Industry to Leavitt: Withdraw rehab from NCB

Sunday, July 1, 2007

WASHINGTON - With "time running out," the industry has appealed to the secretary of the Department of Health and Human Services to withdraw not only complex rehab but also standard rehab from national competitive bidding, at least in the first round.

AAHomecare's Rehab and Assistive Technology Committee (RATC) sent a letter to Secretary Michael Leavitt June 29. Sen. Arlen Specter, R-Pa., sent a letter to Leavitt June 15. Both letters argue that the power mobility benefit deserves a breather after the coding and pricing changes of November 2006.

"(The rehab carve-out bill) is a fine piece of legislation, but we're running out of time," said Tim Pedersen, the new chairman of RATC and CEO of WestMed Rehab in Rapid City, S.D. "It's time to open up another front on the regulatory side."

The Medicare Modernization Act (MMA), which requires CMS to implement competitive bidding, gives the secretary of HHS authority to withdraw products from the program.

Providers now have until July 20 to submit bids for competitive bidding. The carve-out bill, which would exempt only complex rehab, has seven co-sponsors.

RATC and Specter lobby for withdrawing both standard and complex rehab because last year's coding and pricing changes trounced both product categories, if not standard rehab more, sources said. The industry successfully lobbied CMS to ease its price cuts for certain Group 3 products (See HME News, January 2007).

RATC lobbies for withdrawing complex rehab permanently.

Already, the changes have reduced access to power mobility devices, RATC and Specter point out. Only 9,860 Medicare beneficiaries received a PMD in December 2006 compared to an average of 15,300 beneficiaries for all other months that year--a 48% reduction.

"We're very concerned that if you put any of these products in competitive bidding, it will further reduce access," said Seth Johnson, vice chairman of RATC and vice president of government affairs for Pride Mobility. "That's the trend we're seeing."

H.R. 2231 focuses on complex rehab because NCART, the group behind the bill, represents providers who supply those products. Additionally, if the bill had included standard rehab, its cost or "score" would have been "dramatically increased," hurting its chances of passing, said Sharon Hildebrandt, executive director of NCART.

But some industry sources believe the issue needs to be addressed "globally."

"We have to find a way to unite as an industry and keep the same message out there," said Mark Leita, director of public affairs for The Scooter Store. "When you go in with a fragmented message, its difficult for members of Congress to clearly understand what it is you're really looking for. It becomes self serving more than it is about Congress recognizing that we have a growing problem."