Podcast Review: Sen. Frist Interviews NSM CEO Bill Mixon

A Second Opinion: Sen. Bill Frist Interviews NSM CEO Bill Mixon

Podcast

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57 minutes

Summary: A great example of advocacy in action, and a reminder of how issues familiar to CRT professionals look very different to those outside the industry.

When your everyday conversations routinely include tilt in space, pressure injuries, seat width, camber, HCPCS codes, and ruling out less costly equipment, it can be easy to forget what Complex Rehab Technology (CRT) sounds like to those outside the industry.

In Episode 183 of the A Second Opinion podcast, former Sen. Bill Frist talks with National Seating & Mobility (NSM) CEO Bill Mixon about a range of CRT issues.

“We create custom solutions,” Mixon said, in explaining NSM’s role as a CRT provider. “This is not the wheelchair you see at the airport or when you’re getting discharged from the hospital. These are custom devices that are custom fabricated to the measurements, specifications and requirements that the individual has. These folks spend many hours a day in these chairs.”

Frist (R-Tenn.), a physician who served in U.S. Senate from 1997 to 2005, demonstrates throughout the podcast that he knows quite a lot about the CRT landscape. “They’re not scooters, they’re not what you used to see on TV,” he said, as Mixon was explaining the custom-built/fit nature of CRT wheeled mobility.

“This is not your scooter,” Mixon confirmed. “These are highly specialized, custom devices. The great example is Christopher Reeve. We all know he had a traumatic accident, falling off a horse. Many folks spend many hours a day in these devices, so it’s critical that they’re properly measured precisely to their body style, shape and size. Also, the seating systems are super critical because as you know, decubitus skin breakdown is a real issue. That’s a reason we have readmission to the hospital.”

Later in the podcast, Frist asked, “Once someone gets a power wheelchair, do they keep that for a month, a year, or the rest of their life, typically?”

“The CMS [Centers for Medicare & Medicaid Services] protocol is about a five-year cycle time,” Mixon answered. “On a five-year rotation, CMS authorizes a new device for most [seating and mobility clients]. Most of the commercial payors and Medicaids follow that guideline. It’s a little different sometimes for pediatrics: If a child is outgrowing their chair, many times there can be the ability to show medical necessity to get a chair earlier than that.”

Other topics discussed in the podcast: Why CRT equipment can take so long to be delivered (and how one major payor manages to be three times faster than Medicare); why repairs can take so long, and the right-to-repair movement; the impact of COVID-19 on CRT providers (and on reimbursement established pre-pandemic); and the potential future of CRT.

“After the initial recovery,” Mixon said of a client who needs CRT, for example, after an accident, “the focus begins to be on ‘What is life going to look like, how am I going to function, what is my home going to look like?’ These devices are central to their ability to function fully in society.”

Editor’s Note: Asked for a comment on his conversation, Mixon said, “I very much enjoyed spending time with Sen. Frist discussing our industry and our mission. Much of our conversation centered on the complicated aspects of current health insurance policies and the impact of these policies on individuals whose lives depend on mobility equipment.

“Currently, access to custom-configured manual and power wheelchairs and other adaptive devices critical to the functional needs of individuals with disabilities often hinges on health insurance approvals tied to cumbersome policies and requirements. It is critical that we spotlight this issue and find ways as an industry to work with insurance companies to standardize and expedite the processing of these claims. We should spend less time worrying about medical necessity with these types of conditions and more time focused on facilitating the provision of the equipment and services needed to support the independence and self-reliance these consumers deserve.”

About the Author

Laurie Watanabe is the editor of Mobility Management. She can be reached at lwatanabe@1105media.com.

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