One size does not fit all

Medicare competitive bidding should not include complex rehab needs

Five Minnesotans joined almost 200 other rehabilitation professionals from across the nation to go to Washington and advocate for people with complex rehab needs. They met with elected officials to present concerns about exempting the complex rehab durable medical equipment needs from the Medicare competitive bidding process.  The concern is that limiting options for those with complex medical needs (spinal cord injuries, MS, MD, ALS, CP, etc) would greatly limit function, mobility and access to technology. 

Here’s the issue. Medicare is requiring competitive bidding on equipment needed for rehab. While this may seem like a good cost-saving policy, it will be a disaster for people with complex medical equipment needs such as specialized wheelchairs, seating, and alternative drive controls, etc. Here’s why. For this group of people, rehab and assistive technology products are highly individualized and must be assembled, fitted, and programmed to accommodate each person’s individual medical needs and requirements. Moreover, there is a need for ongoing service, adjustments and monitoring of these products to ensure that they continue to meet the medical needs of the person. Competitive bidding does not work in situations like this. The person will be limited to choices and access to current technology, leaving her or him less independent, and at high risk for medical complications (such as pressure ulcers and contractures).

The Minnesota delegation met with the legislative aids for Rep. Bachmann, Rep. Ellison, Rep. Peterson, Rep. Ramstad, Sen. Klobuchar, and Sen. Coleman. The group was seeking support on House Bill HR 2231 that was introduced in the House of Representatives last year by Reps. Tom Allen (D-ME) and Ron Lewis (R-KY). Rep. Peterson has signed onto the bill already.  Rep. Ramstad has been verbally very supportive but has not yet signed on. The advocates called for a companion bill in the Senate and have met with both MN Senate offices concerning this.  According to Sen. Klobuchar’s health legislative aide, this was a relatively new topic to them, but they were supportive of the issues.  Sen. Coleman’s legislative aide is very knowledgeable on the topic and expressed verbal support. 

Following the advocates visit, on April 29, a bipartisan companion bill was introduced in the Senate, S 2931 to HR 2231, these bills both exempt complex rehab from national competitive bidding. The National Coalition for Assis-tive and Rehab Technology (NCART) is encouraging everyone to contact their Senators and Representatives and urge them to cosponsor S. 2931 and HR. 2231.