Complex Rehab Stakeholders Buoyed by Push for Carve-Out

WASHINGTON–After months of frustration in their battle for a
complex rehab carve-out from competitive bidding, stakeholders left
Washington, D.C., last week feeling cautiously optimistic following
a successful call-in effort to legislators, a warm reception to
their visits on Capitol Hill and the promise of a companion bill to
H.R. 2231.

Members and supporters of the National Registry of
Rehabilitation Technology Suppliers and the National Coalition for
Assistive and Rehab Technology journeyed to the capital last week
for CELA ’08, a combined educational and legislative advocacy
event. Their aim was to lobby for support of H.R. 2231, a bill
authored by Reps. Tom Allen, D-Maine, and Ron Lewis, R-Ky, that
would exempt complex rehab from the DMEPOS competitive bidding
program.

For once, things turned out better than planned. The
organizations had hoped for 120 people to visit legislators
Thursday, but more than 200 turned out, organizers said.

“We had a lot of visits [to legislators], and the reports
I got back were pretty much all favorable. People seemed to
understand and sympathize with the issue,” said Sharon
Hildebrandt, executive director of NCART.

Hildebrandt said she expected more legislators would sign on to
H.R. 2231 as cosponsors this week. “We were trying to
generate more support with the [House] bill, and some did agree to
sign on,” she said.

“We had a real good reception from them,” she added,
noting that while most of the legislators were familiar with
competitive bidding, they were not particularly knowledgeable about
complex rehab. To help educate them about the sector, advocates
were armed with photos of products and people using them, she
said.

“Once we showed them the photos, they seemed to understand
it much better. We told them, ‘These are not the kind of
wheelchairs you see on television. These are very customized
wheelchairs with a special seating system.’”

While the photos helped, the best advocacy for a complex rehab
carve-out came from users themselves, Hildebrandt said.

“We had some consumers join us on some of the visits, and
that was … invaluable,” she said. “They demonstrated
their chairs and told how the seating systems helped them. [Most
legislators] had never seen a complex system before, and now they
saw why it was important and how it aided the individual in being
more independent. They got a better appreciation for what it was.
It’s something these folks are in for 12 hours or more a
day.”

The visits were supported by a strong call-in effort on Tuesday.
Stakeholders placed 4,588 calls to members of Congress who sit on
committees that affect Medicare legislation.

“We had hoped for a thousand calls,” said
Hildebrandt. “This was four-and-a-half times what we
expected.”

All of this sets the stage for the announcement of a Senate
companion bill to H.R. 2231.

“We’ve been waiting for it to drop, but we understand it
is to be introduced [this] week,” Hildebrandt said.

“Ever since we found out that the Senate is where Medicare
legislation is going to originate this [year], we’ve been pushing
hard to get a companion bill there,” said Tim Pederson, CEO of
WestMed Rehab, Rapid City, S.D., and chair of the American
Association for Homecare’s Rehab and Assistive Technology
Council.

If the companion bill is introduced this week, both Pederson and
Hildebrant said the rehab community’s next objective will be to get
the carve-out language included in the Medicare legislation the
Senate is currently crafting. Because neither the House bill nor
the Senate bill would have a chance of moving forward on their own,
the carve-out provision needs to ride on another, larger bill, the
rehab advocates said.

Nevertheless, both Pederson and Hildebrant said last week on the
Hill was encouraging.

“Every time we visit the Hill we get more support …
Legislators understand the issues and they realize the unintended
consequences of including complex rehab in competitive bidding, so
that in and of itself is a great victory,” Pederson said.

Concluded Hildebrant, “We definitely believe we will see
some results here.”