New benefit for complex rehab: 'This is an evolutionary process'

Thursday, February 4, 2010

BUFFALO, N.Y. - Industry stakeholders are drafting a white paper that details a new benefit for complex rehab, and they'll unveil it to the broader industry in a highly anticipated Webinar next month.

"It's at the point where people are getting a little impatient with the process--that's understandable," said Tim Pederson, a member of a steering committee working on the new benefit and chairman of AAHomecare's Complex Rehab and Mobility Council (CRMC). "But it's better to make sure that we have appropriate input from all of our stakeholders so there are no surprises."

The steering committee held a two-day meeting in St. Louis last week to nail down some of the specifics of the new benefit, including coverage criteria and provider standards. It hopes to have four organizations--NCART, NRRTS, CRMC and RESNA--review a draft of the white paper later this month.

During a Webinar on March 4, the steering committee plans to discuss the white paper, answer questions and, most importantly, gather feedback.

"We want to be sensitive to the idea that this is a finished product--it's not," said Don Clayback, who leads the steering committee and is the executive director of NCART. "This is an evolutionary process. We started at 50,000 feet and now we're at 25,000 feet. But we'll continue to drop down as we get into more detailed conversations with broader groups of people."

In addition to hosting the Webinar, the steering committee plans to reach out to the various state and regional HME associations.

"We have to make sure that, along the way, the appropriate people are onboard," said Simon Margolis, a member of the steering committee and executive director of NRRTS. "We keep getting reminded of the debacle to reform the oxygen benefit."

Also this month, the steering committee gave Avalere Health, a Washington, D.C., consulting firm, the go-ahead to start part two of its project: developing a strategy for getting Congress and CMS to buy into the new benefit.