I posted a blog last week about how just as many of you rehab providers complain about Medicaid reimbursement as you do Medicare reimbursement (with reason, of course). I’ve already written a story about how NRRTS is on the case and now NCART is joining the fray.
Executive Director Don Clayback sent out an e-mail yesterday asking rehab providers to complete a 20-question survey on Medicaid coverage and payment in their areas. The results of the survey will be summarized and posted to NCART’s Web site. One of NCART’s goals in creating a separate benefit for complex rehab is influencing other payers like Medicaid; I wonder if the survey results will play into that somehow.
NCART’s survey is open until March 31. Take it. It’s the least you can do.
Why, the “Steampunk Professor X chair” by designer designer Daniel Valdez of course. The chair boasts “a digital amped sound system, Vodka cranberry dispenser, an event triggered sound processor and a portable smoke machine to rock the static routine of the physically impaired in style.”
Neat, right? (You have to at least appreciate the creativity.)
I listened to the Webinar this morning on the separate benefit for complex rehab. Hearing Don Clayback, Rita Hostak and others overview the “discussion paper” on the benefit and hearing the questions that providers and therapists asked afterward made me realize just how big an initiative this is, especially when stakeholders are committed to making it as open a process as possible. I’m writing up a story as we speak, but in the meantime, here are a string of tweets I posted during the Webinar (read them from bottom to top):
hmeliz Increase paperwork requirements? “Don’t want more overwhelming than already are, but make them easier, clearer.”
hmeliz Providers could also have written arrangement for service with another accredited complex rehab technology company.
hmeliz For services and repairs, benefit would require providers—if they sell it, they must fix it.
hmeliz Will RTP replace ATP or CRTS? No—just “placeholder for generic description.”
hmeliz “Ideal situation may not be achievable in every instance, but won’t let that dissuade us from getting there or close”
hmeliz A few questions have come in. How deal with rural areas, where no seating clinics and few experienced clinicians?
hmeliz Q&A part has started. No one’s asking questions
hmeliz RTP—passed ATP exam and has met “additional requirements.” Those are TBD. RESNA’s SMS and NRRTS’s CRTS are possibilities.
hmeliz They’ve introduced another acronym! RTP: rehab technology professional.
hmeliz Benefit for complex rehab would put “primary weight” of documentation burden on therapist, not doc, but doc would have to sign off.
hmeliz Discussion paper will be posted to www.ncart.us later today. Send comments to complexrehabtech@gmail.com.
hmeliz Don Clayback: Discussion paper detailing separate benefit available after today’s two Webinars.
hmeliz Listening to Webinar on separate benefit for complex rehab.
(Shameless plug: Follow me on twitter at http://twitter.com/hmeliz)
There’s a lot of talk about Medicare in the HME industry, but increasingly, when I’m on the phone with rehab providers, I’m hearing a lot about Medicaid. Here’s the thing with Medicaid: It does what Medicare does then, usually, takes it up a notch. That’s rarely ever good news for providers.
I came across this article in Topeka Capital Journal today about how Kansas Medicaid has changed reimbursement for wheelchairs and seating systems to 35% above cost or 20% below the manufacturer’s suggested retail price. The cuts are taking their toll on end users like Brittany Ryan. Her seating system is on hold due to the cuts, forcing her to make do with a system that leaves her in pain.
The article hits all the bases—in addition to quoting end users, it quotes several rehab providers and representatives from several disability groups (Pat Terick of the Cerebral Palsy Research Foundation says: “I’ve been working in the field for nearly 30 years now. I’ve not seen it this bad”).
It also quotes a spokesman for Kansas Medicaid. He hardly makes a case for the chaos the agency has created for providers and the patients they serve:
Peter Hancock, a spokesman for the Kansas Health Policy Authority, said the change in reimbursement systems shouldn’t have been a surprise, although some providers say they were caught off guard. The reimbursement change was aggravated when plummeting state revenues led Gov. Mark Parkinson in November to order a 10 percent cut in Medicaid reimbursements. Those cuts began hitting providers in January.
“It was just a big wham all at once,” Hancock said.
I know Medicaid-related issues are on the agenda of various rehab industry groups like NRRTS, but I have a feeling that once those groups are able to put a check mark next to creating a separate benefit for complex rehab, this will have to be their next major initiative.
NCART sent out a reminder this week that it will hold two Webinars Thursday, March 4, to review a 25-page “discussion paper” that details a new benefit for complex rehab. There is no charge for the Webinars but advanced registration is required.
Register for 8:30 a.m. EST at https://www2.gotomeeting.com/register/364894402
Register for 5 p.m. EST at https://www2.gotomeeting.com/register/423449202
Clayback says: “As you know this is a major initiative for the industry. I would strongly encourage you to attend or have someone from your company do so.”
Here are a few of my most recent stories on efforts to create the new benefit:
An ATP named Jeffrey McDaniel e-mailed me last week to tell me about a commentary he wrote for a blog called the Complex Rehab Network. I e-mailed Jeffrey back for more info (I haven’t heard back from him yet), then I checked out the blog.
