New Bill to Provide Path for Titanium, Carbon Fiber Wheelchair Upgrades

• By Laurie Watanabe
• Sep 14, 2023

A bill introduced on Sept. 8 in the U.S. House of Representatives could provide a way for Medicare beneficiaries to upgrade to carbon fiber or titanium ultralightweight wheelchair frames.

H.R. 5371 — introduced by Rep. John Joyce (R-Pa.) — is the Choices for Increased Mobility Act of 2023. The text of the bill said it would “amend title XVIII of the Social Security Act to clarify payment rules for manual wheelchairs under part B of the Medicare program.”

Tom Ryan, President/CEO of the American Association for Homecare (AAHomecare), said in a Sept. 9 announcement, “Stronger patient access to lightweight carbon fiber and titanium wheelchairs will allow more individuals with mobility challenges to function independently and take part in their communities. Working to build support for this measure has been a priority for our association and other mobility stakeholders. We appreciate Congressman Joyce introducing this legislation, and Congresswoman Michelle Steel (R-Calif.) for joining it as an original co-sponsor, in advance of our virtual legislative conference later this month, giving our advocates a chance to build support for the bill.”

AAHomecare also announced an issue brief with more information on the bill, and the December 2016 DME MACs’ policy decision that has prevented Medicare beneficiaries from requesting ultralightweight wheelchair frame upgrades.

In a joint Sept. 11 announcement ahead of this week’s CRT (Complex Rehab Technology) Virtual Fly-In, NCART and NRRTS said, “In the case of ultralightweight manual wheelchairs, upgrading to a titanium or carbon fiber base may offer increased medical benefits to the user, such as shock absorption and vibration dampening, which can increase sitting tolerance, support proper positioning, and decrease pain. For active users, the upgraded materials also provide increased durability that facilitates the performance of mobility-related activities of daily living (MRADLs) and maximizes the useful lifetime of the equipment.”

Medicare’s current reimbursement amounts for ultralightweight wheelchairs “do not cover the cost of upgrading to titanium and carbon fiber for enrollees who would benefit,” the NCART-NRRTS statement said. “Unfortunately, providers cannot afford to offer these upgrades at no charge, and currently, theonly way to provide a custom manual wheelchair with these upgraded materials is to bill the equipment as ‘unassigned.’ This can only be done by non-participating Medicare providers and means that the CRT user must pay out of pocket for the entire wheelchair and then wait for partial reimbursement from Medicare. This system limits clinicians and providers, reduces patient choice, and creates inequity for those who would medically benefit from titanium or carbon fiber, but do not have the financial means to pay out of pocket.”

NCART and NRRTS said the new bill, which allows for code upgrades for Medicare-reimbursed titanium and carbon fiber wheelchairs, “would not result in any additional cost to the Medicare program. We believe that individuals should have the right to utilize their insurance benefits while still being able to optimize their equipment if they choose to do so.”