Committee drops PWC reimbursement cut

Sunday, November 20, 2005

WASHINGTON - The rehab industry scored a victory late Wednesday, when a House-Senate Conference Committee "unexpectedly" dropped a proposal to cut reimbursement for power mobility devices 1.5%. The cut was part of an amendment to delay CMS's transition from CMNs to physician prescriptions.

The committee dropped the cut before forwarding the amendment to the House and Senate for final votes and to the president for signing.

Industry officials crossed their fingers that both bodies would approve the bill before Thanksgiving. But late Thursday, the House rejected it. The reason: Congressmen couldn't agree on a provision that would ban Medicare from paying for erectile dysfunction drugs beginning in 2006.

"The good news is that the conferees, unexpectedly, agreed to drop the 1.5% reimbursement cut," said Cara Bachenheimer, vice president of government relations for Elyria, Ohio-based Invacare.

By Friday, House leaders were trying to broker a deal that would allow congressmen to pass the bill over the weekend, according to Seth Johnson, vice president of government affairs for Pride Mobility Products. Other options: Send the bill back to the Conference Committee or pass a continuing resolution that sets spending based on the previous year's budget.

The industry, led by Pride Mobility and Invacare, lobbied legislators to drop the 1.5% reimbursement cut from the amendment, calling it unnecessary. Two congressmen came to their defense: Reps. Don Sherwood, R-Pa., and Ralph Regula, R-Ohio, both members of the Appropriations Committee.

"They agreed that [the 1.5% reimbursement cut] wasn't necessary, and it wasn't in the best interest of our industry, and they went to bat for us," said Dan Meuser, president of Exeter, Pa.-based Pride Mobility.

The cut has its roots in politics, industry sources say. The amendment, as part of an appropriations bill, needed to be budget neutral. Because CMS expects $10 million in savings from its interim final rule (IFR)--more beneficiaries in scooters rather than wheelchairs, for instance--a cut was necessary to offset the costs of the delay.

The amendment, which was crafted by Sen. Arlen Specter, R-Pa., requires CMS to re-issue an IFR by Jan. 1, 2006. It then requires the agency to hold 45-day comment and transition periods, and implement the rule no sooner than April 1, 2006.