March 20, 2020

Dear NCART Member,

There has been a great deal of activity this week as we continue to pursue solutions to the challenges presented by COVID-19. We have been communicating with our contacts at CMS and at state Medicaid programs about urgent action needed to protect access to Complex Rehab Technology (CRT).  

While the issues are significant, we've been grateful for the collaboration that is taking place with NCART, NRRTS, AAHomecare, VGM, US Rehab, Clinician Task Force, and the dedicated State Associations. It is this collective effort that will yield the best outcomes for the people that rely on CRT and Home Medical Equipment (HME). 

Here is a review of the CRT work that's been going on this week: 

  1. We submitted a formal request to CMS asking for temporary policy changes for the relief required to preserve CRT access. CMS has confirmed receipt of our requests and we are expecting to speak with them early next week.
  2. We have established a COVID-19 CRT work group consisting of providers, manufacturers, and clinicians to identify issues, develop action plans, and secure solutions.
  3. We are pursuing specific "remote" guidance as it applies to CRT wheelchair and seating evaluations. To help in this area, we are assembling a work group from the Clinician Task Force, NCART, and NRRTS to develop suggestions and protocols for guidance on "remote evaluations". Additionally, the American Physical Therapy Association (APTA) and the American Occupational Therapy Association (AOTA) are working to get further clarification on what activities they are able to do remotely.
  4. We are finalizing targeted state letters with CRT requests. We will be joining as a co-signer with AAHomecare, VGM, and State Associations on CRT/HME letters that will be going out to State Medicaid Directors.
  5. The Department of Homeland Security issued federal guidance for states to aid in determinations of "essential services" permitted to continue under COVID-19 restrictions. We believe that portions of that guidance related to medical equipment and supplies support the position that the manufacturing, delivering, and repairing of CRT should be classified as "essential". Each state makes their own decision and manufacturers and providers should be able to use this guidance to remain in operation.

Finding solutions quickly is the top priority. Unfortunately, policy makers and health-related programs are experiencing an unprecedented number of requests during this time. We expect the outreach that is being done will provide the guidance and relief necessary to meet the CRT needs of individuals with disabilities. 

More details to come next week. Take good care of yourself and others!

Regards,

Don Clayback
Executive Director | NCART
dclayback@ncart.us | www.ncart.us