Medicaid sticks with ATP requirement

Friday, February 29, 2008

ATLANTA - Medicare may have dropped its requirement that independent ATPs conduct evaluations for complex power wheelchairs, but Georgia Medicaid still has its eye on the prize.
When Medicare announced plans to implement the requirement, Georgia Department of Community Health soon followed suit, announcing the same requirement for Medicaid. Recently, Georgia Medicaid pushed back the deadline to April 1, 2009.
"We feel we have developed reasonable expectations for performance," said Patricia Ross, a DME program specialist for Georgia Medicaid. "We believe in what we started here in Georgia and we want to continue to move forward."
Georgia Medicaid already requires that providers who supply complex manual and power wheelchairs be NRRTS registrants and ATSs. The requirements, program officials say, have improved patient care and reduced fraud.
Providers like Bruce Vanhoorn applaud Georgia Medicaid for staying focused.
"There are too many people who don't know what they're doing," said Vanhoorn, owner of Roman Wheelchairs in Rome, Ga. "The ATP credential isn't perfect, but it's a step in the right direction."
Still, providers, especially those in rural areas, worry there aren't enough ATP-certified PTs and OTs in Georgia to evaluate their patients. Of the 41 ATPs listed on RESNA's Web site, 18 work in Atlanta. Furthermore, a number of them aren't independent, meaning they work for facilities that also supply wheelchairs.
Mike Daniels, owner of Valdosta, Ga.-based Acute Rehab, said the closest ATP to him is in Albany, Ga., an hour and a half away. Atlanta is three and a half hours away.
Ross acknowledged that the requirement could make life difficult for providers in rural areas.
"There may be isolated areas where a clinic may not have qualified evaluators, which will require a member to travel to another location," she said. "If transportation is required, the state has a non-emergency transportation program."
That may be too simplistic a view, Daniels said.
"Folks that have a true need will have to go to Atlanta, and they're going to come back with a chair from Atlanta," he said. "Then we're stuck because we lost business in our back yard, and they're stuck because when their wheelchairs tear up, they won't have anyone nearby to fix it."