It turns out it’s sponsored by Active American Mobility, a rehab provider in the Houston area, and it’s chock full of articles by McDaniel and other company employees. Topics range from everything to “The Ability to Protect: Self Defense for Wheelchair Users” to “The Stark Law…Are You in Compliance?”
It’s great (although, I’m not quite sure who their targeted audience is—other rehab professionals, consumers?). You can tell by reading the articles that the employees enjoy writing them. And why wouldn’t they? It’s a validating exercise. This is their specialty and now they have an outlet for talking about it.
For all of you other rehab providers out there, my only question is: When do you start your blog? Already have one? I want to hear about it.
If the thought of adding retail mobility products like vehicle ramps and lifts and promoting them gives you a headache, it doesn’t have to.
In a recent HME News TV interview, Cy Corgan, national sales director for retail mobility at Pride Mobility Products, explains that much of what providers need to do to get their retail mobility business up and running is already in place.
“Most providers have databases that they’ve accumulated over time—those are an excellent way to data mine your current customer base and educate them on new products that you’ve introduced into your organization,” he said. “It could be bill stuffers, direct mail, newspaper advertising. It could be something as simple as a catalog that you drop off at a customer’s home when they’re making a delivery.”
Retail mobility “makes sense,” Corgan says, because the rehab industry has the odds stacked against it. Congress and Medicare delivered a 9.5% reimbursement cut in 2009 for standard and complex power wheelchairs and they plan to implement competitive bidding in 2011 for standard power wheelchairs. They’ve also threatened to eliminate the first-month purchase option for standard power wheelchairs.
Adding and promoting retail mobility shouldn’t be a daunting task, but it’s one that rehab providers need to take seriously, Corgan says.
“They really need to get involved in it,” he said. “They need to make a commitment from a resource standpoint. They need to make a commitment of having individuals who are going to be focused on that segment of the business.”
Other words of wisdom from Corgan: The sky’s the limit, in terms of retail mobility product offerings (baskets for scooters and incontinence pads for lift chairs, just to name a few); and training is key (”So when customers walk in, they have confidence that the individual they’re dealing with knows what the products are all about and how they best fit their needs,” he said).
I received an e-mail from Otto Bock Healthcare last week that reminded me that the Olympic Winter Games don’t end on Feb. 28. The Paralympic Games, also in Vancouver, follow the Olympics March 12-21.
The reason Otto Bock was e-mailing me: They, along with the International Paralympic Committee, will have a special exhibit at the ski resort Whistler as part of the Paralympic Games. The exhibit, the “Snow Dome,” will provide information on the paralympic movement and the Paralympic Games, including stories of athletes and background info on technology.
Visitors to the exhibit will also be able to try “ice sledge hockey” or “sled hockey,” a sport that was designed to allow participants who have a physical disability play ice hockey. It’s one of the most popular sports at the Paralympic Games. Top contenders: Sweden, where the sport was invented; Norway; Canada; and USA, which didn’t have a team until 1990.
While eating her breakfast on Jan. 26, Laura Cohen read a brief in the January 2010 issue of HME News titled “CMS differentiates between ATP, sATP.” Then she called me.
The brief details an article published in December by Noridian Administrative Services, the DME MAC for Jurisdiction D, on the difference between assistive technology professionals (ATPs) that work as clinicians and those that work as suppliers. The article refers to ATPs that work as suppliers as sATPs.
“It’s not a recognized title,” said Cohen, coordinator of The Clinician Task Force and chair of RESNA’s Professional Standards Board. “ATP is a trademarked title, and RESNA would not support that.”
Cohen explains that, the way she read the article, Noridian used sATP to abbreviate an ATP that works for a supplier, not to create a new designation.
If you’re wondering what the big deal is, it’s this: Part of the reason RESNA combined its assistive technology supplier (ATS) and assistive technology practitioner (the original ATP) certifications a year ago was to stop people from attaching certain roles to the certifications.
“A certification demonstrates competency and a scope of knowledge, but it does not give you permission to do something that otherwise you’re not licensed to do,” Cohen said.
When I asked Cohen whether she or RESNA had contacted Noridian about its use of sATP, she said, “No.”
“We don’t want to make a big deal out of it, but if it persists, we will,” she said. “It’s not their title to retitle.”
In an earlier post to this blog, I wrote about how the Power Mobility Coalition (PMC) was closing its doors due to “industry consolidation.” At the time, one industry watcher told me that with a decreasing number of groups representing wheelchair providers and manufacturers, watch for AAHomecare’s Complex Rehab and Mobility Council (CRMC) to gain power and play a bigger role.
I think AAHomecare and the CRMC took their first step toward doing that last month, when they launched a new “micro” Web site to better inform policymakers, the media and consumers about complex rehab and mobility products and services. The site hits all the hot-button issues: documentation, efforts to create a separate benefit for complex rehab and the first-month purchase option.
The reason Otto Bock was e-mailing me: They, along with the International Paralympic Committee, will have a special exhibit at the ski resort Whistler as part of the Paralympic Games. The exhibit, the “Snow Dome,” will provide information on the paralympic movement and the Paralympic Games, including stories of athletes and background info on technology.
Visitors to the exhibit will also be able to try