Tuesday, August 31, 2004

Rehab coverage criteria
with Seth Johnson

Q.What impact does the House Appropriations report language have on CMS?

A. In July, Congressman Don Sherwood, R-Pa., inserted language into a House bill that not only communicates frustration with the DMERCs using an excessively narrow interpretation of what constitutes non-ambulatory, but also directs CMS to use its resources (funding provided by the committee) to develop a coverage policy firmly based on a functional standard of non-ambulatory. Report language is a method regularly used by the Appropriations Committee to communicate its position on issues under the jurisdiction of the agencies the Appropriations bill funds, in this case CMS. While report language does not have the force of law, it clearly sends a strong message to the agency, and is typically followed in order to avoid repercussions next year when they go before Congress with their funding request. This method is an indirect way for Congress to tell an agency what to do without passing a law. It is very effective and has been responsible for changing the direction of misguided regulations. This language is included in a House bill that will be considered in September. Senator Arlen Specter, R-Pa., has been made aware of this important language and has provided encouraging words regarding similar language being included in the Senate version of the bill.

Seth Johnson is director of government affairs at Pride Mobility Products. He can be reached at 800-800-8586.