Drive Begins for Complex Rehab Separate Benefit

WASHINGTON — It wasn’t Forrest Owens’ first time lobbying in Washington, D.C., but this time, it was a lot more successful: One of the congressmen he visited last week agreed to cosponsor a bill to create a separate Medicare benefit for complex rehab.

“I was jumping up and down when I left that office,” said the co-owner and CFO of Glass Seating and Mobility in Memphis, Tenn.

Owens and 159 other providers, clinicians and consumers attending the annual CELA (Continuing Education and Legislative Advocacy) Conference Feb. 16-18 helped push a separate benefit the first step of the way with more than 220 visits to legislators on Capitol Hill. (See “Complex Rehab Advocates Head to CELA, Hope for Separate Benefit.”)

The annual conference, sponsored by the National Coalition for Assistive and Rehab Technology and the National Registry of Rehabilitation Technology Suppliers, kicked off the formal drive for the separate benefit, which would split off complex rehab from traditional durable medical equipment. CELA attendees presented a package of information to legislators that included draft legislation, a position paper and the proposal for the benefit.

“I think we had very positive responses with people,” said NCART Executive Director Don Clayback. Legislators were familiar with complex rehab after last year’s Hill visits, he said, and “they now have a clear understanding of the issues we are facing.”

Those two factors made the visits more successful than in the past, Owens said. “This time we had the [draft] legislation. We had it right there and we could give it to them,” he said. “The legislation just makes sense, so it’s hard to discount that.” As a result, Owens said, Rep. Steve Cohen, D-Tenn., agreed to cosponsor the bill.

Legislators also heard by phone from those who couldn’t attend the CELA conference.

“We had a national call-in day for complex rehab,” said Simon Margolis, executive director of NRRTS. “We had close to 800 register on the website. A few people that we were meeting with mentioned that they had gotten some calls.”

While a leader in the effort hasn’t yet surfaced, plenty of support has, Clayback said. “We do have several offices we are talking to we feel may champion the bill for us … but they want us to get more information on the cost of the legislation.”

Owens said that was a common refrain among the legislators he visited, since lawmakers caught in the heat of a national economic crisis are particularly wary of any legislation that might further deplete the nation’s coffers. “I got to meet with a first-time senator, Sen. [John Boozman, R] from Arkansas. He was very aware about what complex rehab was. He was concerned, as a lot of the representatives we met with were, with the score — the cost analysis,” Owens said.

Margolis said stakeholders are already working with a Washington group to compile the score.

“That’s critical,” he said. “We are going to have to have those numbers. Even something that is only costing a couple of million dollars — you still have to have the combination of a good cause that people can get behind and an appropriate score.”

Organizers said they do not expect creating a separate complex rehab benefit to be very costly. In the draft legislation, reimbursement is set at no less than 100 percent of 2009 allowable charges for various complex rehab codes and no more than 110 percent. There are stipulations for a hike in reimbursement for inflation, as well as for fees for repairs and rental equipment.

Even if the score is high, it doesn’t mean hope is lost. “You’re not dead if it isn’t a good score — you’re just slowed down a bit,” Margolis said. “I don’t think that will be an issue … The bill will be introduced this year, I am absolutely certain.”

“All we have to do now is follow up with the cost analysis and the ball is really rolling,” agreed Owens.

Clayback, too, was encouraged by response from legislators. In an email to CELA attendees this week, he encouraged them to send thank-you notes to their legislators and reinforce the benefit request with a copy of the draft bill and a letter from the Independence Through Enhancement of Medicare and Medicaid Coalition (ITEM).

The group is a coalition of more than 30 organizations that support a separate benefit, including the American Academy of Physical Medicine and Rehabilitation, the American Association of People with Disabilities, the Christopher and Dana Reeve Foundation, Easter Seals, National Multiple Sclerosis Society, Rehabilitation Engineering and Assistive Technology Society of North America and United Cerebral Palsy.

Clayback also suggested including a link in the follow-up email to a video of Jenny Siegle, a complex rehab technology user from Denver who has advocated for the separate benefit at both this year’s and last year’s CELA conferences.

“Stay engaged and stay in touch with your congressional contacts,” he urged. “It’s all about follow up, follow up, follow up!”

“This is only the beginning,” Margolis said. “If people don’t follow up with members of Congress, then they have really wasted their time on the Hill.” Advocates must set up meetings with their legislators when they are in their home offices, he said, and hold legislators and aides accountable for whatever they said in the Washington meetings.

Margolis said the industry has spent $200,000 on the initiative, with about $120,000 from NCART, NRRTS and the American Association for Homecare.

“I believe this is our last, best hope,” he said.

As for Owens, he knows it will be a battle to get the separate benefit legislation introduced and passed. But he was encouraged by his reception in Washington and he came home reinvigorated and enthusiastic.

“It was an opportunity to meet other people in the trenches fighting like we are for our patients’ rights,” he said. “It sort of reaffirms that there are other people out there fighting the good fight, too.”