NCART on separate benefit: It's not simple and it won't be quick

Sunday, October 4, 2009

WASHINGTON - NCART's Don Clayback laid out a detailed roadmap for creating a separate benefit for complex rehab during a Webinar last week.

Clayback told listeners that the planning phase for the new benefit is under way, with two of six steps completed: A steering committee has been formed and objectives have been defined. The objectives include clearer and more consistent coverage policies; tighter provider standards; recognized services and payment stability.

Step three--gathering comments--is in progress, with the Webinar on Sept. 30, another Webinar scheduled for Oct. 8, a panel discussion scheduled for Oct. 13 at Medtrade and a consensus conference scheduled for Oct. 29 in St. Louis.

"We're really looking for broad input as we start down this road," said Clayback, who leads the committee. "While we've put a few things in place to get things started, we're going to have several opportunities for stakeholders to make comments and offer suggestions as we move through the process."

Steps five and six: Develop an action plan with strategies, a timeline and resources; and garner support and begin implementation.

Clayback told listeners that Avalere Health has recommended that the committee take a combined legislative-regulatory approach to creating the new benefit. Once the committee develops an action plan and garners support, Avalere will help it draft legislation and identify key components to work on with CMS officials.

The committee hopes to walk away from the consensus conference with that action plan.

The "real rough timeline" for the new benefit is to introduce legislation in 2010 and implement the benefit in 2011, Clayback said.

"It's not a simple initiative, and it's not a quick initiative," he said.