Hello Mary:

Thanks for the recap. What you typed is what I remembered.

About  a  year  ago,  when  AOTA was providing input to CMS on pending
changes  to  the  PMD  regs, I asked them to include a statement about
REQUIRING  a OT eval for all PMDs. I don' know if they included such a
statement  but  as  you  said below, a therapist eval is currently not
required.

I think the RESNA cert is crazy. In my experience there are really two
distinct  category of w/c users. Those with positioning/mobility needs
and  those  with mobility needs. For example, the vast majority of w/c
evals  that  I've  done  are  for clients who have no specific seating
needs  and  where standard seating is very satisfactory. In this types
of  situations,  no  specific seating knowledge (beyond what we get in
school)  is necessary. On the other hand, there are those patients who
need extensive seating and positioning equipment. In these situations,
I think RESNA certification is indicated.

Ron

----- Original Message -----
From: Mary Alice Cafiero <[EMAIL PROTECTED]>
Sent: Monday, February 05, 2007
To:   [email protected] <[email protected]>
Subj: [OTlist] ethical wheelchair question

MAC> I  don't  have the current CMS reference but currently CMS is not
MAC> requiring  a  therapist  evaluation.  They  are  requiring that a
MAC> patient   be  seen  for  a  face-to-face  evaluation  with  their
MAC> physician  within  60  days  of the wheelchair prescription. Many
MAC> physicians  are  able  to  identify  and  document  the  mobility
MAC> limitation  of  their  patient  but  are not able to sufficiently
MAC> document  the  patient’s  functional  ability  to  perform MRADLs
MAC> within their home. Whereas a therapist is more able to thoroughly
MAC> address  the  patient’s  mobility  limitations and identify which
MAC> piece  of  Mobility  Assistive  Equipment will meet the patient’s
MAC> needs. Keeping in mind that the least costly alternatives must be
MAC> tried  or  at least considered and ruled out if a PMD is going to
MAC> be  considered  for  payment. Medicare has made it clear that for
MAC> these  situations the ordering physician may refer the patient to
MAC> the  PT/OT  to  perform  a  wheelchair  assessment.  However, the
MAC> therapist  performing  this  wheelchair  assessment cannot have a
MAC> financial  relationship  with the supplier of the equipment. This
MAC> physician  ordered  wheelchair assessment is reimbursable through
MAC> Medicare  Part  B.  The  physician  may then sign the therapist's
MAC> evaluation to show their agreement with the findings.

MAC> So at this point, the therapist is not technically required to do
MAC> the  evaluation,  but  is  often called upon to do the evaluation
MAC> that the physician then signs off on. The word is that the future
MAC> of Medicare will be a therapist evaluation as a requirement for a
MAC> power  wheelchair. Even more interesting is that the current plan
MAC> is  that  the  therapist  will  have  to  be  an  ATP  (Assistive
MAC> Technology Practitioner through RESNA) by 2008 (I think April).

MAC> Does that make sense?

MAC> Mary Alice
MAC> On Feb 5, 2007, at 6:32 PM, Ron Carson wrote:




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