HME News

APR 2017

HME News is the monthly business newspaper for home medical equipment providers. This controlled circulation publication reaches 17,100 home medical equipment services providers, including traditional HME dealers & suppliers, hospital- and pharmacy-o

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Mobility HM e N e WS / a P ril 2017 / WWW . HM e N e WS . C o M 15 The Access Strength ensures fitness for all By T R a C y oR ze L , Contributing w riter T H e aCC e SS Strength is making it easier than ever for wheelchair users and those with disabilities to pump iron. Various universities, hospitals, com- munity centers and care facilities have already ordered The a ccess Strength, a fitness machine that can be used by anyone regardless of ability, which took "Best in Show" at the recent i nternational Design e xcellence a wards. "We built, designed and engineered it from the ground up to remove the bar- riers that are found in traditional sys- tems," said Ryan e der, founder & C e O of i ncludeFitness. e der was a senior at the University of Cincinnati studying industrial design when he noticed a man in a wheelchair at the gym with a bag containing home- made accessories to help him adapt to the equipment. i t was then that he decided to focus his senior thesis on the initial concept for The a ccess Strength. " i t was extremely strenuous for him and you could see his frustration from across the room," he said. The machine features a patented pul- ley system, which can be reconfigured to meet an individual's reach, whether they're in a standing or sitting position; and hands-free handles to secure weight stacks. "They function the same way a spring- loaded pin does; however, you can adjust the entire machine with a single arm and a closed fist," said e der. " i n fact, we had a quadruple amputee able to adjust the machine with his elbows." The machine also collects data—such as workouts, exercises and machine con- figurations—via the i FCloud, which is H i P aa compliant and integrates directly with healthcare providers. "We can really start to understand what is working and what's not for an individ- ual, as well as look at trends across entire demographics," said e der. "This allows us to provide high quality care with bet- ter outcomes at lower costs in a way that is simple, intuitive and enjoyable for the patient or consumer." Various universities, hospitals, com- munity centers and care facilities have already ordered The a ccess Strength, but when it comes to retail, e der says, "those conversations are still very early on." hme FODAC lights up Friends of Disabled a dults and Children surpassed its $1.5 million fundraising goal. t he money was used to pay off the mortgage on its corporate headquarters. " p aying off the mortgage relieves us of a large financial burden and prepares us to meet the ever-growing needs of the disabled community," Chris Brand, president and C e O of FOD a C. "Recent cuts in Medicare and Medicaid funding have left more people needing more help with equipment costs, and now FOD a C will have more resources to meet those needs." t he organi- zation, which provides refurbished DM e for people with injuries and disabilities, held a mortgage burning ceremony to celebrate. ACCE ss ORIE s C O n t i n U e D F R O M p R e v i O U s pa g e other co-sponsors, four Republicans and four Democrats, three of whom sit on the Finance Committee. The first task at hand: meet or surpass the number of co-sponsors for last year's bills—147 and 26 in the House and Sen- ate, respectively, Clay- back says. "We need to move quickly to build on past co-sponsors," he said. From there, three dif- ferent scenarios could play out, stakehold- ers say: The bills could be attached to a larger vehicle and passed; the bills could be passed on their own, through a suspension process; or, if time is running out, industry champions in Congress could extend the delay. "We're working on all tracks, but if there is not an opportunity to address the issue before the July 1 implementation date, they're ready to provide the additional time needed for a permanent fix," said Seth Johnson, vice president of government affairs for Pride Mobility Products. Stakeholders are also in communication with the new leadership at CMS. They argue it's within the regulatory author- ity of Tom Price, the new secretary of the Department of Health and Human Ser- vices, to drop the reimbursement change. " We ' re p u r s u i n g w h e t h e r o r n o t there's an opportunity there," Johnson said. "M i P aa , the law passed in 2008 that exempts complex rehab from com- petitive bidding, clearly exempts com- plex rehab wheelchairs and options and accessories." hme UPITT s UR v E y C O n t i