Fwd: [QUAD-L] PIE SYSTEM for Sale
I have this product. I have only used a few times, but it workedveryefficiently and didn't take very much time. I believe the price was $12,000. I was surprised my insurance coveraged. I did not even know that the bags into being would cost so much as it came with a number of them. I was going to check out the price of equipment.Very expensive, this information was provided by Mark in an earlier post. I thought it might be better than going to the hospital. I don't know if the bags would qualify for reimbursement. It seems they shouldnot probably don't. Medicare wouldn't cover and Medicaid would not cover and Kansas, although I believe it hasn't some states with a lot of documentation.. Dana (C-4-5, 31 years post, 51, KC) In a message dated 8/24/2005 3:03:39 P.M. Central Daylight Time, [EMAIL PROTECTED] writes: Mrs Wessman still has the PIE system and many accessories available and readyto sell. It's not new, but hasn't been used since they received it. Her son decidedafter it was purchased that he didn't want it and now the family is stuck with it.Send her an email and make an offer on the system. For those who wish to know howit works, email her at: [EMAIL PROTECTED]This is truly the best system of its kind and deserves some attention. I have noidea what her asking price is, but I'm sure anyone can check E-Bay for like pricing.W ---BeginMessage--- Mrs Wessman still has the PIE system and many accessories available and ready to sell. It's not new, but hasn't been used since they received it. Her son decided after it was purchased that he didn't want it and now the family is stuck with it. Send her an email and make an offer on the system. For those who wish to know how it works, email her at: [EMAIL PROTECTED] This is truly the best system of its kind and deserves some attention. I have no idea what her asking price is, but I'm sure anyone can check E-Bay for like pricing. W ---End Message---
[QUAD-L] Research
Can you believe this crap? The Government is blocking medical research on medicinal marijuana because "it wouldnotbeconsistent withpublic interest"! Or maybe it's not in the pharmaceutical companies best interest. Mark Legal Proceedings Begin Challenging NIDA's Monopoly Of US Cannabis Supply Washington, DC: Administrative hearings began this week at the US Drug Enforcement Administration (DEA) to determine if the agency improperly denied a request from the University of Massachusetts at Amherst to cultivate cannabis for private, federally approved clinical research. The application - filed with the DEA in June of 2001 by Lyle Craker, director of the UMass-Amherst Medicinal Plant Program, in association with the Multidisciplinary Association for Psychedelic Studies (MAPS) - requested a federal license to cultivate cannabis at the University for FDA-approved research. Currently, all federally approved research on marijuana must utilize cannabis supplied by and grown under contract with the US National Institute on Drug Abuse (NIDA). The UMass-Amherst proposal sought to provide clinical investigators with an alternative, independent source of cannabis for FDA-approved clinical trials. In recent years, several US researchers have complained that the low quality of NIDA-grown marijuana is insufficient to use in clinical studies evaluating cannabis' therapeutic potential. Others have questioned NIDA's willingness to provide cannabis for clinical protocols seeking to investigate the drug's medical uses. In 2004, the agency's Director Nora Volkow stated that it is "not NIDA's mission to study the medical uses of marijuana." The DEA rejected Craker's application in December of 2004, stating that the establishment of such a production facility "would not be consistent with public interest." In testimony this week before DEA Administrative Law Judge Mary Ellen Brittner, legal counsel for the respondents argued that the establishment of the proposed UMass-Amherst cannabis production facility is in the public interest because it would encourage competition in the marketplace and promote technological and scientific advancement in the field of medicine. "The DEA's refusal to permit me to grow marijuana for research necessarily prevents an accurate assessment of this plant's potential medical properties," Craker said. NORML Board Member Rick Doblin, head of MAPS, testified that the establishment of an independent provider of medical cannabis is necessary in order to conduct the clinical trials required to establish cannabis as an FDA-approved drug. "This lawsuit is really our last hope for trying to take marijuana - whether it's smoked or vaporized - through the FDA regulatory system," he said. Doblin, who described MAPS as a "non-profit pharmaceutical company," said that his organization's goal was to bring natural cannabis to market as a FDA-approved medicine. MAPS has previously received an "orphan drug" designation from the FDA for marijuana for the treatment of the AIDS wasting syndrome. Orphan drug status is a designation granted by the FDA to facilitate the development of a prescription drug for rare diseases. Lawyers for the DEA said that they were unaware of complaints regarding the quality and availability of NIDA-grown marijuana. Testimony in the case will continue the week of September 26, 2005. For more information, please contact Paul Armentano, NORML Senior Policy Analyst, at: (202) 483-5500 or visit: http://www.maps.org Additional background on the case is available online from the American Civil Liberties Union Drug Litigation Project at: http://www.aclu.org/medicalmarijuana
