Complex Rehab Advocates Head to CELA, Hope for Separate Benefit

WASHINGTON — More than 300 complex rehab stakeholders will muster their muscle toward getting a separate Medicare benefit for the category during the Continuing Education and Legislative Advocacy Conference Feb. 16-18 in Washington.

“We’ve got more than 200 appointments scheduled with attendees visiting their senators and representatives,” said Don Clayback, executive director of the National Coalition for Assistive and Rehab Technology. NCART is co-sponsoring the CELA conference with the National Registry of Rehabilitation Suppliers.

“The message,” Clayback said, “is basically sharing the story for the need for a separate benefit for complex rehab. There are 100 new congressional men and women we need to be talking to.”

This year’s conference features a roster of noted speakers, including Jean Minkel, PT, ATP, MSPT, of consulting firm Minkel & Assoc., and Jennifer Higgins, the policy expert-in-residence for the Washington, D.C.-based Capitol Health Group.

The focus of the event, however, will be to kick off what organizers are calling a “marathon” effort to get complex rehab carved out as a separate benefit. In fact, the conference is purposely being held four months earlier than usual to take advantage of a longer legislative session, Clayback said.

The hunt is on for congressional champions to take up the cause and author a separate benefit bill, and “CELA is really our kickoff for having these one-on-one discussions with the various offices and identifying where we have some strong interest,” he added.

Attendees will be outfitted with the newly revised (as of January) proposal for creation of a separate benefit and draft language for its legislation. The two components are vital for members of Congress get a sense of the issue so that “we can have some substantive discussions,” Clayback said.

In addition to CELA’s face-to-face visits on Capitol Hill, a national call-in day will be held Wednesday, Feb. 16, for those who are unable to attend but want to campaign on behalf of the benefit. (Register www.celaadvocacy.org.)

NCART and NRRTS have been working toward a separate benefit for three years to distinguish the complex rehab sector from traditional home medical equipment. “We are different,” said Clayback.

The talking points provided to conference attendees spell out the “whys:”

• Complex rehab technology is individually configured to people with complex disabilities.
• Products and services are different than standard DME.
• Outdated DME policies and codes do not address needs of people with disabilities.
• CRT is similar to orthotics/prosthetics.
• A separate benefit category would provide needed distinction and solutions.
• Significant challenges threaten access to complex rehab technology products and services for individuals with disabilities.
  
• These threats (coding, coverage, payment) will only increase unless meaningful changes are made.
• The purpose of a separate benefit category is to improve and protect access to these products and services for these individuals.

“We need to have some distinction, and as CMS or Congress looks through the proposal, hopefully we can point out things we think are pluses,” Clayback said.

He acknowledges this is a tough time to be launching the drive, considering the economic and financial difficulties the country is facing and the health care reform boondoggle. “It certainly is a challenging environment, but the dilemmas and the challenges that consumers, suppliers and clinicians are facing haven’t decreased. We need to protect access and institute additional safeguards,” Clayback said.

“While it is a challenging path,” he continued, “there are some things going on that are very concerning from an access level … If we don’t do something that is not this comprehensive, we know things are not going to change at all.”

For information about CELA, see www.ncart.us or www.nrrts.org.