States pick up seperate benefit

A bill signed recently in Colorado establishes separate recognition for complex rehab within the DME category. Similar legislation is pending in several other states.

“We're lucky in the state of Colorado in that we have not only an advocate community that is very supportive of disability rights, but also a department that is very aware of some of the implications and programs Medicaid will introduce and how they will affect that community,” said Patrick Mahncke, owner and president of USA Mobility.

Colorado's law is set to take effect Jan. 1, 2015. It mandates maintenance of appropriate reimbursement rates for complex rehab; requires Medicaid to continue to pay for the products as purchase items rather than capped rental items; and excludes them from any future Colorado Medicaid competitive bidding program, said Mahncke.

Industry stakeholders have been lobbying for H.R. 942 and S. 948, bills that would create a separate benefit for Medicare, for years. The bills have 128 and 14 co-sponsors, respectively.

“A significant portion of complex rehab is paid for at the state level through Medicaid programs,” said Don Clayback, executive director of NCART. “What we're working on at the federal level is important, but we also need these changes to flow through into the state Medicaid programs.”

A similar law took effect in Washington state in January. Legislation in Connecticut awaits the governor's signature, and a bill was recently introduced in New York.

“The co-sponsors who introduced it in the Senate are very comfortable with it,” said Carol Napierski, executive director of the New York Medical Equipment Providers association. “We hope for a complete companion bill.”

Securing separate benefits on the state level takes time, said Clayback.

“The biggest challenge is always to get that first state,” he said.