Clinician Task Force Takes on Pandemic Issues

• By Laurie Watanabe
• May 14, 2020

For the last seven weeks, Complex Rehab Technology (CRT) stakeholders have been coming together on Thursday afternoons to get the latest updates on swiftly changing federal and state coverage and funding policies during the COVID-19 pandemic.

These Webinars demonstrate industry unity at its best: Presentations are cohosted by NCART, NRRTS, U.S. Rehab and the Clinician Task Force. The Webinar is led by Don Clayback (NCART), Weesie Walker (NRRTS), Dan Fedor (U.S. Rehab) and Cathy Carver (Clinician Task Force), with panelists Seth Johnson (Quantum Rehab), Mickae Lee (NCART), Rita Stanley (Sunrise Medical) and Jim Stephenson (Permobil) available to answer attendee questions.

The Webinars have given the industry, particularly those on the supplier side, the opportunity to get better acquainted with the Clinician Task Force (CTF), a group of about 80 seating and wheeled mobility clinicians who mobilize when a clinical perspective is needed for issues related to advocacy, policy making and funding.

Cathy Carver, PT, ATP/SMS, is CTF’s current Executive Director at one of the most challenging times ever faced by the CRT industry, its professionals, and its end users.

Then again, CTF has existed long enough to also have lived through Operation Wheeler Dealer, the Medicare fraud crisis that forever changed funding for Medicare beneficiaries’ durable medical equipment, especially power wheelchairs and scooters.

“It started about 15 years ago with just two or three clinicians who were trying to respond to Medicare cuts for people needing CRT,” Carver said about CTF. “They worked on issues involving Operation Wheeler Dealer, and then it grew to needing more people to help. Laura Cohen, Barb Crane and Mark Schmeler were the beginnings of it.”

About 18 months ago, CTF had grown enough to warrant changes in structure and leadership so the organization could most efficiently work on a growing list of projects. CTF became a 501c4 non-profit in 2014 and in 2018 created a leadership structure that now has executive board members and the Executive Director serving two-year terms on a rotating basis, after Cohen had served in that role for CTF’s first 14 years.

CTF retains a membership balance: 80 percent of its members are PTs and OTs who have no affiliation with a CRT manufacturer or supplier, while 20 percent are employed by manufacturers or suppliers. Despite the organization’s steady growth, Carver said, “We like to term ourselves a ‘worker bee’ organization. We can network and reach each other for specific needs and be able to respond quickly without having to go through certain channels and chains and signing off approvals. We like to call ourselves quick responders to CRT issues needing a clinical voice.”

Four Major Areas of Work

During CTF’s restructuring, members identified four main priorities to focus on. The first is federal legislative issues, including the push for a separate CRT benefit for Medicare beneficiaries. The second is Medicare coverage criteria for standing and seat elevation, as well as technology with benefits or using materials that exceed existing code sets. The third area is Medicaid coverage and the challenges of managed care and restricted coverage or lack of access to CRT.

And the fourth priority is education, namely supporting the next generation of seating and wheeled mobility technicians as they enter the industry. “We want to invest in those who want to start working in this area and just don’t know where to start,” Carver explained. “We’re working to build a mentoring structure, so if somebody comes in and says, ‘I’d really like to learn the ropes of this,’ we have a process in place so a CTF member could walk through a Webinar series or a continuing education series and be their contact. That is another reason that we’d like to grow to a point where we have a member in every state: so that someone in a certain state, if they get interested in it, would have someone local to talk to.”

Having a CTF member in every state would also be helpful when Medicaid issues arise, Carver said: “When we’ve had specific state issues like in Ohio, Michigan, California and Washington State, we had members in each one of those states that we called. We got in touch very quickly, and they were able to be there to provide information from the clinical perspective.”

The ideal candidate to join CTF has clinical experience in seating and wheeled mobility, along with experience in advocacy at state and/or federal levels. During this pandemic, CTF has been on the front lines to advocate for allowing occupational and physical therapists to bill for telehealth services, which wasn’t an option until the Centers for Medicare & Medicaid Services changed its policy in late April.

The CTF board meets every August, Carver said, to review the organization’s priorities and mission statement and adjust them as needed for the coming year. “For example,” Carver said, “earlier in the year we partnered with the ITEM Coalition as the primary leader on the topic of power seat elevation and power standing. We provided the clinical subgroup information for them, the recommended coverage criteria, the research behind that and wrote up a draft of recommendations from a clinical perspective.”

CTF members are volunteers; only Executive Director and Administrator positions are paid, and even then, Carver continues to work as a full-time physical therapist at the University of Alabama at Birmingham. The organization draws financial support from CRT manufacturers and providers.

While many Webinar attendees might only now be learning in depth about the CTF, the organization has been quietly and industriously working alongside other CRT industry associations and stakeholders for a long time.

“We are all over the place,” Carver said, “and we are available to help.”