Docs, PTs, OTs flock to rehab forum

Friday, March 31, 2006

PITTSBURGH - A first-of-its-kind educational forum in February attracted nearly 200 physicians and clinicians to a Sheraton hotel here to learn the ins and outs of Medicare's new requirements for wheelchairs and scooters.
Blackburn's, a Tarentum, Pa.-based provider, with help from two other sponsors, the Pennsylvania Association of Medical Suppliers (PAMS) and Pride Mobility Products, got them under one roof.
"Industry changes like the national coverage determination are forcing providers to take a more proactive stance," said Angelene Adler, a provider who plans to hold a similar event on the West Coast. "What are we doing as a company to make sure we're compliant? We have to rely on physicians and clinicians to get there, so education and developing relationships is key."
At the forum, industry heavyweights like Dr. Paul Hughes, Region A medical director, led about 40 physicians and 160 therapists through the national coverage determination and the now-delayed interim final rule, which replaced CMNs with prescriptions and notes
The biggest take-home from the forum may have been what physicians and clinicians left without: a quick and dirty template for meeting Medicare documentation requirements.
"There were attendees who had heard about the documentation changes and thought that they could get additional information (from the speakers)," said Georgie Blackburn, the compliance director at Blackburn's. "But the bottom line--and I think Dr. Hughes did a good job with this--is that the NCD is the NCD. Everything they need is in there."
That's a reality that physicians and clinicians--not to mention providers--have to get used to, Hughes said.
"There is a template: the nine questions that make up the algorithm," he said. "But it's not a fill-in-the-blanks template. If you look at the recent history of the CMN and all that's gone on with that, including the Maximum Comfort case, I don't think the agency can ever move back to formal documentation."
(In March 2005, a judge ruled that CMS wrongly demanded that Maximum Comfort repay Medicare $600,000 for not supplying additional documentation beyond CMNs for power wheelchair claims. Two months later, Medicare appealed the decision.)
Hughes and three other speakers helped Blackburn's draw physicians and clinicians to the forum, Blackburn said. The other speakers were Jeff Wheeler, vice president and general counsel for TriCenturion; Dan Meuser, president of Pride Mobility; and Dr. Michael Boninger, executive director of the Center for Assistive Technology at the University of Pittsburgh.
"CMS challenged providers to educate referral sources and that, with informational sources we respected, was our goal," Blackburn said.
Ironically, Hughes, who has addressed providers and manufacturers at industry events for years, said it was only the second time in 11 years that he has been asked to address physicians and clinicians.
"What was notable about this event is that it was the first of its kind to bring together providers, manufacturers, state associations and the medical community," he said.