Separate benefit for complex rehab: Committee courts clinicians

Thursday, September 9, 2010

WASHINGTON - A steering committee collecting support for its efforts to create a separate benefit for complex rehab is trying to climb the next rung on the ladder.

Don Clayback, chairman of the steering committee and executive director of NCART, plans to meet with officials from the American Physical Therapy Association and the American Occupational Therapy Association in Washington, D.C., this month.

"First, we want them to be aware of the issue," he said. "Second, we'd like their input and, third, we'd like them to be supportive."

The ITEM Coalition, a consumer group, endorsed efforts to create a separate benefit earlier this year.

The steering committee has included clinicians--namely Laura Cohen, co-coordinator of The Clinician Task Force--from the get-go, but it now seeks input and support from a wider base of physical and occupational therapists, who often conduct the evaluations required to provide complex power wheelchairs.

Clinicians will likely have two main questions for Clayback, says Mark Schmeler: How is the current benefit creating an access problem vs. a reimbursement problem, and will a separate benefit infringe on their practice?

"I'm very supportive of a separate benefit, but if I'm trying to strategize with the industry, it can't be about taking something out of the pot we all eat out of and it has to be about supporting and collaborating with clinicians," said Schmeler, an assistant professor at the University of Pittsburgh's School of Health and Rehabilitation Services.

At the same time that it's collecting additional support, the steering committee has been working with a Washington, D.C., law firm to develop legislative language for a separate benefit for complex rehab. The committee planned to have that language, as well as an updated discussion paper, completed in September.

Additionally, two work groups on coverage and quality standards will meet for a face-to-face meeting in Nashville in October, and Clayback will give an update at Medtrade in November.

"This isn't something that was just a great idea and never got off the ground," Clayback said. "It's gaining momentum."