Re: [QUAD-L] filing papers
a hanging file cabinet is very handy for this. i have tried saving things to appropriate folders like electric, phone, insurance, car, home, investments i have now switched back to a single folder per year for everything. it makes taxes easier - also just one place to look for elusive info. i use a credit card for almost everything outside of direct payment, then just save store receipts long enough to verify against electronic bank records. i have found one mistake in thepast 3 years - a restaurant forgot to include my tip on the final transaction. using the card insures i have a recourse on a bad transaction. dave [EMAIL PROTECTED] wrote: how do you guys file your papers? every 2 or 3 days my desk is covered with papers, which i just keep putting to the side, neglecting to sort them. luke Start your day with Yahoo! - make it your home page
[QUAD-L] Estate Tax
Hey people, This Estate Tax is coming up for a vote and we "all" need to write to our Senators and give our opinion. http://www.faireconomy.org/estatetax/ETWhoPays.html Mark Subject: Tell your friends: Save the Estate TaxAs soon as the Senate returns to Washington in September they will vote on eliminating the Estate Tax for the richest 2 percent of Americans(1). If they succeed, millionaires will save close to $1 trillion dollars in the first ten years--that tax burden will shift to us and future generations -- and Republican leaders are just one or two votes away.Eliminating the Estate Tax will personally benefit President Bush, Vice President Cheney and 11 other cabinet members up to $344 million - and we'll have to pick up that tab!Will you sign our petition before the Senate vote?Thanks!
Re: [QUAD-L] get pressure sore well
I have had a bad pressure sore one time and it became a open wound because I did not want to stay in bed to let it heal up. Well it got so much worse that it took six weeks for it to finally heal completely and if it weren't for using the Bag Balm 10 days in to trying to get it to close up. Other words I had someone putting Iodine 10% for the first 10 days and nothing was changing of it till I started with the Bag Balm. Still took six weeks in all before I could sit in my chair again. Chet ( Cquad7 )Silas Shelburne [EMAIL PROTECTED] wrote: Hey Chet, Can you use the bag balm right in a open wound? Silas - Original Message - From: Chet Smith To: Stacy Harim ; Quad_List Sent: Tuesday, August 23, 2005 10:58 AM Subject: Re: [QUAD-L] get pressure sore well Hello Stacy, Is where you're having to sit on it because if that's the case you may have to sacrifice a few day's and stay completely off of it to get it well, plus use Bag Balm on your pressure sore to speed up the healing process. You can get the Bag Balm at any feed and seed store most of the time. Hope it gets better for you and then stays away. Chet ( Cquad7 )Stacy Harim [EMAIL PROTECTED] wrote: Hey guys, I have a pressure sore right on the inside of my thigh at the top. I had a pressure mapping but no pressure shows there so can't get Medicare to cover a different cushion. School starts soon and really can't afford to take off. Has anyone healed a sore while being up between 6-8 hours a day? Would a roho help? Thanks. I am so sick with myself over this. I'm trying to stay off of it in my current situation but it's hard when I live alone. Thanks guys, Stacy __Do You Yahoo!?Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com Start your day with Yahoo! - make it your home page
[QUAD-L] get pressure sore well (udder balm vs Bag Balm)
Farmers have been using udder balm on milking cows for years. Their wives also use udder balm on chap'd hands. But its not sterile. Bag Balm, is sterile, but don't know if its suitable for use on open wounds... Maybe you found a cure? W In a message dated 8/26/05 7:46:42 PM, [EMAIL PROTECTED] writes: I have had a bad pressure sore one time and it became a open wound because I did not want to stay in bed to let it heal up. Well it got so much worse that it took six weeks for it to finally heal completely and if it weren't for using the Bag Balm 10 days in to trying to get it to close up. Other words I had someone putting Iodine 10% for the first 10 days and nothing was changing of it till I started with the Bag Balm. Still took six weeks in all before I could sit in my chair again.
