Legislative update: Separate benefit

Tuesday, June 30, 2009

There are “different schools of thought,” sources say, on how to approach creating a separate benefit for complex rehab.

One school prefers regulation and working with CMS to develop policy. The other prefers legislation and working with lawmakers to draft and pass a bill.

“There’s no unanimity at this point,” said Don Clayback, vice president of government relations for The MED Group and part of the executive leadership for NCART. “We’re fleshing each one out to see which has the greater chance of success.”

The efforts to create a separate benefit for complex rehab are still in the early stages, but both NCART and AAHomecare’s RATC have created committees to move the process forward. They have also participated in conference calls.

Supporters of regulation say legislation should be a last resort. 

“It may be required in the future, but if we can get away with not doing it, that’s preferable,” said Tim Pederson, co-chairman of RATC. “We’ve already gotten some very encouraging feedback from the medical directors. They believe a lot of what we need is already in place.”

Pederson, CEO of WestMed Rehab in Rapid City, S.D, added: “Look at our track record with legislation.”

But others worry that regulation can be too easily reversed.

“Legislation would give us some protection, if we need it,” said Sharon Hildebrant, executive director of NCART. “It would lay out what CMS should do and how they should do it. We don’t want to leave it to their discretion.”

At the end of the day, there’s not much to the differences, sources say, because the industry will likely need support from both CMS and lawmakers.

“We’re all working toward the same goal,” said Seth Johnson, co-chairman of RATC and vice president of government affairs for Pride Mobility Products. “That’s what’s important.”