The American Association for Homecare’s rehab and assistive technology council (RATC) claimed a victory this week when three senators introduced the Medicare Access to Complex Rehabilitation and Assistive Technology Act of 2008. Senators Tim Johnson (D-SD), Olympia Snowe (R-Me) [pictured], and Debbie Stabenow (D-Mich) introduced the bill, dubbed S 2931, that would exempt complex rehabilitation from Medicare competitive bidding. “Ever since we had the House bill introduced by Reps Ron Lewis (R-Ky) and Tom Allen (D-Me), I have been working on Senator Johnson to do a companion bill in the Senate,” says Tim Pederson, RATC chair and CEO of WestMed Rehab Inc, Rapid City, SD. “It would mean that no complex rehab would be included in any round of competitive bidding. So the first round, even though it included complex, would be taken off the table. If it is implemented July 1, 2008, then they would undo it.”

Possibly working in the industry’s favor is that two of the three prime sponsors of S 2931 are on the influential Senate finance committee (Snowe and Stabenow), while Sen Johnson has close ties with senators on the finance committee such as Max Baucus (D-Mont), Kent Conrad (D-ND), and Chuck Grassley (R-Iowa). Ultimately, Pederson says that the goal is to build enough support to get the bill introduced as part of a broader Medicare package. “The House has already passed the baton to the Senate and let them know that any Medicare legislation this year is going to have to originate in the Senate,” says Pederson. “So Senate Finance will be responsible for writing Medicare legislation this time around.”

Back in March of this year, Jim Greatorex of Black Bear Medical, Portland, Me, got the ball rolling when he convinced Main’s Sen Snowe to commit to the carve-out bill. “We are thrilled that Senator Olympia Snowe is taking the lead on the Senate rehab carve-out bill,” said Greatorex, a member of the RATC. “This comes from an outstanding meeting we had with her at the AAHomecare Washington Legislative Conference. She was very supportive and gave us a verbal commitment that day.”

Ultimately, the legislation would exempt complex rehabilitative services from competitive bidding and help preserve access to custom-configured items that meet the needs of people with various conditions such as spinal cord injury, traumatic brain injury, cerebral palsy, and multiple sclerosis. The Senate bill is a companion to HR 2231, the Medicare Access to Complex Rehabilitation and Assistive Technology Act of 2007, introduced in the House last year by Reps Allen and Lewis. That bill currently has 41 cosponsors in the House.

In a statement introducing the bill this week, Sen Stabenow commented, “Competitive bidding, while well-intentioned, does not work well for items that must be customized for individuals with complex and specialized needs.” Senator Snowe added an example in the same statement of how the bidding program will make it harder for Medicare beneficiaries to access rehabilitative and assistive technology. “If a Medicare beneficiary has been diagnosed with muscular dystrophy and uses a power wheelchair due to the loss of muscle tone in the body, a wheelchair that is tailored to the individual is imperative for several reasons,” said Snowe. “Power wheelchairs that are not adapted to the particular needs of the individual lead to more than mere discomfort, but also can further worsening health."