I don't think that AOTA is "jumping in now that another organization has stepped up and been recognized by CMS." From what I understand the DMERC medical directors approached RESNA, not the other way around. Further, we asked CMS to address the qualifications issue a number of times going back to the original "wheeler dealer" investigation. They would not respond to our requests and again the LCD requiring RESNA certification was quite a surprise. The original implementation date for the requirement was delayed, but as it stands now will go into effect in April 2008. We expect the DMERC Medical Directors to respond to our reconsidation request by mid-November.
-----Original Message----- I am absolutely not saying that there is an easy answer to this question/dilemma, but I am frustrated that AOTA seems to be jumping in now that another organization has stepped up and been recognized by CMS. Who even knows if the rule will actually go into effect? Very few have, at least on the original planned date. We still have to make it through competitive bidding that the dealers are going through. I live in one of the test markets that is requiring competitive bids now with the anticipation that CMS will announce the "winning" companies that can require equipment in this area. I think CMS has too many things going on at once with no idea where any of them will lead. It is an interesting time to be in this field and specifically in this specialty. Mary Alice On Oct 30, 2007, at 3:25 PM, Chuck Willmarth wrote: > Mary Alice, > > Our position is not that every OT fresh out of school can perform PMD > evaluations. OTs are required by state licensure laws and the > Code of > Ethics to only provide those services for which they are competent. > We do not believe that RESNA certification should be required for > payment > under Medicare. Such a policy would put us on a slippery slope. > Should Medicare require certification for payment when providing > others interventions such as wound care? PAMs? Should there be > different certifications for the various practice settings? > > We understand that CMS wants to ensure that they are paying for > quality services provided by competent therapists. We think that is a > fine > goal. However we do not have information about the problem they are > trying to solve. If beneficiaries are getting the wrong chairs, is it > because of the OT or PT? Is the problem fraud? Is the problem > overutilization? We don't know. Would requiring RESNA certification > solve the problem? We don't think so, plus we believe that the > certification requirement will cause a whole new set of problems > including access to care. > > Chuck > > -----Original Message----- > From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On > Behalf Of Mary Alice Cafiero > Sent: Tuesday, October 30, 2007 3:43 PM > To: [email protected] > Subject: Re: [OTlist] ATP > > I have to say more on this subject. Sorry if I'm boring some of you! > Unless things have changed dramatically in OT schools since I > graduated, OTs do not come out of school with knowledge of seating and > positioning or function-based wheelchair assessment. I have spoken > with many students on their internships in the past 7-8 years, and > they report that they still get the 1/2 to 1 day education on what a > wheelchair is but nothing more in depth than that. > > Do I think OTs are the best profession ultimately to be doing this > type of assessment? Absolutely! BUT, I don't think being an OT > automatically makes you qualified to be recommending complex rehab > equipment and advanced seating. > RESNA respects and requires hours of direct experience in the field > before you are even qualified to take the exam. Currently AOTA does > not have a way to acknowledge or recognize OTs that are specialists in > this field. How can AOTA expect CMS to turn to them for definitions > and qualifications of who should be performing this type of > evaluation? > > I'm not just trying to be stubborn and disagreeable, but this is an > area that I feel passionate about. Recommending equipment that is > inappropriate for a client can cause harm. Recommending equipment that > will not accommodate a client's needs for the next 4-5 years can cause > the patient to be "stuck" because funding will not cover another > mobility device. > > Mary Alice > On Oct 30, 2007, at 2:01 PM, Chuck Willmarth wrote: > >> >> I'd like to address part of this discussion. There was no request >> from >> CMS to provide our qualifications to evaluate chairs prior to the LCD >> draft issuance. We LONG advocated for OTs to be specifically >> recognized as qualified to do this, starting with when CMS began the >> process of disseminating the National Coverage Decision, but CMS' >> response to us repeatedly (in writing and on calls) was that they >> were > >> going to leave the decision of who would be qualified to another >> process. They didn't identify the DMERC Medical Directors as the >> group tasked with determining who would be qualified until very late >> in the game, a few months before the draft LCD was issued. >> >> We commented on the draft LCD and subsequently requested >> reconsideration of comments. We had a conference call with the DMERC >> Medical Directors last week to make our case. We should know >> something by mid-November. >> >> Here are some articles that discuss the issue in more detail. >> >> http://www.aota.org/Archive/NewsA/FedReimbA/39756.aspx >> >> http://www.aota.org/News/AdvocacyNews/fedreim/39739.aspx >> >> http://www.aota.org/Practitioners/Reimb/News/Letters/40713.aspx >> >> http://www.aota.org/Practitioners/Reimb/News/Announcements/40727.aspx >> >> >> Chuck Willmarth >> Director, State Affairs and Reimbursement & Regulatory Affairs AOTA >> >> >> -----Original Message----- >> From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On >> Behalf Of Mary Alice Cafiero >> Sent: Sunday, October 28, 2007 11:35 AM >> To: [email protected] >> Subject: Re: [OTlist] ATP >> >> >> >> 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 >> ********************************************************************* >> * > >> ** >> ************** >> >> -- >> 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 > ********************************************************************** > ** > ************** > > -- > 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 ************************************************************************ ************** -- 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 **************************************************************************************
