Pushin’ON VOL 34 | NUM 1 2016 UAB Spinal Cord Injury Model System Digital Newsletter Headline News The University of Alabama at Birmingham Spinal Cord Injury Model System (UAB-SCIMS) provides Pushin’ On twice annually as an informational resource for people with spinal cord injury (SCI). UAB-SCIMS Program Director: Amie B McLain, MD Pushin’ On Editor: Phil Klebine, MA 529 Spain Rehabilitation Center 1717 6th Avenue South Birmingham, AL 35233-7330 Phone: 205-934-3283 TDD: 205-934-4642 Fax: 205-975-4691 WWW.UAB.EDU/SCI firstname.lastname@example.org /UABSCIMS /UABSCIMS /UABSCIMS The contents of this publication were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number H133N110008). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this publication do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government. ©2015 University of Alabama Board of Trustees. The University of Alabama at Birmingham provides equal opportunity in education and employment. UPDATE! In the last issue of Pushin’ On, we asked you, our readers, to contact your federal legislators to prevent the Centers for Medicare and Medicaid Services (CMS) from cutting reimbursement rates for Complex rehab technology (CRT) components. These components are medically necessary, individually-configured manual and power wheelchair systems, adaptive seating systems, alternative positioning systems, and other mobility devices that require evaluation, fitting, configuration, adjustment or programming. These cuts would have made it very difficult or, in most cases, impossible for people with severe disabilities to get the vital CRT components they need. The UAB Spinal Cord Injury Model System (UAB-SCIMS) is happy to report that Congress did pass the Patient Access and Medicare Protection Act that included a delay in the planned reduced pricing on CRT by CMS. First, we thank everyone who took action to help in this victory for people with severe disabilities. Second, we stress that the recently passed Act only delays the CMS from making cuts to CRT. We will likely have to fight this battle again soon. Thank you. - Phil Klebine, Editor. Exoskeleton technologies are once again in the news. In February, suitX launched its Phoenix exoskeleton. It costs $40,000, which is not cheap, but the company claims it is currently “the least expensive of all exoskeletons.” It weighs 27 pounds, making it also one of the lightest exoskeletons currently out there. The battery life offers up to 4-hours of continuous walking time and a maximum walking speed of 1.1 MPH. In March, the FDA approved the Indego exoskeleton for both clinical and personal at-home use. The Indego is priced at about $80,000. It weighs in at 26 pounds, which is also among the lightest exoskeletons. Indego’s battery life is also listed at about 4 hours of use, but the company brochure does not mention a maximum walking speed. In April, Ekso Bionics gained FDA approval for its Ekso GT exoskeleton. While other exoskeletons are approved for use with persons with paraplegia, the Exso GT is the first exoskeleton cleared for use with persons with injury levels from T3 to C7 (ASIA D) in a rehab setting. It is not approved for home use. There are no details on weight, speed and cost found on the website. All have unique features, but the big question remains: who will pay for it? Although the ReWalk exoskeleton is now covered by the US Department of Veterans Affairs at a cost of around $70,000, there is no Medicare/Medicaid “rate code” for exoskeletons. Without a rate code, there is no health insurance payment and no reimbursed for up to 80% of the cost as a medical device. Getting that rate code might take years. Until then, the cost is out of pocket. It is obvious, though, exoskeleton technologies are quickly evolving. Units are getting lighter and more compact. Battery life is getting longer. Units are getting modular. Exoskeleton technologies may be on the path to one day replace manual wheelchairs.