n U e D F R O M p R e v i O U s pa g e said, both clinicians and consumers need to be aware of technological changes in other markets and how they might be tapped for wheelchair users. "There needs to be a subset of clini- cians and consumers willing to take risks on new and innovative technologies, as well as willing to develop creative financing mechanisms," he said. hme CURRICU l UM C O n t i n U e D F R O M p R e v i O U s pa g e has entailed countless surveys and focus groups of faculty and students at numer- ous PT programs across the country. Cohen says the curriculum focuses on 11 content areas—everything from the wheelchair service delivery process to measurement taking to mobility skills education—and takes an interactive approach that involves lectures, lab work and extracurricular activities. " i t's been a big- ger project than we expected," she said. But the pay-off will be worth it, Cohen says. The curriculum will go a long way toward making sure the students who come out of PT pro- grams have a baseline of knowledge in seating and wheeled mobility. "Not all schools have this and some that do just have, spend a day in a wheelchair and talk about your expe- rience," she said. "That hardly pre- pares you to be a responsible party for a patient and this type of equipment." For complex rehab providers, who live in a regulation and documenta- tion-laden world, the curriculum will help ensure the clinicians they work with will get them what they need, the right way. "We want to make sure that the capacity of the work force is there for these specialty evaluations," she said. "This is a systems change—we want to change the pipeline of students coming out of training." hme BUMP y s TART f OR PRIOR AUTH s C O n t i n U e D F R O M pa g e 1 last minute. i t finally scheduled another spe- cial forum on March 9 for March 16. "We understand that there are changes going on at CMS, but our position is, this is ridiculous," said Don Clayback, executive director of NC a RT. Stakeholders pointed out that it wasn't until the last minute that they had access to an "operational guide," a document that paved the way for a smooth transition when CMS began requesting P a s for standard power wheelchairs as part of a demonstra- tion project that's now running in 19 states. "That's the one document that has been extremely important for providers who are currently doing the demo," said Seth John- son, vice president of government affairs for Pride Mobility Products. "That really has the necessary information that providers need to implement this and educate their employ- ees." a dditionally, stakeholders would like fur- ther guidance on, among other things, why the prior authorizations, unlike the advance determination of Medicare coverage process currently being used by many providers, only cover the base and not accessories. "That's a vague area that could get a little scary," said Chuck Spiedel, the rehab manag- er for Springfield, i ll.-based Personal Mobili- ty, who says he's now sending documentation to the quality review team a second time to make sure it meets all the necessary criteria. " i n my opinion, they shouldn't be doing that. i t's a package of complex equipment." While CMS's implementation hasn't been seamless, stakeholders and providers stand by the essence of prior authorizations. "The demo has worked really well for us," Westerdahl said. "So going into this, we've had a positive approach to it. hme Laura Cohen Sen. Casey Sen. Portman At a glance: Prior authorizations 4 K0856: Power wheelchair, group 3 standard, single power option, sling/ solid seat/back, patient weight capacity up to and including 300 pounds 4 K0861: Power wheelchair, group 3 standard, multiple power option, sling/ solid seat/back, patient weight capacity up to and including 300 pounds 4 phase one: CMS contractors CGS and Noridian on March 6 began accept- ing prior authorization requests for Ko856 and K0861 in a handful of states for dates of delivery on or after March 20. The states: New York, Illinois, West Virginia and Missouri. 4 phase two: CMS will implement prior authorizations as a condition of payment nationwide on July 17. 4 D e CI s I ons : CMS says it will respond to an initial request in 10 business days and subsequent requests in 20 busi- ness days. It will respond to expedited requests in two business days. 4 appea L s : CMS says the standard appeals process applies when the claim is denied due to no prior authorization request submitted, in addition to: no GA modifier appended on the claim (CO denial); GA modifier is appended and ABN deemed missing or invalid (CO denial); GA modifier is appended and ABN deemed invalid (PR denial). hme

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