HME News

April 2012

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■ Martin Szmal says providers call on consultants like him to keep track of all the changes CMS throws at them. See story page 24. NRRTS backpedals on new standards ................ 1 RESNA's new certification manager speaks. . . . . . . . . . . 23 Advocacy groups boost consumer voices ............ 23 Providers work to keep patients safe ................ 26 Mobility WWW.HMENEWS.COM / APRIL 2012 / HME NEWS 23 BRIEFS Hasco Medical acquires Ride-Away for $6 million MOBILE, Ala. – Hasco Medical acquired New Hampshire-based Ride-Away for $6 mil- lion, it announced March 5. It's the fourth acquisition in nine months for Hasco. With this latest deal, Hasco acquires Ride- Away's 11 East Coast locations which generate more than $70 million annually in wheelchair van modifications. Mark Lore, Ride-Away founder and president, will stay onboard to run the company. Stakeholders make progress on complex rehab documents BETHESDA, Md. – The first draft of a special- ized knowledge and skills paper for com- plex seating and wheeled mobility for the AOTA is complete, said Cindi Petito, one of the lead authors. The final document, which should be completed this fall, will outline the skills and knowledge needed to provide both non-complex and com- plex seating and mobility. A second AOTA document, the Policy Fact Sheet on Com- plex Rehab Technology, is complete and awaiting AOTA approval, Petito said. The fact sheet is intended to educate the pub- lic, policymakers and stakeholders about complex rehab. Both documents are part of an effort to garner AOTA support for complex rehab as a specialty, which could lend weight to the complex rehab separate benefit initiative. Providers want patients to reach out to Congress BROOKLYN PARK, Minn. – MAMES providers are circulating a letter to Rep. Erik Paulsen, R.-Minn., asking the lawmaker to take the lead on a bill to establish a separate ben- efit for complex rehab. Patients can sign and send the letter to Paulsen. The letter, drafted by Jackie Semrad, the compliance officer for Reliable Medical Supply in Brook- lyn Park, Minn., states, "The current benefit structure presents serious and often insur- mountable obstacles for individuals who need CRT." The letter informs Paulsen that a separate benefit will ensure beneficiaries have access to critical assistive devices. USM donates wheelchair to young vandalism victim SCOTTDALE, Pa. – United Seating and Mobil- ity in February donated a wheelchair to a 6-year-old boy with cerebral palsy whose wheelchair was vandalized. The boy, who was recently diagnosed with an inoperable brain tumor, had his motorized wheelchair destroyed as part of a crime spree that has been attributed to a pair of brothers who are also alleged to have burglarized 32 cars. Short Take Rehabmart.com will now offer pressure reducing support mattresses and related healthcare products through a collaboration with New Hyde Park, N.Y.- based Mason Medical Products. PRIOR AUTHORIZATIONS Demo should slow down audits Audits that do occur should be easier on providers, officials say BY ELIZABETH DEPREY, Associate Editor WASHINGTON – CMS answered a few key ques- tions about the PMD demonstration project during a Special Open Door Forum Feb. 23. Among the most important: Will the required prior authorizations help protect providers against post-payment reviews? CMS officials said they should, at least with MAC and RAC audits on medical necessity and other elements included in the prior authorizations. But "there could be other require- ments that are not reviewed during the prior authorization process, like the home assessment," said Melanie Combs-Dyer, deputy director of the Provider Compli- ance Group at CMS. Also, providers may still be subject to CERT audits and fraud-fighting audits like ZPICs, CMS officials said. Still, the audits that do take place should be easier on providers, Dyer said. "Hopefully that would be a much short- er review—you've got that on file and it's nothing you'd have to write to the physi- cian and track down," she said. "We really do believe that having in place this prior authorization process will make life easi- er for suppliers in terms of post-payment reviews." The forum was the first opportunity that providers had to get more informa- tion about the revamped seven-state PMD demo since CMS announced Feb. 3 that it would drop the prepay review phase. The demo is set to begin on or after June 1. Other new information: Prior authori- zation decisions will be sent to providers, physicians and patients within 10 business days. If denied, the decisions will come back with detailed explanations. The number of allowed resubmissions is unlimited, with 30-day response times from the DME MAC. CMS will continue to offer educational outreach, including monthly Open Door Forums through July. HME Users add their voices to efforts BY ELIZABETH DEPREY, Associate Editor WASHINGTON – United Spinal Association and UsersFirst in February launched a series of webinars that will educate con- sumers about wheeled mobility and advocacy. The webinars will help promote two new efforts: the UsersFirst Mobility Map online educa- tional tool, and the first-ever Roll on Cap- itol Hill. The goal: to empower consumers and help them make their voices heard. "I think that it's important consumer because it guides them through the entire ser- vice delivery process—so that they can take charge in choos- ing the best equipment to meet their needs," said Eubank in a press release. Other webinars will prepare consumers for the Roll on Capitol Hill, set for June 25-26 in Washing- ton, D.C. Tobin said that con- Paul Tobin that consumers speak for them- selves with regard to the prod- ucts and services that have the greatest impact on their quality of life," said Paul Tobin, presi- dent and CEO of United Spinal Association. The first webinar walked consumers through the Users- First Mobility Map, which is designed to help users under- stand the service delivery pro- cess, said Ann Eubank, Users- First executive director. "The Mobility Map will play a big role in empowering the sumers on the Hill will advocate for the com- plex rehab separate benefit, as well as other programs and services that ensure those with spinal cord injuries or diseases are healthy and active in their com- munities. George Gallego, a consumer and founder of New York-based Wheels of Progress, plans to speak about the consequences of a lack of accessible housing. "I think the folks that make the decisions want to hear what the people think," said Gallego. "I'm hoping this is only the first of many trips we take down there." Providers should direct patients to www.spinalcord.org, said Tobin. HME Will it reign in 'the beast,' ask providers BY ELIZABETH DEPREY, Associate Editor E IGHTY-FIVE PERCENT of HME NewsPoll respondents support CMS requiring prior authori- zations for power wheelchairs and scooters, but there are a lot of "ifs" attached. Two of the biggest: If it works to cut down on fraud and abuse, and if it means no more audits. "As a taxpayer, I like that progress is made to halt unnecessary payments," said Jimmy King, billing manager of NEWSPOLL SEE PAGE 24 No big changes to ATP planned BY ELIZABETH DEPREY, Associate Editor ARLINGTON, Va. – Eric Nepomu- ceno may be just weeks into his new job as RESNA's certi- fication and education man- ager, but he's sure of one thing already—the Assistive Technol- ogy Professional (ATP) creden- tial is fine just the way it is. "I don't see any changes in the immediate future," he said. "We're in a maintenance cycle right now for that exam." Nepomuceno started his new position in early Feb- ruary. He is in charge of the ATP and Seating and Mobil- ity Specialist (SMS) creden- tials, including maintain- ing their accreditation. He's also in charge of educational offerings. RESNA SEE PAGE 26 PHOTO CREDIT: BRENT GERVAIS PHOTOGRAPHY MEDIchair sponsors curling Canadian wheelchair curling teams had the opportunity to participate in round-robin style curling championships Jan. 27-29. Norm Gervais, whose MEDIchair franchise is the title sponsor of the event, also volunteers as coach for the Sudbury, Ontario team.

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