I had a struggle with something similar a few years ago. A vendor selling
equipment that had not been approved for our program was making cold calls
door-to -door, putting equipment into people's homes and giving them my
number at work to call to get 'the government' to pay for it. The sales
people were 'just following orders' and really had no idea they were doing
anything wrong. The kicker here is that we do the ordering under Alberta's
program and often have suppliers install equipment or provide wheelchairs on
trial as part of the evaluation. Prior approval of both need and equipment
is not the easiest process to explain when 'the nice man said I really
needed it' and 'He said I should phone you to arrange it all'. 
You need the backing of AOTA, your local (state or provincial) association
or, if it is part of your work situation, union to deal with this. You are
potentially vulnerable to a lot of pressure not least of all from clients
who are vulnerable as well and whose needs you want to serve. On the other
hand you don't want to lose your licence and you need to know if that is a
possibility.
At least in this jurisdiction the client is personally responsible to pay
for any equipment supplied by a vendor prior to evaluation by a therapist.
Joan
  

  

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf
Of Mary Alice Cafiero
Sent: Monday, February 05, 2007 12:01 PM
To: [email protected]
Subject: Re: [OTlist] ethical wheelchair question

As an OT who does wheelchairs as a primary part of my practice, this  
whole scenario just makes me cringe! The DME company has set you up  
to be such the bad guy! No, it is not ethical! Also, who knows if the  
wheelchair the client has is the appropriate one for them to have??
Why is the DME company even having a therapist do an eval now? Rules  
didn't change until very recently. Unless they have not billed until  
recently, and are trying to cover themselves, there should not be a  
reason to have a therapist eval. (Of course I think every client  
getting a chair should have a therapist eval. I'm just saying it was  
not a requirement until recently. And still technically isn't in a  
lot of ways!)

I would stay a long way from this as a therapist. I would also  
seriously consider letting Medicare know about this situation.

Mary Alice
On Feb 5, 2007, at 10:37 AM, Jenny Daup wrote:

> Here is an ethical question for all of you.
>
> -DME company dispenses a number of wheelchairs to clients with the  
> promise
> that medicare or insurance will pay for them.
> - DME company then requests that an outpatient clinic send a  
> therapist to
> evaluate clients for the wheelchairs that they already have and  
> then file
> paperwork for medical necessity.
>
> Here is the clincher...the patients have had their wheelchairs for an
> extended length of time, anywhere from 6 months to 18 months! Many  
> of the
> clients are openly hostile to the OT because they don't see a  
> reason that
> she is there to do a "wheelchair evaluation". They are afraid she  
> is going
> to take their wheelchair away.
>
> What do you think? Is it ethical to perform the eval "after the fact"?
>
>
>
> -- 
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