Thought list members might be interested in this development.

Chuck

*******

http://www.aota.org/News/AdvocacyNews/pw.aspx

AOTA Victory: Medicare Removes Certification Requirement on OT Power
Wheelchair Evaluations 

After more than 2 years of advocacy, AOTA is happy to announce its
success in eliminating an additional requirement for occupational
therapy wheelchair evaluations under Medicare. Reimbursement and
Regulatory Policy staff convinced the Centers for Medicare and Medicaid
Services (CMS) to eliminate a requirement that would have required an
additional certification for occupational therapists (OTs) performing
wheelchair evaluations for higher-end power devices. 

AOTA had responded to this change, proposed to be implemented in 2008,
because it caused deep concern about access for Medicare beneficiaries
and an unwarranted restriction on an evaluation that is clearly within
the scope of occupational therapy practice.

The provision was included in the Medicare Durable Medical Equipment
(DME) contractor's Local Coverage Determination (LCD) Policy for Power
Mobility Devices (PMDs) released in 2006. 

Specifically, the original LCD required that occupational therapists and
physical therapists attain certification as RESNA Assistive Technology
Practitioners (ATPs) in order to perform the specialty evaluation
required for patients receiving Group 2, Group 3, or Group 4 power
wheelchairs. The same LCD was adopted by each of the medical directors
across the country, making it a national policy in effect. 

Initially, AOTA voiced grave concerns that the policy, set to take
effect April 1, 2008,  did not measure a therapist's competence in
performing evaluations and that it would unreasonably restrict a portion
of OT practice. Further, it would result in an access problem for
Medicare beneficiaries because of the limited number of OTs with an ATP.


AOTA then met with the Acting Administrator of CMS, Herb Kuhn, to put
these concerns forward. That was followed by a formal request for
reconsideration of the LCD, including a telephone conference call with
regional Medicare medical directors. On December 3, 2007, the DME
medical directors told AOTA of their decision to accept AOTA's
recommendation and eliminate the requirement for RESNA ATP
certification. 

No additional certification for wheelchair evaluations will be required
as of April 2008. 

According to the ruling by the medical directors, the current
requirement will remain in place, that is, the patient must have a
specialty evaluation performed by a licensed/certified medical
professional such as an OT or physical therapist, or by a physician who
has specific training and experience in rehabilitation wheelchair
evaluations. The evaluation must document the medical necessity for the
wheelchair and its special features. 

AOTA made the argument to CMS that the code of ethics for occupational
therapy supports the expectation that an OT performing such an
evaluation would only do so if she or he was competent by reason of
training or experience. AOTA also reminds practitioners to be sure their
competence and training is appropriate for the performance of such
specialty evaluations. AOTA continues to support continuing education
and training as part of a practitioner's lifelong responsibility to
provide quality services to clients.

The local DME Medicare contractors will publish an article on their
individual Web sites that notifies providers of this decision. This
information will also be incorporated in a future revision of the Power
Mobility Devices LCD.




-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On
Behalf Of Chuck Willmarth
Sent: Monday, November 05, 2007 8:35 PM
To: [email protected]
Subject: Re: [OTlist] ATP

Ron,

Just to clarify, AOTA does not have a seating and wheel mobility
certification...the ad hoc group is examining the need for such a
certification from what I understand.

I was suggesting that a broader level, AOTA's Board and Specialty
Certifications are not tied to reimbursement.

We are stilling waiting to hear from the DME Medical Directors in
response to our request that the withdraw the ATP certification
requirement.

Chuck

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On
Behalf Of Ron Carson
Sent: Monday, November 05, 2007 7:04 PM
To: [EMAIL PROTECTED]
Subject: Re: [OTlist] ATP

Hello Theresa:

Thanks for the update.

In an earlier message, I think Chuck Wilmarth indicated that AOTA's w/c
seating certification is NOT tied to reimbursement.  Is this accurate?
Is AOTA not pursing acceptance of their certification with CMS instead
of only the ATP certification. The ATP certification is such over-kill
for many, many w/c evals. If the AOTA certification is NOT accepted by
Medicare as a qualifying credential, why will OT's pursue it?

Thanks,

Ron


----- Original Message -----
From: [EMAIL PROTECTED] <[EMAIL PROTECTED]>
Sent: Monday, November 05, 2007
To:   [email protected] <[email protected]>
Subj: [OTlist] ATP

> Laura:  The seating and wheeled ad hoc committee is in the process of 
> studying the issues around this topic and will be surveying membership

> soon (probably this week so look for the survey through AOTA
One-Minute 
> update).  After that we will be putting together a report to the 
> commission on practice of whether to pursue a certification process 
> through AOTA or not.

> Theresa Gregorio-Torres











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