Stark bill carves out complex rehab

Sunday, June 15, 2008

WASHINGTON - The rehab industry scored "a real win" on June 12, industry sources say, when Rep. Pete Stark, D-Calif., included carve-out language in his high-profile and fast-moving bill to delay national competitive bidding.

The bill would carve out Group 3 and above wheelchairs and accessories. The Senate planned to introduce a bill with similar language the week of June 16Th.

"We're delighted with this; we're happy; we're excited," said Sharon Hildebrandt, executive director of NCART. "We knew we needed to get attached to something, because it wouldn't pass as a standalone bill. This is a vehicle."

The rehab industry has two carve-out bills on the books, one in the House of Representatives and one in the Senate. In June, H.R. 2231 had 48 co-sponsors and S. 2931 had six.

There are a few drawbacks to the bill, industry sources acknowledge. First, the carve-out doesn't apply to certain wheelchairs that CMS included in its complex rehab product category. Examples: high-end manual and tilt-and-space wheelchairs.

"It gives us part of what we wanted," said Simon Margolis, executive director of NRRTS. "Right now, that's extremely important."

Second, even though the bill carves out complex rehab, it subjects the product category to a 9.5% payment cut. Stark included the cut nationwide for all product categories in Round 1 to pay for the lost savings from delaying competitive bidding.

"We are very concerned about that," Hildebrandt said. "Rehab providers have small margins--2% to 3%--so to ask them to take a 9.5% reduction doesn't make sense."

Additionally, a payment cut, like competitively bidding complex rehab, will result in access issues, Hildebrandt said.

Still, being included in the Stark bill is a "major, major step forward," industry sources said. They lauded provider, clinician and consumer lobbying efforts. In April and May alone, groups like NCART, NRRTS and AAHomecare staged hundreds of visits to Capitol Hill and thousands of calls to legislators.

"I think we've gotten where we are largely due to the grassroots efforts that have happened over the past few months," said Seth Johnson, vice president of government relations for Pride Mobility Products and vice chairman of AAHomecare's rehab council.