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On the record with Rita Hostak

On the record with Rita Hostak

When it comes to the industry's government relations professionals, Sunrise Medical's Rita Hostak is one of the toughest to track down. She prefers to ply her trade behind the scenes. But when you do corner her, Hostak has plenty to say, especially when it comes to complex rehab, Sunrise's specialty. Here are some excerpts from a long conversation she had with HME News recently.

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Reimbursement

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We need to get back to the point where we are thriving as an industry. If we don't, there's a concern that manufacturers are going to start moving toward less featured products because of the reimbursement. The innovation will not be there.

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Complex rehab carve out
A new benefit category for complex rehab seems to be the only thing that encompasses the possibility for fixing all of the issues. You can address the unique population of Medicare beneficiaries that uses complex rehab. You can possibly impact the payment methodology, and maybe there is a chance to get reimbursement for some of the supplier services. There is an opportunity to impact the in-the home rule.

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If every product in a code is not similar enough to address the same clinical needs, then somebody needs to look at maybe there needs to be a separate code. We're looking at the possibility of meeting with some folks at HHS (on that). A number of people along the way have been encouraging, and I hope so because this has been a long time coming. We've got many examples of HCPC codes that have too broad an array of technology that fits into them. It results in a kind of K0011 scenario where CMS pays too much for some standard equipment, and not enough for more complex (items). It's called an access issue.

 

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- Mike Moran

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