Rehab carve out: 'We're talking to anyone who can help us'

Sunday, June 8, 2008

WASHINGTON - The rehab industry, the self-described "new kid on the block," is competing against more experienced special interest groups to get its carve-out bill attached to a Medicare package.

"It's going to be, from what we understand, a relatively small package and there are a lot of people who want certain provisions included," said Sharon Hildebrandt, executive director of NCART. "We're working to get more co-sponsors in both the House of Representatives and Senate. We're talking to anyone who can help us."

Currently, H.R. 2231, which would exempt complex rehab from national competitive bidding, has 48 co-sponsors. A companion bill in the Senate, S. 2931, has six co-sponsors. Rep. Tom Allen, D-Maine, the lead sponsor of H.R. 2231, aims for 100 co-sponsors.

While lobbying legislators, the rehab industry, in some ways, has had to distinguish itself from the home medical equipment industry and its efforts to delay competitive bidding, sources say. Because the carve out and the delay vary greatly in cost (about $46 million vs. about $6 billion over five years), the rehab industry doesn't necessarily want legislators to view the two together.

"If they get intertwined, one could get sucked down with the other," said Simon Margolis, executive director of NRRTS.

Additionally, Margolis said, the reason for the delay hangs more on the mismanagement of the program, whereas the reason for the carve out hangs on the danger of competitively bidding a product category as complicated as complex rehab.

While the rehab industry thinks its chances of getting a carve out attached to this year's Medicare package are better than they've ever been, it has a Plan B, Hildebrandt said.

"If we don't get an exemption, we'll be monitoring the 10 CBAs," she said. "We were right when we predicted that inexperienced providers would win bids, and we think we're going to be right when we say people are going to get hurt by this program."