Rehab Benefit Poised to Take Another Step Forward

BUFFALO, N.Y. — Legislation to create a separate complex rehab Medicare benefit could be finalized by the end of the month, according to Don Clayback, executive director of the National Coalition for Assistive and Rehab Technology.

“The plan is to have legislation introduced in the early part of the year,” Clayback said Friday, adding that proponents are set to “share the specifics” with members of Congress to get the legislation moving.

Already, he said, work groups are meeting to flesh out details of regulatory changes so it is very clear what needs to be changed, why and how it could be altered for the better. “We want to be in a position to work with CMS on specific details,” he said. “It’s been a long process and we’ve got quite bit ahead of us, but you just take it a step at a time.”

Proponents also hope that if Medicare adopts a separate benefit for complex rehab, it will spill over into Medicaid. That program’s reimbursement has been at risk in many states, which prompted NCART to hold the first National Medicaid Summit earlier this month in Nashville. Focused on complex rehab and how to protect Medicaid coverage, the event drew nearly 100 attendees from across the country.

Clayback said NCART has been pushing the separate benefit in the Medicaid arena as well as for Medicare, “but there hadn’t been this kind of a conference pulling in all the states and sharing information and getting everyone on the same path moving forward.”

The group plans to continue the momentum by making the summit an annual event. “I think it will create a greater awareness of complex rehab,” Clayback said. “A lot of things we are trying to do are really all about increasing people’s awareness about what complex rehab technology is all about and what challenges it is facing.”

Clayback said the potential legislation will also be among the topics at Medtrade next month in Atlanta. In addition to several pre-show sessions aimed at complex rehab, the show’s Rehabilitation and Assistive Technology track includes 17 sessions addressing such issues as patient outcomes, reimbursement and clinical protocol.

Also at the show, the NRRTS Complex Rehab Pavilion will create a central point of complex rehab manufacturers and others, including NCART, RESNA and the University of Pittsburgh-RSTCE. “We have a very central location, so we’ll get good traffic,” said Clayback, noting that grouping complex rehab organizations and manufacturers will allow good networking possibilities for attendees.

Just prior to the show, on Nov. 13 and 14, RESNA will also offer a fundamentals course in assistive technology. The organization recently instituted a new Seating and Mobility Specialist certification, called an SMS. For more information, go to www.resna.org.

In other news from the sector, the push continues to delay elimination of the first-month purchase option for power wheelchairs, now scheduled to take effect Jan. 1. In September, 46 representatives signed a letter to the House Energy and Commerce and Ways and Means committees supporting the delay. Seven senators signed a similar letter that was sent to the Senate Finance Committee.

“We are continuing to work to increase the level of support in both the House and Senate to strengthen the industry’s chances of securing a one-year delay in implementation of the purchase option elimination provision,” said Seth Johnson, vice president of government affairs for Pride Mobility Products, Exeter, Pa.

Johnson said the hope is that legislators will pick up the issue when they return for a “lame duck” session the week of Nov. 15. The mandate for the delay would need to be a part of other legislation.

“The most likely vehicle remains the ‘doc fix,’ which must pass prior to Dec. 1 in order for physicians to avoid a 20-plus percent reduction in their Medicare reimbursement rates,” Johnson said.