Sen. Specter comes to rehab industry's defense

Sunday, October 30, 2005

WASHINGTON - Powerful industry allies in the U.S. Senate on Thursday flexed their muscles in a better-late-than-never attempt to delay Medicare's plan to replace the CMN for power wheelchairs with a doctor's prescription.

Sen. Arlen Specter, R-Pa., introduced an amendment on Wednesday that would require CMS to re-issue the interim final rule by Jan. 1, 2006. It requires the agency to then hold a 45-day comment period and a 45-day transition period, and implement the rule no sooner than April 1, 2006.

In a voice vote on Thursday, the Senate passed the amendment, which is attached to H.R. 3010, the spending bill for the health and human services, labor and education departments.

The bill now needs approval by the House of Representatives and a signature from the president - two steps that the industry believes will take place seamlessly before Thanksgiving.

"The chances of this provision sticking in the final version of the bill is 98% to 99%," said Seth Johnson, director of government affairs for Pride Mobility and chairman of AAHomecare's Rehab and Assistive Technology Council.

The rehab industry began voicing its disapproval of the rule, especially new documentation requirements that called for replacing CMNs with prescriptions and medical records, soon after it was published in the Federal Register in late August. Providers doubted they would be able to get the proper documentation from doctors.

The industry also bristled at the rule's tight timeline, which included an Oct. 25 implementation date that preceded the comment deadline by one month.

Stakeholders voiced their concerns en masse by encouraging their legislators to contact CMS, and more than 50 did. The Power Mobility Coalition even took CMS to court, in an attempt to convince a federal judge that he should force the agency to delay the rule. During an Oct. 25 hearing, however, it appeared the judge would fail to rule in the PMC's favor due to jurisdiction concerns. A written opinion is expected this week.

Despite all these efforts, the rehab industry watched CMS delay implementing new codes and a local coverage determination in mid-October but stay the course on the rule.

"What has been perplexing and frustrating has been that there were three issues floating around, and CMS agreed to delay two of them but not the third," said Don Clayback, director of The MED Group's National Rehab Network. "It didn't make sense because they're all related."

At the end of the day, however, the rehab industry's efforts, taken together, laid the groundwork for this latest development, said Cara Bachenheimer, vice president of government relations for Invacare.

"There's a new awareness now that there are people looking over [CMS's] shoulders," she said. "That what they do has to make sense, and most importantly, ensures beneficiaries have access."