[QUAD-L] Re: get pressure sore well (udder balm vs Bag Balm)
A Friend of mine had to have skin graphs on his behind because of doing the samething as I did not staying offof the old rearend when it first gets red enough and your helper presses on the spot and it doesn't turn white. It is time for one days rest and alot of weightshifting until it'sback to normal. If it's still pink within 5 days later. Stay off for two day's, then get up and do a lot of weight shifting. I think it isSterile enough ormy sore would have gotten alot redder within threedays of use and possibly I would have need to see a Skin Specialist. Chet ( Cquad7 )[EMAIL PROTECTED] wrote: Farmers have been using udder balm on milking cows for years.Their wives also use udder balm on chap'd hands. But its notsterile.Bag Balm, is sterile, but don't know if its suitable for useon open wounds... Maybe you found a cure?WIn a message dated 8/26/05 7:46:42 PM, [EMAIL PROTECTED] writes: I have had a bad pressure sore one time and it became a openwound because I did not want to stay in bed to let it heal up.Well it got so much worse that it took six weeks for it tofinally heal completely and if it weren't for using the Bag Balm10 days in to trying to get it to close up. Other words I hadsomeone putting Iodine 10% for the first 10 days and nothingwas changing of it till I started with the Bag Balm. Stilltook six weeks in all before I could sit in my chair again. Start your day with Yahoo! - make it your home page
Re: [QUAD-L] filing papers
As I believe Lori said this is a question in which he you will probably receive 100 responses out of 100 people. However, I also use a filing cabinet with the files which are able to hang on a rack. I am able to see the files more readily and direct my PCA. The unfortunate part is I have not been able to do any expensive filing for over one year and I paid the price today. My brother needed some paperwork from me today and it took me about an hour just to have my PCA go through my overflowing temporary file folder only to discover the majority of what I needed was actually in my inbox -- that was primarily filled with that very overflow from my file folder. I guess I need to get off my butt -- like littlequad. :-)Billy"David K. Kelmer" [EMAIL PROTECTED] wrote: Hi Luke, I uselarge manila envelopes dated with the year outsidewith business size envelopes inside. On the outside of each envelope I'll write the name of the company, person,or department the paper is from.The ones I think I'll need to use info off of I will scan and file on my computer. With Love, CtrlAltDel aka DaveC4/5 Complete - 29 Years PostTexas, USA [EMAIL PROTECTED] wrote: how do you guys file your papers? every 2 or 3 days my desk is covered with papers, which i just keep putting to the side, neglecting to sort them. luke__Do You Yahoo!?Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com
[QUAD-L] Scanning
I have read that several individuals scan in their documents in order to conserve space and allow for better retrieval. I have been wanting to do something similar. In fact, it is almost imperative that I get many documents stand in the event I have to evacuate due to a catastrophic weather occurrence. The problem I am having is that each document which I scan is extremely large and difficult to store. For instance, I scanned in a very simple contract (two pages) and it took up 2MB worth of space. My question is does anyone know how to scan in a document so that it does not take up an inordinate amount of space. The primary reason I am asking is because I like to keep these documents on CDs for easy transportation in case of a disaster. FYI, I have been using Adobe Acrobat to scan in documents. I appreciate any feedback.Billy__Do You Yahoo!?Tired of spam? Yahoo! Ma! il has the best spam protection around http://mail.yahoo.com
Re: [QUAD-L] Transfers
