I think I had mentioned earlier that I am an ATP. I agree with you that users who truly need a standard chair or even a scooter should not require the services of a therapist with an advanced knowledge of seating and mobility. I do think that it is something to consider for the more involved client. Remember that ATPs are PTs as well as OTs. I think both AOTA and APTA will probably raise enough of a fuss that the CMS regulation will not actually go into effect, but I think it is interesting that they are trying something like this. I hope they will be able to institute something that indicates a higher level of knowledge for therapists prescribing high end custom chairs. I know that the one class session I had in school would not qualify me to make this type of decision or make recommendations to a client about something that is so serious!
Mary Alice On Feb 6, 2007, at 6:32 AM, Ron Carson wrote: > 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: OTlist@OTnow.com <OTlist@OTnow.com> > 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: > > > > > -- > Options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/otlist@otnow.com > > ********************************************************************** > **************** > 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/otlist@otnow.com ************************************************************************************** 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 **************************************************************************************
