With any product category, coding, coverage and payment are the
vital factors that control access.
The home mobility and rehabilitation industry has not had a
chance to adjust to the myriad changes impacting power mobility
and, yet, more changes are being proposed that threaten any chance
for stabilizing the market. So, it is important to focus on what
else needs to be done to ensure access to this technology that is
so critical to individuals with mobility deficits.
For the National Coalition for Assistive and Rehab Technology
(NCART), a coalition of providers and manufacturers of assistive
and rehab technologies, the focus has been on three
initiatives:
Ensuring passage of the Medicare Access to Complex
Rehabilitation and Assistive Technology Act of 2007 (H.R.
2231);
Ensuring that a first-month purchase option for power
wheelchairs remains an option; and
Collecting viable, credible data that supports our arguments
regarding the need for adequate reimbursement.
Efforts to ensure the rehab exemption from competitive bidding
have been recharged with the announcement by CMS that complex rehab
products will be included in round two. NCART's next goal is to see
a companion Senate bill introduced and gain support of cosponsors
for H.R. 2231.
Fortunately, the Continuing Education and Legislative Advocacy
Conference (CELA) was held April 23-25 in Washington. This event
was sponsored by the National Registry of Rehabilitation Technology
Suppliers (NRRTS) in association with NCART and the University of
Pittsburgh's Department of Rehabilitation Science and
Technology.
CELA was the first event of its type and brought hundreds of
individuals to Washington for two important causes: to obtain
required continuing education and to help educate members of
Congress about complex rehab and request their support for H.R.
2231 and related issues.
President Bush's proposed 2009 budget raises additional concerns
for NCART.
The budget calls for a 13-month rental for power mobility
products. Regardless of the viability of the president's budget, it
is troubling to see this proposal continuing to be considered after
tremendous efforts to educate policymakers about the impact of such
a change. However, it is clear that additional focus will need to
be expended on this issue.
This issue and many others that ultimately impact reimbursement
are what led NCART's board of directors to authorize a two-year
study, conducted by the Georgia Institute of Technology (Georgia
Tech) and the University of Buffalo, to look at the services, costs
and outcomes associated with providing complex rehab
technology.
The results that will be reported out of this study will offer
reliable and credible data to support our claims when fighting
reimbursement-related issues.
In addition to the need for data to support efforts at the
federal level, the information from this study has implications for
Medicaid as well. Moreover, since the OIG is working on additional
studies in 2008 focused on power mobility, NCART recognizes the
need to have credible data on the same subject.
While these initiatives are the focus of NCART's current efforts
around complex rehab and specifically power mobility, new issues
always arise that require everyone to expand their work, all aimed
at bringing stability to the industry and ensuring appropriate
access to technology.
For more information, visit www.ncartcoalition.org. For more on NCART's
concerns with the inclusion of complex rehab in competitive
bidding, see “Round One Shocker” on page 6.
Rita S. Hostak is president of the National Coalition for
Assistive and Rehab Technology and vice president of government
relations for Sunrise Medical, Longmont, Colo. She can be contacted
at rita.hostak@sunmed.com.
