CELA a Pivotal Point in Move toward Separate Rehab Benefit

DULLES, Va. — Is this the year complex rehab finds a voice — and a benefit — of its own? Key stakeholders believe it is, and they are banking on the upcoming CELA conference to lay the groundwork.

Scheduled April 28-30 in Dulles, Va., the Continuing Education and Legislative Advocacy Conference is sponsored by the National Registry of Rehabilitation Technology in association with the National Coalition for Assistive and Rehab Technology. So far, nearly 250 consumers, therapists, providers and manufacturers are pledged to visit Capitol Hill as part of the conference, according to Simon Margolis, NRRTS executive director.

"The goal is to alert members of Congress and their staffs that we are going to push for a bill to be introduced to set up a separate benefit for complex rehab," Margolis said.

NRRTS, together with NCART and other organizations, is working on the initiative. Stakeholders point out that complex rehab products differ significantly from standard DME because each is unique to the user, specialized staff is required to assist in the selection of appropriate equipment and rehab providers are held to greater standards than others.

CELA could be the pivotal step in making that separate benefit a reality, Margolis believes. And that would be a relief after the sector's difficulties in 2009, when both providers and consumers ran into problems after a 9.5 percent Medicare cut to "pay for" the delay in competitive bidding.

Even though complex rehab was exempted from future bids, it was included in the reimbursement cut. That hit rehab providers especially hard, since most skate on a thin margin that seldom exceeds 10 percent, and consumers encountered accessibility dilemmas as a result.

"We had a really tough 2009," said Margolis. "It was a bad year. We did get hit with the 9.5 percent [Medicare reimbursement] cut, which we shouldn't have because Congress already exempted Class 3 chairs from competitive bidding. But this is the year we turn it around."

Margolis believes it will be the consumers' stories that resonate with Congress.

"The thrust of CELA is not the members of the profession coming to the Hill but the consumers coming to the Hill," he said. "We have 40 consumers from all over the country. These folks are coming to tell their own stories as to how the equipment they are using has made them successful and how they were impacted when they couldn't get the equipment they needed … They are coming because they agree with our position that the best way to ensure access is to get a separate category."