Separate benefit for complex rehab: 'We're headed in the right direction'

ST. LOUIS - About 50 stakeholders attended a consensus conference here yesterday to discuss creating a separate benefit for complex rehab.

“We wanted to gather comments from people to see if we're heading in the right direction,” said Don Clayback, executive director of NCART. “I think we feel comfortable now, with the feedback we've gotten, that we're headed in the right direction.”

During the daylong conference, Clayback and other members of a steering committee updated stakeholders on the efforts to create a separate benefit, including the efforts of several subcommittees examining issues related to reimbursement, coverage and credentialing.

Committee members and stakeholders spent a good amount of time discussing a definition for complex rehab, which will form the foundation of the benefit. The consensus: The definition must address technology, first and foremost, as well as the process of providing complex rehab and the individuals who use it.

“That's not a huge revelation,” said Simon Margolis, executive director of NRRTS and a member of the steering committee. “But we needed to confirm what some people on the steering committee were saying. That's exactly what needed to happen.”

The steering committee now plans to craft a proposed definition, circulate it and work to get buy-in from stakeholders, Clayback said.

Other topics of discussion: how to involve consumers and clinicians in the discussion (the consensus: The steering committee needs to come up with resources that ATPs and rehab technicians in the field can use in one-on-one conversations with them) and whether to strengthen provider standards and accreditation requirements for complex rehab providers (the consensus: It needs to be done).

So what now?

“The big next steps are fleshing out an action plan, starting to draft legislation and having very preliminary discussions with members of Congress and CMS in the next 60 days,” Clayback said. “We want to have something more specific in place in January, so we can start drumming up some support.”

But if you didn't participate in the two Webinars held in October or the consensus conference, it's not too late. The committee plans to hold additional Webinars, probably in November.

“We're light years ahead of where we were six months ago, but we're still light years behind where we need to be,” said Tim Pederson, CEO of WestMed Rehab and a member of the steering committee.