I know that when the doctors told me that I was C5-C6 complete, all I wanted to be was a sea C8 with enough dexterity to use my hands, you as a screwdriver or just write without an aide. At the rehab, everyone I conversed with wanted to be just one or two levels more than what they were. Tom Houston - Original Message - From: Stacy Harim To: Houston809 ; dave oconnell ; quadlist ; [EMAIL PROTECTED] ; David K. Kelmer Sent: Wednesday, August 24, 2005 6:52 PM Subject: Re: [QUAD-L] Transfers Houston, I've had a taste ofboth levels. I was a quad when I got out of my coma. I just thought that I would love it if I could use my arms. I'm T 7/8 but my torso is so long that I am paralyzed rightbelow my chest. I think quads want to be paras and paras want to walk. AB's want a better life, etc.. It goes on and on. Everyone wants something better than what they have. Stacy - Original Message - From: David K. Kelmer To: Houston809 ; dave oconnell ; Stacy Harim ; quadlist ; [EMAIL PROTECTED] Sent: Wednesday, August 24, 2005 7:01 PM Subject: Re: [QUAD-L] Transfers Hi Houston, I agree with you about Dave. I think we all are super just by showing each other, and everyone else, that we're here and doing whatever we can to live a good life. Each day adds up, and as the years go by we learn a little more about ourselves. I hope yours is a lucky 7. :) With Love, CtrlAltDel aka DaveC4/5 Complete - 29 Years PostTexas, USA Houston809 [EMAIL PROTECTED] wrote: Dave,You sound 2 be a super quad yourself. Keep pushing you and others truly inspire me. Ive met a few quads that stand, Ive only met 1 so far that actually walk I like some others pray for medical break throughs. Id love 2 just have a little more return. I just want to be a low level Para.Houston On 8/23/05 4:25 PM, "Ol' Man River" [EMAIL PROTECTED] wrote: when i was at Wayne state univ in 1970 we had a few walking quads - we called them super-quads. they walked with short arm braces - it was very laborious and not completely functional out in the real world but still, they were impressive. I'm a incomplete c3 from a trampoline and i used to stand to put my w/c into the back seat of my 2 door cars. my legs are now not trustworthy enough for such activity so i have switched to a power chair and a van with a ramp. i have lived alone before and still can but prefer to have an a/b around in case i fall. getting up is outside my abilities. i drag my butt in and out of bed and get some help from triggered leg spasms to get there. i use back and leg muscles to get onto the raised jon. i really would like to offer more help to you on the list but it's evident we don't have all that much in common. i do suffer from many of the ills and dep! ressions described on here and of course am just as helpless as any quad in many public situations. heavy doors, curbs, narrow jon stalls, high drinking fountains, all are just as unusable to me as they are you. i do however, frequently ask for and get cheerful help from anyone around women seem particularly drawn to my helpless situations. not my first idea for meeting chicks tho. the winning combo is - never give up - persistence wins in the end.DaveStacy Harim [EMAIL PROTECTED] wrote: Wow, that is impressive to transfer without a board. I'm paraplegic and cannot in anyway do that. I have to have my board and I'm paraplegic. My torso is way too long to get shoulder depression b/c I am way strong enough. My tone doesn't work with me like yours does with you as well. I'm not mad about it but I am very impressed by you.Stacy - Original Message - From: [EMAIL PROTECTED] To: quad-list@eskimo.com Sent: Tuesday, August 23, 2005 11:24 AMSubject: [QUAD-L] TransfersIn a message dated 8/23/2005 10:12:33 AM Central Standard Time, TheOmen723 writes: hey paulcan you do a weight shift in your chair or turn yourself at night? if not that would be a good starting point. I'm c-5/6 incomplete, have very weak tricepts and have been transfering independently (without sliding board) for couple of years. i transfer to the shower chair, stander, and bed. i use the tone in my legs to help me move. when i start to lean forward my spasms automatically kick in to help me lean back. when you first start transfering you'll have a tendency to
Re: [QUAD-L] Scanning
