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After two years in draft form, a bill to make “Complex Rehab Technology,” it's own funding class via Medicare (and, ultimately, Medicaids and private insurers), has a sponsor, Congressman Joseph Crowley of New York, a member of the Ways and Means Committee that has partial jurisdiction over the funding of home medical equipment, including power wheelchairs. In short, the goal is to separate complex rehab mobility products from their current lumping with lower-end products, better securing funding for this vital, specialized class.

However, you, like some in Washington, may be wondering, what precisely is “complex rehab technology,” and why does it need its own funding designation?

Complex Rehab
Complex rehab power wheelchairs (most often referred to as simply, “rehab”), are technologies designed and custom-tailored for those with severe physical disabilities and advanced seating needs. Rehab power wheelchairs really begin with the seating, where advanced positioning and pressure management is required. Pressure-management cushions and backrests, tailored legrests, specialized armrests, and power seating (such as tilt), are emblematic of rehab models (of course, the list goes on and on, as some rehab models offer over 1-million configurations to meet individual, medically-based needs). To go along with such advanced seating, as well as accept options like specialty drive controls and ventilators, rehab power bases typically incorporate larger batteries and motors to handle the extra weight, programmable electronics for specialty controls, and a larger wheelbase and suspension for maximized stability. Rehab power wheelchairs are classified as “Group-3” models by Medicare.

In Practical Terms
In practical terms, then, a standard power wheelchair is among the most basic in nature, commonly used by the geriatric population, whereas a complex rehab power wheelchair is very advanced and custom-tailored for those with the most severe disabilities. For example, an elderly user needing a power mobility product due to an arthritic or heart condition may qualify for a standard power wheelchair, whereas a quadriplegic would qualify for a complex rehab model.

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Why Complex Rehab Technology Needs Its Own Funding
Currently, all power wheelchairs are placed in one funding family, so to speak, and the funding line is blurred between standard and complex rehab models. However, while standard power is a more one-size-fits-most, sit-and-go technology, rehab models are far more complex. Rehab power wheelchairs are more of a prosthetic device that's custom-tailored, custom-built, and custom-fitted to each individual. In this process, not only is the technology more involved, but the clinical services related to it – the prescription process, fitting, adjustments, maintenance, etc. – are vastly more involved. Although there are currently government “funding codes” defining different payment levels, it truly doesn't recognize the clinical and real-world differences between standard and rehab power – that is, the government makes no distinction between a sit-and-go power wheelchair and a far more complex, vital, clinically-intensive rehab power wheelchair in actual practice. As a result, as funding has been diminished, all power wheelchairs have suffered – namely because Washington doesn't know the difference among them.

Creating complex rehab technology as its own funding class would finally define it as its own entity, the most clinically-intensive, vital wheelchair technology, for those most in need – ideally creating a defense mechanism against further funding cuts. A lot of this need for a separate class is educationally-based, where if our representatives know that these are not the wheelchairs “as seen on TV,” but are life-sustaining devices that serve those with the most severe disabilities, of course they wouldn't keep cutting funding in this category. The folks in Washington simply don't know what complex rehab technology is, so by defining it as its own funding class, it can become a protected class – much like prosthetic limbs that retain meaningful coverage.

The complex rehab technology bill is still in its infancy. However, as it evolves, we, as those with severe disabilities – the ultimate stakeholders and the ultimate voice – need to be prepared to speak up to our legislators. ...I'll keep you posted as this initiative develops.

Published 11/2011, Copyright 2011,