Reporter's notebook: Separate benefit's 'missing link'

Monday, April 25, 2011

I caught up with NCART's Don Clayback a few weeks after he and other stakeholders hit the Hill to lobby for a separate benefit for complex rehab technology.

When they made those visits with lawmakers, the big question was: How much would it cost?

Stakeholders have contracted with a firm to determine the "score" for a bill that would create a separate benefit and they expected to hear back by the end of March, but at press time in early April, they were still waiting.

Here's what Clayback had to say about the process:

"It's not a simple calculation. It's not like we're saying we're going to take these codes and they're going up 5%. (As part of creating a separate benefit, we want to) eliminate the in-the-home restriction--there isn't any study or formula you can apply to that. You have to make step-by-step assumptions. How many are using wheelchairs; how many need different devices, because they're more active outside? Those are the kinds of things we're formulating."

Stakeholders want the score to be "a very transparent road map," Clayback says, because once a bill is introduced, the Congressional Budget Office (CBO) will then formulate its own score.

"It'll be an example of what to do," he said.

Clayback continues to be pleased but realistic about efforts to create a separate benefit.

"I'm happy with our progress at this point," he said. "We weren't expecting 20 people to knock on our door as sponsors (of a bill to create a separate benefit). We have about 10 offices that are showing interest. And three weeks out of CELA, there's still some good activity. We're following up; we're keeping the conversation alive."

But a score is something stakeholders will need before they get any final commitments from lawmakers, Clayback acknowledges.

"It's the missing link," he said.