Focus on: Power Mobility Devices

DME MACs Release FAQs on ATP Involvement

The Centers for Medicare & Medicaid Services’ (CMS) four DME MACs are distributing a new FAQ document regarding power mobility devices (PMDs) and the involvement of assistive technology professionals (ATPs) in the assessment and equipment selection processes.

In particular, the FAQ document distinguishes between the required involvement of ATPs conducting the specialty evaluation and the ATP employed by the supplier (referred to by the abbreviation “sATP” in the FAQ document).

The document also discusses at length the required involvement of the sATP in the equipment selection process.

In one answer, the FAQ says, “There must be evidence in the supplier’s file of direct in-person interaction with the patient by the sATP in the wheelchair selection process. The supplier, LCMP (licensed certified health-care professional) or treating physician must document how the sATP is involved with the patient….Just “signing off” on a form completed by another individual would not adequately document direct, in-person involvement.”

As an example, the FAQ suggests, “The sATP can create a note documenting their involvement in the specialty evaluation process and that the recommendations reflect their input.”

The FAQ document repeatedly emphasizes that the sATP must be directly involved in the equipment selection process. In reply to a question asking if an sATP can review and approve the equipment recommendations of other non-ATP staff members, “An sATP cannot simply ‘review’ and ‘sign off’ on non-credentialed staff work in order to meet the requirement.”

In response to the question of whether the sATP’s evaluation can be conducted at the time that the PMD is delivered to the beneficiary, the FAQ says, “No. The purpose of the sATP evaluation is determining the proper seating, accessories and other components of the PMD prior to ordering and delivery.”

The FAQ also says the sATP cannot perform any part of the face-to-face examinations required by Medicare as part of the PMD and complex rehab wheelchair assessment process.

Focus on: Pediatrics

Researchers Working on Urine Test to Detect Sleep Disorders in Kids

The American Thoracic Society Journal reports that researchers at the University of Chicago have determined a way to screen kids for obstructive sleep apnea (OSA) by testing their urine.

Said Dr. David Gozal, professor and chairman of pediatrics at the University of Chicago, “These findings open up the possibility of developing a relatively simple urine test that could detect OSA in snoring children. This would alleviate the need for costly and inconvenient sleep studies in children who snore, only about 20 to 30 percent of whom actually have OSA.”

Researchers studied groups of children suspected of having OSA along with non-snoring children who acted as the control group. Urine samples were taken from the children after they woke from the sleep study, and researchers discovered “a number of proteins were differently expressed in children with OSA compared to children with habitual snoring or healthy, nonsnoring children,” according to the Journal.

The Journal added that 1 to 3 percent of children ages nine and under are thought to have OSA, but the American Sleep Apnea Association points out that children with cerebral palsy or muscular dystrophy are at higher risk.

Focus on: Power Mobility Devices

CMS Issues Reminder on PMD Replacement

The Centers for Medicare & Medicaid Services (CMS) have issued a reminder to DME suppliers regarding the requirements for replacing a power mobility device (PMD) for a Medicare beneficiary. In a previous FAQ document on the topic, CMS noted, “All new PMD requirements must be met. Many new products are available, the codes have changed, and a patient’s functional status must be assessed through a face-to-face evaluation in order to establish need.”

In its latest reminder, CMS added, “When replacing a PMD after the five-year reasonable useful lifetime is met, the beneficiary must meet all of the coverage requirements outlined in the local coverage determination for PMDs, including a new 7-element order and face-to-face evaluation. Claims that do not meet the coverage, coding or documentation criteria will be denied.”

Focus on: Complex Rehab

NCART Launches New Web Site

Consider it part of a continuing campaign to win the “hearts and minds” of consumers, clinicians, payors and legislators who don’t fully appreciate or understand the immense value of complex rehab technology.

The National Coalition for Assistive & Rehab Technology (NCART) has launched a new Web site “to provide timely information and resources on complex rehab technology and services, and help battle the issues that threaten consumer access.”

Said NCART Executive Director Don Clayback, “With the coverage and funding issues now and those that lie ahead, our Web site will serve as an important tool in telling the complex rehab technology story and protecting access to these important products and services. It has been designed to provide information and resources in an easy-to-access format, to allow for increased advocacy interaction and communication, and to give us a structure that we can add to and enhance as we move ahead.”

Sections of the new site include Current Issues, Advocacy, Position Papers, Medicaid, Educational Material, Policy Makers, Membership, Other Resources, Updates, and Contact Your Legislator.

Visit the new site at ncart.us.