Providers make case for excluding rehab

Sunday, August 31, 2003

WASHINGTON - While associations such as AAHomecare are fighting the fight for the whole HME industry, smaller groups are fighting to keep rehab, specifically, out of any final Medicare reform legislation that includes competitive bidding.

The Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) recently sent key House and Senate members a position paper warning that competitive bidding would eliminate the individualized assessment, as well as diminish the training and support, that’s so important for custom rehab equipment.

Others in the rehab industry are drafting language that would carve out custom rehab from HME - much like orthotics and prosthetics (O&P) - because of its technical and service-intensive nature. The language could be inserted into any final legislation that includes competitive bidding.

Current Medicare reform legislation passed by the House includes competitive bidding. The Senate has passed legislation that includes a CPI freeze and a accreditation requirement. The two bodies are working now to hammer out a compromise package.

In its position paper, RESNA argues that competitive bidding makes price a determining factor in securing referrals and providing products, tempting some providers to cut corners.

“When low-ball bidders provide substandard care, competitive bidding may actually cost more than the current system due to increased client visits, replacements necessitated by ill-fitting devices and the cost of related, secondary conditions and medical complications,” the paper states.

Simon Margolis, president of RESNA, said the position paper was sent to the members of a conference committee charged with reconciling the House and Senate versions of the legislation.

“The House bill does have an out to exclude certain classifications of products,” Margolis said. “So we have a little wiggle room there.”

Those drafting language to carve out rehab from HME are hoping to find a sympathetic ear on that conference committee who can introduce their language, if competitive bidding is included in the final legislation. HME