Rehab carve out gains momentum

Sunday, May 4, 2008

WASHINGTON - Three senators introduced a bipartisan bill last week that would exclude complex rehab and assistive technology from national competitive bidding, paving the way, industry sources hope, for inclusion in a Medicare bill now in the works.

"There might be a pot of gold at the end of the rainbow," said Jim Greatorex, president of Black Bear Medical in Portland, Maine, who lobbied Sen. Olympia Snowe, R-Maine, to sponsor the bill at AAHomecare's congressional fly-in in March.

Sens. Tim Johnson, D-S.D., and Debbie Stabenow, D-Mich., joined Snowe in sponsoring S. 2931, a companion bill to H.R. 2231 (41 co-sponsors). Snowe and Stabenow are members of the powerful Finance Committee, which is working on a Medicare bill.

During her introduction of the bill, Snowe sided with the industry, saying complex rehab is "inappropriate" for competitive bidding. If it remains part of the program, beneficiaries will be forced into "ill-fitting products that will inevitably increase discomfort, further limit functional ability and may even cause loss of function for individuals who seek independence and mobility in their lives," she said.

Industry stakeholders like the carve out's chances of sliding into the Medicare bill. Money, usually the biggest stumbling block, shouldn't be an issue: The industry estimates the cost of excluding complex rehab to be about $46 million over five years, an amount that one of the bill's sponsors called "budget dust."

"(Johnson) doesn't believe it will require an offset," said Tim Pederson, chair of AAHomecare's Rehab and Assistive Technology Council and CEO of WestMed Rehab in Rapid City, S.D. "($46 million) sounds like a lot to you and I, but that's nothing for our government. It's a rounding error."

With a Senate bill now on the books, industry stakeholders urge providers, clinicians and consumers to ask Finance Committee members to support the bill--but to not stop there.

"The key targets are the committee members, but the Senate as a whole is very important," said Julie Piriano, a PT and ATP who's director of rehab industry affairs for Quantum Rehab, a division of Pride Mobility Products. "If we move into Round 2, there are 70 other areas and all of a sudden it's in almost in everyone's backyard. We want the entire Senate to have at least some base knowledge of complex rehab and why it's inappropriate for competitive bidding."