Separate benefit: Rehab industry debates best approach

Sunday, June 14, 2009

YARMOUTH, Maine - There are "different schools of thought," sources say, on how to create a separate benefit for complex rehab.

One school prefers regulation and working with CMS to develop policy. The other prefers legislation and working with lawmakers to draft and pass a bill.

"There's no unanimity at this point," said Don Clayback, vice president of government relations for The MED Group and part of the executive leadership for NCART. "We're fleshing each one out to see which has the greater chance of success."

The efforts to create a separate benefit for complex rehab are still in the early stages, but both NCART and AAHomecare' Rehab and Assistive Technology Council (RATC) have created steering committees and work groups to move the process forward. NCART and RATC have also participated in conference calls and met in-person at AAHomecare's legislative fly-in in June.

Supporters of regulation say legislation should be a last resort. 

"It may be required in the future, but if we can get away with not doing it, that's preferable," said Tim Pederson, co-chairman of RATC. "We've already gotten some very encouraging feedback from the medical directors. They believe a lot of what we need is already in place."

Pederson, CEO of WestMed Rehab in Rapid City, S.D., added: "Look at our track record with legislation."

But others worry that regulation can be too easily reversed.

"Legislation would give us some protection, if we need it," said Sharon Hildebrant, executive director of NCART. "It would lay out what CMS should do and how they should do it. We don't want to leave it to their discretion to do something."

At the end of the day, there's not much to the differences of thought, sources say, because the industry will likely need support from both CMS and lawmakers if it wants to get anything done.

"We're all working toward the same goal, and we're just being methodical about getting it done," said Seth Johnson, co-chairman of RATC and vice president of government affairs for Pride Mobility Products. "That's what's important."