CBO remains hurdle for complex rehab bills

WASHINGTON �- Complex rehab stakeholders have a tough, but not impossible, battle ahead of them to get their legislation passed in Congress this year, lobbyist Amy Cunniffe told the attendees of the National CRT Leadership & Advocacy Conference on April 25.

Stakeholders have two bills they're trying to pass in Congress: H.R. 3730 and S. 486, which would stop CMS from applying competitive bidding related pricing for accessories for complex rehab manual wheelchairs; and H.R. 750, which would create a separate benefit for complex rehab technology.

These have been long-standing goals for stakeholders, begging the question: Why is it taking so long?

“It's not anything that we're doing wrong,” said Amy Cunniffe, a principal with SplitOak Strategies. “It has a lot to due with the way the process has changed in Congress, especially for health care. They're really looking for bills that are bi-partisan and that have been scored by the CBO and that score is de minimis.”

For stakeholders, the latter, not the former, is the bigger hurdle, Cunniffe says.

“The CBO has been challenging to work with,” she said. “We bring forth real data estimates and the CBO looks at it and says, 'That looks nice, we're going to put a multiplier of five on it,'” she said. “We ask, 'What's the basis for that?' and they say, 'That's none of your business, thanks for coming, now please leave.' We're trying to come up with creative solutions to address that.”

Another hurdle: A limited number of larger pieces of legislation will be moving through Congress this year, an election year. There are only three bills poised to move on opioids, the budget and an omnibus, Cunniffe says.

“It's not like typical years, where there are multiple moving bills,” she said.

The industry's efforts got a nice boost during the conference. Stakeholders had visits at more than 240 congressional offices on April 26, but that push must continue past the conference, Don Clayback says.

“We need thousands of (touch points with lawmakers),” said Clayback, executive director of NCART, which hosts the conference with NRRTS. “The important thing is not to lose faith and realize that we're making incremental improvements.”