i have scanned in many documents and find the largest file is 250k saved in jpg format. i usually scan at 300 dpi and in b/w. color scanning is very expensive bytewise. a cd would hold 700,000/250 = almost 3000 such documents. dvd burners are now less that 100$ and a 4.7 gig single density dvd will hold ~7 CDs. please condider an external USB hard drive before burning CDs or DVDs. A 200gig external USB drive runs about $150 and is mush more dependable than CD or DVD. I have a lot of CD and DVDs that are unreadable. My externat USB is always readable. Look on eBay - they are the best way to go. P.S. leave them unplugged unless you are actively backing up or restoring. Run XCOPY /? in a DOS window to simplify backing up. I use the following to back up periodically: :: this backs up d to the usb external drive:set budrive=h:\home:set logfile=z_usb_bu-2-H.log::echo \i386\ _nocopy.txtecho \$VAULT$.AVG\ _nocopy.txtecho \_Restore\ _nocopy.txtecho \Recycled\ _nocopy.txtecho \System Volume Information\ _nocopy.txtecho \RECYCLER\ _nocopy.txt:echo \ghost\ _nocopy.txt:echo --- start %logfile%date /t %logfile%time /t %logfile%xcopy D:\*.* %budrive%\DBU\ /E /D /C /F /H /R /Y /EXCLUDE:_nocopy.txt date /t %logfile%time /t %logfile%echo --- done %logfile%exit if you need help, please ask. Dave "B. Kimberlin (Quadius)" [EMAIL PROTECTED] wrote: I have read that several individuals scan in their documents in order to conserve space and allow for better retrieval. I have been wanting to do something similar. In fact, it is almost imperative that I get many documents stand in the event I have to evacuate due to a catastrophic weather occurrence. The problem I am having is that each document which I scan is extremely large and difficult to store. For instance, I scanned in a very simple contract (two pages) and it took up 2MB worth of space. My question is does anyone know how to scan in a document so that it does not take up an inordinate amount of space. The primary reason I am asking is because I like to keep these documents on CDs for easy transportation in case of a disaster. FYI, I have been using Adobe Acrobat to scan in documents. I appreciate any feedback.Billy __Do You Yahoo!?Tired of spam? Yahoo! Ma! il has the best spam protection around http://mail.yahoo.com Dave - C3, 1967, Phoenix AZ__Do You Yahoo!?Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com
Re: [QUAD-L] Transfers
i hear ya tom. i'm a c3 partial "super-quad" and i'd give my left nut to be able to crap like my wife. we all seem to want just that little more than we got - i guess all things are relative aren't they? on judgement day - this nightmare goes away and we will answer all questions based on our current abilities. hopefully we can all say, "i did the best with what i had." keep stroken' dude. grades are for effort not accomplishments. dave tahouston [EMAIL PROTECTED] wrote: I know that when the doctors told me that I was C5-C6 complete, all I wanted to be was a sea C8 with enough dexterity to use my hands, you as a screwdriver or just write without an aide. At the rehab, everyone I conversed with wanted to be just one or two levels more than what they were. Tom Houston - Original Message - From: Stacy Harim To: Houston809 ; dave oconnell ; quadlist ; [EMAIL PROTECTED] ; David K. Kelmer Sent: Wednesday, August 24, 2005 6:52 PM Subject: Re: [QUAD-L] Transfers Houston, I've had a taste ofboth levels. I was a quad when I got out of my coma. I just thought that I would love it if I could use my arms. I'm T 7/8 but my torso is so long that I am paralyzed rightbelow my chest. I think quads want to be paras and paras want to walk. AB's want a better life, etc.. It goes on and on. Everyone wants something better than what they have. Stacy - Original Message - From: David K. Kelmer To: Houston809 ; dave oconnell ; Stacy Harim ; quadlist ; [EMAIL PROTECTED] Sent: Wednesday, August 24, 2005 7:01 PM Subject: Re: [QUAD-L] Transfers Hi Houston, I agree with you about Dave. I think we all are super just by showing each other, and everyone else, that we're here and doing whatever we can to live a good life. Each day adds up, and as the years go by we learn a little more about ourselves. I hope yours is a lucky 7. :) With Love, CtrlAltDel aka DaveC4/5 Complete - 29 Years PostTexas, USA Houston809 [EMAIL PROTECTED] wrote: Dave,You sound 2 be a super quad yourself. Keep pushing you and others truly inspire me. Ive met a few quads that stand, Ive only met 1 so far that actually walk I like some others pray for medical break throughs. Id love 2 just have a little more return. I just want to be a low level Para.Houston On 8/23/05 4:25 PM, "Ol' Man River" [EMAIL PROTECTED] wrote: when i was at Wayne state univ in 1970 we had a few walking quads - we called them super-quads. they walked with short arm braces - it was very laborious and not completely functional out in the real world but still, they were impressive. I'm a incomplete c3 from a trampoline and i used to stand to put my w/c