Separate but not equal?

The rehab industry may have its hands full trying to convince lawmakers that they should exempt complex wheelchairs from the 9.5% Medicare reimbursement cut, but that's not stopping it from keeping an eye toward the future.

The rehab industry has begun exploring the possibility of divorcing HME, making complex wheelchairs a separate benefit.

“Every time the HME industry gets cut, it hurts us the most,” said Sharon Hildebrandt, executive director of NCART. “We're different. We have a very large service component. We think we should be treated differently.”

NCART and AAHomecare's Rehab and Assistive Technology Council (RATC) are spearheading the effort, which would require legislation.

The rehab industry has talked about separation for years, but before now, stakeholders have never taken action. The reason: Until it succeeded last year in getting complex wheelchairs carved out from national competitive bidding, it didn't feel its message was resonating with lawmakers.

“Now that there's a sensitivity in Congress to the specialized nature of complex wheelchairs, this is the next logical step,” said Tim Pederson, co-chairman of RATC.

The rehab industry is looking to model itself after other industries that are similar to but separate from HME - like orthotics and prosthetics.

“There are vast similarities between rehab and O&P,” said Peterson, whose company, WestMed Rehab in Rapid City, S.D., does both. “In fact, rehab is even more complicated.”

The rehab industry's also keeping a close eye on efforts to make home oxygen therapy its own benefit.

“We're evaluating the receptivity in Congress to that proposal,” said Seth Johnson, co-chairman of RATC and vice president of government affairs for Pride Mobility Products. “What they like; what they don't like.”

While making complex wheelchairs a separate benefit is definitely on NCART and RATC's agenda for 2009, industry stakeholders plan to take their time exploring the possibility.

“This is a long-term goal and not something we will accomplish this year,” Johnson said. “But we'll do significant research and development that, moving forward, will put us in a positive position.”