New Legislation Would Carve Rehab Out of NCB

WASHINGTON–Legislation to exempt complex rehab and assistive
technology from the national competitive bidding program was
introduced in the House of Representatives on Wednesday.

Reps. Tom Allen, D-Maine, and Ron Lewis, R-Ky., introduced the
measure, which “would ensure that Medicare beneficiaries would
continue to have access to appropriate complex rehab and assistive
technology products,” according to the National Coalition for
Assistive and Rehab Technology, which has long pushed for the
exemption.

Without the legislation, according to the group, such customized
products and services would be unavailable to beneficiaries because
their costs exceed the fee schedule amount.

The Medicare Access to Complex Rehabilitation and Assistive
Technology Act of 2007″ (H.R. 2231) defines complex rehab and
assistive technology products as “medically necessary adaptive
seating, positioning and mobility devices and speech-generating
devices fitted, configured, adjusted or programmed to meet the
specific and unique needs of an individual with a primary diagnosis
resulting from injury or trauma or which is neuromuscular in
nature,” NCART said.

At a Washington fly-in last week, the organization’s members
made more than 130 visits to lawmakers to drum up support for the
bill, said Sharon Hildebrandt, executive director of the coalition
of providers and manufacturers.

“They seemed to understand,” Hildebrandt said, adding that
photographs and a half-dozen rehab patients who accompanied the
group to the Hill seemed to make the issue clearer. “[The
congressmen] were very receptive to our arguments.”

“The bill makes sense and the cost is not high,” said Gary
Gilberti, vice president of NCART and president and CEO of
Chesapeake Rehab Equipment in Baltimore. “Many folks we have talked
to are already supportive.”

Hildebrandt said the current fee schedule does not account for
the services that go into complex rehab, adding that if fees are
set any lower under competitive bidding, providers may not be able
to deliver the range of products or the highly configurable
products within the category.

“They’re going to have to cut back on the amount of services
they provide,” Hildebrandt said, pointing out that, ultimately,
beneficiaries would have reduced access to complex rehab products
and services.

She also referred to an NCART study released last year that
shows the profit margin for complex rehab providers is less than 2
percent (see HomeCare Monday Jan. 8).

Going forward, Hildebrandt said, NCART will focus on educating
consumer groups about the implications of the legislation and on
getting a companion bill introduced in the Senate.