into the back seat of my 2 door cars. my legs are now not trustworthy enough for such activity so i have switched to a power chair and a van with a ramp. i have lived alone before and still can but prefer to have an a/b around in case i fall. getting up is outside my abilities. i drag my butt in and out of bed and get some help from triggered leg spasms to get there. i use back and leg muscles to get onto the raised jon. i really would like to offer more help to you on the list but it's evident we don't have all that much in common. i d! o suffer from many of the ills and dep! ressions described on here and of course am just as helpless as any quad in many public situations. heavy doors, curbs, narrow jon stalls, high drinking fountains, all are just as unusable to me as they are you. i do however, frequently ask for and get cheerful help from anyone around women seem particularly drawn to my helpless situations. not my first idea for meeting chicks tho. the winning combo is - never give up - persistence wins in the end.DaveStacy Harim [EMAIL PROTECTED] wrote: Wow, that is impressive to transfer without a board. I'm paraplegic and cannot in anyway do that. I have to have my board and I'm paraplegic. My torso is way too long to get shoulder depression b/c I am way strong enough. My tone doesn't work with me like yours does with you as well. I'm not mad about it but I am very impressed by you.Stacy - Original Message - From: [EMAIL PROTECTED] To: quad-list@eskimo.com Sent: Tuesday, August 23, 2005 11:24 AMSubject: [QUAD-L] TransfersIn a message dated 8/23/2005 10:12:33 AM Central Standard Time, TheOmen723 writes: hey paulcan you do a weight shift in your chair or turn yourself at night? if not that would be a good starting point. I'm c-5/6 incomplete, have very weak tricepts and have been transfering independently (without sliding board) for couple of years. i transfer to the shower chair, stander, and bed. i use the tone in my legs to help me move. when i start to lean forward my spasms automatically kick in to help me lean back. when you first start transfering you'll have a tendency to scoot, which if you're in manual chair it will slide away from you. i use my tone to give me a push to lift and move over. i have never ended up on the floor doing a transfer (KNOCK ON WOOD). when my tone is real bad
Re: [QUAD-L] Transfers
i to am c-5/6 without the use of my fingers and iwork at whatever it is i'm trying to do with my hands until i figure out a way get them to accommodate me. now people, a lot of times, can't even tell my hands are paralyzed. In a message dated 8/26/2005 9:44:53 PM Central Daylight Time, [EMAIL PROTECTED] writes: I know that when the doctors told me that I was C5-C6 complete, all I wanted to be was a sea C8 with enough dexterity to use my hands, you as a screwdriver or just write without an aide. At the rehab, everyone I conversed with wanted to be just one or two levels more than what they were. Tom Houston
Re: [QUAD-L] filing papers
I also use any two-tier file cabinet. I use folders with pockets to do my filing. I only use the top layer level. I can use the lower-level but once I grab a folder, I have to insert it in my mouth in order to rise backup in the chair. - Original Message - From: Aaron Mann To: gina ; [EMAIL PROTECTED] ; quad-list Sent: Thursday, August 25, 2005 11:13 AM Subject: RE: [QUAD-L] filing papers Two-drawer filing cabinet w/ hanging file folders work for me. I only use the top drawer and my wife uses the lower one. From: gina [mailto:[EMAIL PROTECTED] Sent: Thursday, August 25, 2005 11:07 AMTo: [EMAIL PROTECTED]; quad-listSubject: Re: [QUAD-L] filing papers Hey Luke you sound like me..lol But I guess since I dont have a filing cabinet I use a bag to put my bills in, because I use online billing I just get the bills to make suretheir right. The other papers are in one of those plastic bins right now. Kind of in order.. Guess you could say I know where they are..lol Sorry couldnt be more help.. Gina[EMAIL PROTECTED] wrote: how do you guys file your papers? every 2 or 3 days my desk is covered with papers, which i just keep putting to the side, neglecting to sort them. luke Why expect the worst when it will probably never happen? Wipe those gloomy thoughts from your mind and focus on what's going right instead. Havingf a positive outlook can change the outcome in so many ways.
