Implementation of Healthcare Reform
(1) Testified to IOM panel on the definition and scope of rehab devices and related services within the essential health benefits package
(2) Organized, sponsored and facilitated Congressional Briefing on importance of rehab devices and related services, in the context of EHB, and Medicare and Medicaid reforms
(3) Met with Don Berwick, CMS Administrator, on the importance of covering DMEPOS and other assistive devices and technologies within the essential benefits package; sent accompanying memo to Berwick
(4) Conducted survey of employer sponsored coverage of rehab services and devices
(5) Worked with HHS on not repeating Medicare restrictions in private market reform, benchmark package
(a) Worked with IOM, NAIC and HHS on the definitions of rehabilitation devices
–Submitted information to HHS
–Commented on CMS regulation for summary of benefits and definitions of terms for consumer documents in new health insurance exchanges
(b)DMEPOS as a minimum
–In the Home
–Exception for all devices that use a lens
–Medicaid benchmark package must include coverage of devices
–Vision services for children under 21
Complex Rehab Technology and Medicare Independent Living Act
(1) Circulate ITEM position statement in support of separate CRT category
(2) Plan with Langevin’s office to incorporate Medicare Independent Living Act strategy into CRT strategy (CRT would not be subject to DME “In the Home” exclusion)
Protecting Medicare and Medicaid Rehabilitation Devices
(1) Wrote and met with CMS on the least costly alternative issue raised when the agency denied coverage for complex devices as not covered, rather than not medically necessary, and that effect on access to complex devices
(2) Monitored critiques of competitive bidding by leading economists; participated in mock auction at UMD
(3) Advocated to exempt specialized seating cushions, certain orthotics and prosthetic, and other complex technology from the second round of competitive bidding; Responded to implementation of second round of bidding
(4) Participated on call with GAO on its monitoring of the affect of competitive bidding on beneficiary access to devices
(5) Commented on CMS regulation which would alter the definition of DME to apply a minimum lifetime requirement of 3 years
(6) Wrote to the Treasury Department about concerns with applying medical device tax to DME and other home care equipment regularly purchased directly by consumers
(7) Organized Congressional Briefing raising concerns about cuts to devices and related services to offset other budget items
(8) Sent letter to Congress on using cuts to DME and demos to offset SGR
(9) Monitored and responded to potential DME demos to ensure that patient access is not restricted
(10) Communicated with Congress and Administration our concerns about speeding up the expansion of competitive bidding to produce savings
HHS Fixing HCPCS Codes, Particularly Around Mobility Devices and CRT
