Setup for a Comeback

In his wonderfully warm and witty book Battling the Beast Within — Success in Living with Adversity, (The Cleveland Clinic Press), David T. Williams offers sage advice to all of us who will be providing durable medical equipment services under the Medicare Modernization Act (MMA).

Williams, who recently retired as director of governmental relations for Elyria, Ohio-based Invacare, chronicles his personal story in dealing with the physical changes he has faced secondary to multiple sclerosis. Among the many important life messages he presents in the book, two of his personal lessons will be essential for professionals in DME to heed in the coming years as our industry undergoes dramatic changes.

From his experience with MS, Williams said, he discovered that “a setback is a setup for a comeback.”

For professionals providing honest and ethical service to those who truly need power mobility, the headlines of the past year revealing blatant fraud and abuse by a very small, but now very visible, segment of our industry have been viewed as a setback in our quest to project DME service provision as a profession.

However, this setback is shaping up to be the comeback we need.

The Centers for Medicare and Medicaid Services has recognized that part of the problem in the power mobility market has been the very poorly differentiated K0011 code, a code that describes almost all products on the market, regardless of actual performance or price. The agency directed the head of the Statistical Analysis Durable Medical Equipment Regional Carrier (SADMERC), Dr. Doran Edwards, to propose a redraft of the power wheelchair coding system.

Edwards collaborated closely with industry experts, including members of the National Coalition for Assistive and Rehab Technology (NCART) and the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) to draft the new codes, which, released in early February, more closely reflect and describe the broad spectrum of power products currently on the market, including pediatric products.

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Williams' second message describes three phases of the course of his disease: