Proposed CMN process draws debate

Friday, February 28, 2003

ALEXANDRIA, Va. - The contentious issue of just how clinically savvy you have to be to provide power wheelchairs found airing out at AAHomecare in January as the trade group debated its response to CMS’s proposal to modify the CMN process.

In a Nov. 18 Federal Register notice, CMS called for comments to a proposal to formalize the DMERCs’ right to require supporting documentation for claims determinations.

Initially, AAHomecare’s RATC council drafted a proposal which argued that “only credentialed individuals” be allowed to complete a new professional evaluation for “all power wheelchairs (RATC’s emphasis).”

RATC listed CRTS, ATS, ATP, RTS members of NRRTS, PT/OTs and rehab engineers as credentialed individuals. After three years, only CRTS or ATPs would be able to complete the evaluations. And within 4-6 years, only CRTS or ATPs retained by accredited rehab technology companies would be required to complete the evaluation. Currently, the Medicare program doesn’t require any credential to supply a power wheelchair. But even if AAH recommended Medicare adopt such a requirement, some say it’s doubtful the program would implement it.

In January, AAH decided to not recommend credentialing for all providers of power wheelchairs. Instead, AAH is now asking CMS to require ATS, ATP or Rehab Engineering Technology credentials for users who, upon physical evaluation, require a powered mobility system that includes seating and positioning components or some other sophisticated power system, thus making a distinction between providers of geriatric mobility and providers of high-end rehab.RATC is recommending CMS implement its technology assessment requirement six months after adoption but that the credential requirement be delayed for at least three years. HME