[QUAD-L] Fwd: Fw: CMS Issues Updated Regulations for Power Wheelchair POV Claims
New regulations for power chairs.Dana (C-4-5, 31 years post, 51, KC) ---BeginMessage--- - Original Message - From: Bob Kafka [EMAIL PROTECTED] To: Thomas, Stephanie [EMAIL PROTECTED] Sent: Thursday, August 25, 2005 11:39 AM Subject: CMS Issues Updated Regulations for Power Wheelchair POV Claims CMS ISSUES UPDATED REGULATIONS FOR POWER WHEELCHAIR AND POWER OPERATED VEHICLE CLAIMS CERTIFICATE OF MEDICAL NECESSITY NO LONGER REQUIRED The Centers for Medicare Medicaid Services (CMS) today took another step to streamline and ensure appropriate access for people with Medicare to power operated vehicles b? commonly called b?oscootersb?? b?' and power wheelchairs. In an interim final rule with opportunity to comment that went on display today at the Federal Register, CMS clarified the requirements for prescribing, supplying, and receiving payment for these vehicles. The interim final rule builds on current clinical standards of care. b?oThis interim final rule is a critical step in ensuring that people with Medicare have access to appropriate technology to assist them with mobility,b?? said CMS Administrator Mark B. McClellan, M.D., Ph.D. b?oAlong with Medicareb?Ts decision earlier this year to replace the old b?~bed or chair confinedb?T standard with new functional criteria for eligibility, this interim final rule is part of a comprehensive strategy to help Medicare beneficiaries get the mobility assistance equipment they need while avoiding unnecessary administrative burdens and inappropriate Medicare spending. An appropriate professional evaluation and its documentation in the patientb?Ts record are the key to the effective use of mobility devices and the quality and continuity of care for our beneficiaries.b?? CMS is eliminating the requirement that a Certificate of Medical Necessity (CMN) signed by the prescribing physician or other treating practitioner accompany claims for power wheelchairs and scooters. In place of the CMN, the interim final rule describes the clinical documentation from a patientb?Ts medical record that must be submitted along with a written prescription to the supplier before the supplier delivers a power wheelchair or scooter to the beneficiary. b?oDocumentation in the medical record of the beneficiaryb?Ts need for assistance with mobility in the home, as well as the type of technology needed, not only is the best evidence of medical necessity b? it also helps to promote continuity of care for our beneficiaries,b?? said CMS Acting Chief Medical Officer, Barry Straube, M.D. b?oAnd we are recognizing this in our payments to providers.b?? Medicare already pays under the Physician Fee Schedule for the office visit required to evaluate the beneficiary. Because of the changes in the documentation suppliers will need before delivering a power wheelchair or scooter, CMS is authorizing an additional payment to physicians and treating practitioners for preparing and providing the required documentation to the equipment supplier. To receive this payment, the physician or treating practitioner will include a special billing code on the claim for the office visit. CMS is today notifying physicians and other treating professionals, as well as PMD suppliers, of this interim final rule through its Medicare listserves. In addition, between the issuance of this interim final rule and its effective date in 60 days, CMS will target educational efforts to physicians and other practitioners who prescribe power wheelchairs and power scooters as well as to suppliers of PMD, to help them understand the new criteria and new documentation requirements. CMS will also provide billing instructions for suppliers before the implementation date. To help suppliers evaluate and document the patientb?Ts need for a particular type of technology, the contractors who process durable medical equipment claims will issue specific guidance about what information from the beneficiary's medical record is needed to demonstrate the medical necessity of the equipment. This guidance will underscore that an appropriate coverage determination for these products will take into account the patientb?Ts medical history, elements of a physical assessment such as strength and range of motion, a functional needs assessment as documented in the medical record, as well as the availability of other types of devices. In early September, CMS will hold a special Open Door Forum to address power wheelchair and power scooter issues. Open Door Forums offer physicians, suppliers and other stakeholders the opportunity to participate in person or by conference call in a discussion with senior staff about Medicare
