As another year begins, there is a lot to look forward to when looking at the future possibilities and priorities. If you are like me, there is always so much you want to do that deciding how to take positive steps forward is usually the biggest problem. This list of NCART’s key initiatives aim to fulfill our mission to preserve and protect access to complex rehabilitation therapy (CRT). These initiatives comprise our top priorities for 2025.
Protect our CRT members from harmful regulations & legislation.
Our top priority in 2025 is protecting our members from harmful regulations or legislations that deny access to CRT or the skilled professionals that provide it. In 2024, legislation was introduced in 14 states that would have harmed our members' ability to care for their patients. As a result, we increased our efforts to educate legislators and regulators about the CRT industry, the process for acquiring new CRT equipment and the importance of appropriate service and repair reform. Most regulators and legislators that do not understand the difference between CRT and durable medical equipment (DME) are unaware of the full-scale services we provide or just how small the population that utilizes these products is.
As 2025 begins, we are working on 12 state legislative bills related to service and repair reform. The Competitive Enterprise Institute reported the average business spends $277,000 per year complying with federal and state regulations. This is for a typical business operating in a free non-health care market that can pass those costs to the consumer—something CRT companies cannot do.
In 2024, regulation reform for CRT issues was one of our focuses, as we worked in 17 states on fee schedule issues to ensure all CRT codes are included. These reforms seek to ensure patients have access to the new power seat elevation benefit. I am proud that Julie Piriano, NCART’s senior director of payer relations and regulatory affairs, secured Medicaid coverage for power seat elevation in three additional state Medicaid programs—with eight more expected this year. We are also working to eliminate overrestrictive coverage criteria for power seat elevation to ensure access to this technology. We always want to assist our members with regulatory burdens and ensure that the fee schedules reflect the reality of 2025, rather than being stuck in a previous year.
NCART members have shared their frustrations about working with managed care organizations and the added layers of bureaucracy that hinder their ability to provide CRT equipment to their patients. We are working with our members to develop tools and resources that assist them and their patients in fighting against duplicative paperwork, denials and delays.
Help our members grow their business.
NCART takes a consumer-focused approach to coding, coverage and reimbursement initiatives as we aim to identify areas that improve access to CRT, promote design innovation and technology advancement, and advocate for policies, procedures and rates. By helping consumers obtain the equipment they need—in a timely manner and at a sustainable reimbursement rate—we hope to ensure that our members can grow their businesses and deliver new products that allow consumers to participate in life’s activities.
NCART has invested in and partnered with the ITEM Coalition to secure seat elevation coverage, coding and funding for this product, which can be a game changer for consumers and NCART members alike. We remain committed to bringing this enabling technology to all wheelchair users and are working with members to secure coverage and funding where access is being denied.
NCART is also partnering with the ITEM Coalition to have the Centers for Medicare and Medicaid Services open our longstanding request for a national coverage determination for medically necessary power standing technology. Power standing is an innovation that many consumers need to live their most optimal lives. Access to this technology will offer our members an additional product to care for their patients.
NCART also intends to focus on eliminating or changing the requirements for prior approval and medical documentation for CRT repairs. The prior authorization (PA) process for CRT repairs is often duplicative and can slow the consumer repair process by seven to 14 days. This PA requirement adds costs to CRT companies, as they typically must make at least two trips to meet the prior authorization requirement—one to assess the repair, and another to fix the equipment once the PA is provided. NCART successfully eliminated prior authorization in Wisconsin, Tennessee and Connecticut this past year.
NCART is looking forward to a very busy but productive 2025, and we want to thank our members for their support.