Complex Rehab Stakeholders Worried about 'Magnitude of Pain'

ATLANTA--With just a small window of time before the Jan. 1, 2009, implementation of a 9.5 percent reimbursement cut, complex rehab stakeholders are uniting to build a case for exemption from the reduction.

On Wednesday, the Rehabilitation Engineering and Assistive Technology Society of North America sent a letter to members of the U.S. Senate pleading for exclusion from the pay cut mandated by the Medicare Improvements for Patients and Providers Act, which also delayed competitive bidding.

The RESNA correspondence follows a Sept. 19 letter sent by the American Association of People with Disabilities to Sen. Max Baucus, D-Mont., chairman of the powerful Senate Finance Committee, expressing concern about the impending cut.

“Consumer groups have weighed in and now we have disability groups that have weighed in,” said Seth Johnson, vice president for government affairs for Pride Mobility Products in Exeter, Pa. “The clinicians and the physicians that make up the RESNA membership … are talking specifically about the impacts they know this is going to have on beneficiaries who need these complex rehab power wheelchairs and the services that go along with those products.”

While Congress elected to exempt complex rehab from any future competitive bidding program, it did not exclude the segment from the 9.5 percent fee schedule reduction that will be applied Jan. 1 to the products included in round one of competitive bidding.

Stakeholders have said that complex rehab providers operate on slim margins--of as little as 2 percent--and cannot absorb a 9.5 percent fee reduction without deep cuts to service and quality of products.

“We are concerned that with the impending 9.5 percent payment reduction, complex rehab suppliers will be forced to make significant adjustments to their business practices that will directly impact the services they provide,” RESNA’s letter said.

Some of those impacts could include decreased beneficiary access, decreased access to demo/trial and simulation equipment, substitution of recommended products, less robust products and a decrease in essential services, according to the organization.