NCART Commissions Complex Rehab Study; AAH Worried About OIG Audits

Propelled by a flurry of potential reimbursement cuts that could imperil providers and beneficiary access alike, the National Coalition for Assistive and Rehab Technology has authorized a two-year study of services, costs and outcomes associated with providing rehab technology.

Complex rehab has been included in both rounds one and two of national competitive bidding. Last fall, in a report the industry decried as misleading at best, the Health and Human Services Office of Inspector General said Medicare could save millions on power wheelchairs if the government reimbursed them at rates available on the Internet. In addition, Congress has surfaced the idea of eliminating the first-month purchase option for power chairs, a provision President Bush included in his 2009 budget.

While NCART has worked to stem the tide of looming cuts — most notably through support of H.R. 2231, which would carve out complex rehab from competitive bidding — its efforts have been stymied because of lack of data, according to Sharon Hildebrandt, executive director.

“One important element we are lacking as an industry in our attempts to change and modify payment and coverage policies is independent and credible data regarding the non-product related costs associated with the complex rehab service delivery model,” Hildebrandt wrote in a letter announcing the study. “We have good tools that anecdotally describe the processes, and self-reported surveys regarding the costs. But we do not have independent studies of the costs and outcomes of complex rehab.”

Hildebrandt said the study will be conducted at the Georgia Institute of Technology (Georgia Tech) in Atlanta and the University of Buffalo.

Doug Westerdahl, chair of NCART's Medicaid committee and CEO of Monroe Wheelchair in Rochester, N.Y., said the need for concrete data is critical.

“Right now, we go to Capitol Hill or the OIG or CMS or whomever and we tell them we spend all this time [providing rehab], but the studies we show are all our own. The universities will be outside institutions that will be validating the time,” he said.

Hildebrandt said NCART will use the information “to seek higher reimbursement and distinct coding and coverage policies for complex rehab devices. We believe the information resulting from this study will also be of value at the state level as [providers] battle attempts to cut back on reimbursement and restrict coverage,” she added.