Well, I think something needs to be done to have the therapist more involved in the decision making process of what type of equipment is prescribed. Identifying the need for a manual or power chair is merely the first step. After that there are literally thousands of choices out there for seating and manual and power bases. If the therapist is not an active part of the evaluation with knowledge of what is available and best for the client, the dealer/vendor is free to provide anything in the category. For example, if you, the therapist, says to a vendor, that a patient needs a power chair that will maneuver in their home. The vendor can then provide a well-built chair from a reputable manufacturer that will last for years and stand up to every day use, or they can provide a cheapo chair and reap the benefits of increased profit. Medicare classifies chairs by group and reimburses at a single rate for any chair in that group. Their is a lot of dissent among the seating and mobility crowd about how Medicare has grouped chairs, since often they are not comparing apples to apples.
Medicare made this rule because of the rampant fraud in a few places in the country. They are making it sound like the power wheelchair scandal was responsible for the condition Medicare is in today, which is not true. I forgot the exact percentage, but the fraud amounted to less than 1/100 of Medicare's budget for a year. That is not to say the fraud didn't need to be stopped. Dealers were billing Medicare for one type of chair and providing another cheaper chair and reaping the profits. The real loser was the clients who ended up with something they couldn't use because it was inappropriate for them. I still go into homes to do w/c evals now and see the giant assembly line power chair sitting in the corner being used as a clothes rack (kind of like many of the treadmills in the world :-). Because these chairs are often only a few years old and Medicare has a record that they paid for a better quality, more appropriate chair for that client, the client is often stuck. Medicare will not replace a wheelchair for five years unless there has been a significant medical change. Medicare first looked to AOTA and APTA to ask what the standardized education and monitoring was for therapists who performed high end wheelchair evaluations. Neither organization had an answer, so Medicare expanded it's search to RESNA (Rehab Engineering Society of North America), some of the top manufacturers (Sunrise-who makes Quickie chairs, Invacare, Permobil, and Pride) to ask the same questions. The only credential available to show that a therapist has specific knowledge of assistive technology is the ATP exam through RESNA. There is also an ATS exam/credential for suppliers. RESNA requires that you have a certain number of hours in the AT field before you can take the exam and also requires continuing education applicable to the area in which you practice to keep your credential current. Medicare isn't going to require an ATP for every power eval. It is only for Group 2 chairs with a power function such as tilt or recline and any Group 3 chair. Group 3 is for more complex rehab and, in my opinion, should always require a therapist's evaluation. It is a good checks and balances system as well as a good way for clinicians and suppliers to collaborate. I personally think the therapist should be involved in the delivery of higher end equipment every time. So, after all that, my answer to your question is that, yes, it is a good idea to require the ATP. Mary Alice Cafiero, MSOTR, ATP On Oct 27, 2007, at 7:19 PM, Ron Carson wrote: > Hello All: > > Mary, your recent message and your credentials prompted to write this > message. > > Starting in 2008, Medicare will require the ATP credential for certain > types of wheelchair evals. > > How do list members feel about this? Is an ATP credential > necessary to > satisfactorily evaluate a patient for power mobility? > > Thanks, > > Ron > > > -- > Options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/[email protected] > > ********************************************************************** > **************** > Enroll in Boston University's post-professional Master of Science > for OTs Online. Gain the skills and credentials to propel your career. > www.otdegree.com/otn > ********************************************************************** > **************** -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] ************************************************************************************** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **************************************************************************************
