

How FEMA Can Help DMEPOS Businesses Prep for Natural Disasters thumbnail How FEMA Can Help DMEPOS Businesses Prep for Natural Disasters FEMA's latest site update benefits DMEPOS businesses by assisting them in preparing for natural disasters. Ronda Vlog: Two Important Updates: Oxygen Testing and Home Assessment for Manual Wheelchairs Clarification thumbnail Ronda Vlog: Two Important Updates: Oxygen Testing and Home Assessment for Manual Wheelchairs Clarification Check out these updates from Ronda Buhrmester regarding oxygen testing and clarification on home assessment for manual wheelchairs! 75/25 Medicare Impact Survey thumbnail 75/25 Medicare Impact Survey AAHomecare is spearheading a nation-wide initiative to measure the impact of the expired Medicare fee-for-service 75/25 blended rate for non-bid non-rural areas on the HME community and Medicare patients' access to medically necessary equipment. Medicare Advantage Plans Under Scrutiny for HME Denials thumbnail Medicare Advantage Plans Under Scrutiny for HME Denials The coverage of HME by Medicare Advantage plans has recently come under fire. At the VGM Heartland Conference on June 11, stakeholders highlighted a critical issue; Medicare Advantage plans are allegedly denying coverage unjustly. Government Relations Advocate for the Breast Cancer Patient Equity Act thumbnail Government Relations Advocate for the Breast Cancer Patient Equity Act The week of June 3rd, Nikki Jensen, VP of Essentially Women and Ike Isaacson, SVP of VGM Government & Regulatory Relations traveled to Washington D.C. to advocate for the Breast Cancer Patient Equity Act. Williams Brothers Healthcare Hosts Meet-and-Greet Event with Rep. Erin Houchin thumbnail Williams Brothers Healthcare Hosts Meet-and-Greet Event with Rep. Erin Houchin Last week, Williams Brothers Healthcare organized a meet-and-greet event featuring Representative Erin Houchin (R-IN-9) to address crucial topics related to HME services and the challenges faced by providers. OMEPA's Legislative Triumphs: A Tale of Relationships and Persistence thumbnail OMEPA's Legislative Triumphs: A Tale of Relationships and Persistence Over the past few legislative sessions, Oklahoma Medical Equipment Providers Association (OMEPA) has navigated a legislative rollercoaster. Their commitment to building relationships and advocating for patients has led to significant wins. Audit Climate – Taking The Temperature thumbnail Audit Climate – Taking The Temperature As we near the midpoint of 2024, what are the main billing/reimbursement headaches being faced by providers?