With just a little over a year before implementation, the Rehabilitation Engineering & Assistive Technology Society of North America is cranking up its efforts to meet a credentialing mandate from CMS.
Beginning April 1, 2008, CMS will require that the specialty evaluation for certain power wheelchairs be performed by a RESNA-certified Assistive Technology Practitioner (ATP) specializing in wheelchairs or a physician who is board-certified in physical medicine and rehabilitation.
The agency will also require that the wheelchair come from a supplier employing a RESNA-certified Assistive Technology Supplier (ATS) “who is directly involved in the wheelchair selection for the patient.”
The RESNA-certified ATP or the physician cannot have a financial connection to the supplier.
The specialty evaluation refers to patients receiving a Group 2 single- or multiple-power option power wheelchair, any Group 3 or Group 4 power wheelchair or a push-rim activated power assist device for a manual wheelchair.
“We are, as an organization, trying to prepare for the increased interest in two credentials that CMS has so far adopted — the ATP and the ATS,” says Glenn Hedman, president of RESNA and director of the Assistive Technology Unit at the University of Illinois, Chicago.
A decade ago, RESNA devised the ATP credential for service providers involved in the analysis of a consumer's needs and training in the use of a particular device. The ATS is for those who are involved with the sale and service of rehab equipment, assistive technology and commercially available products or devices.
RESNA also offers a Rehabilitation Engineering Technologist credential for those “who apply engineering principles to the design, modification, customization and/or fabrication of assistive technology for persons with disabilities.”
The purpose of credentialing is two-fold, according to RESNA: to ensure consumer safeguards and to ensure consumer satisfaction.
Currently, RESNA has certified 2,700 people, according to Thomas Gorski, executive director. “We are geared up to increase those numbers significantly, if not double them, in short order,” he says. “We have increased the number of exams in 2007, and we are seeing enlarged numbers of people seeking information about the exam.”
Hedman says RESNA will offer the credentialing exam at least 25 times this year. “That's the baseline. We may offer it more. We're trying to make it available to people who are really interested.”
The ATP or ATS exam, which is generally taken by those who have backgrounds as rehabilitation engineers, occupational or physical therapists, speech and hearing pathologists or suppliers, costs $500. Candidates must answer 200 questions, 150 of which are general questions about assistive technology, says Gorski, with another 50 questions specific to a supplier or a practitioner.
Meanwhile, RESNA is also exploring the possibility of creating another specialty credential, this one in seating and mobility. Hedman says RESNA has had preliminary talks with the National Registry of Rehabilitation Technology Suppliers about such a credential.
“We are interested in working with NRRTS on further demonstration of skills and expertise in the seating and mobility area,” says Hedman.“I think the potential is really there to work together to identify an increased level in seating and mobility. Each of these concepts would be built upon the skills that someone has as an ATP.”
Hedman says that implementation of the new credential could be “conceptually possible this year.”
The seating and mobility credential would be a natural extension of the relationship between RESNA and NRRTS. The latter lists 800 registrants on its rolls; only NRRTS registrants who have passed RESNA's ATS exam can carry the Certified Rehabilitation Technology Supplier designation.
To see RESNA's 2007 exam schedule, check www.resna.org.
Margolis Takes Reins at NRRTS
Founding board member and past president Simon Margolis has been named executive director of the National Registry of Rehabilitation Technology Suppliers — and already he is facing industry challenges.
Margolis says that as HME deals with new mobility policies, codes and pricing, “the most important thing is to maintain the high level of expertise and performance and compassion that NRRTS registrants have for their clients, regardless of how much money we're getting paid.
“That's the key issue if we're going to continue to serve our clients as we have because people don't deserve second-class care.”
He adds that it will be up to individual service-deliverers to dialog with their companies about maintaining service levels. “This is not the place to cut,” he cautions. “We have to use our smarts and figure out ways to continue to provide service yet keep costs down.”
As far as a carve-out of complex rehab from competitive bidding, Margolis says, “we're going to have to see what kind of support we can get from the new Democratic majority.” Last year's Congress adjourned without any action on a bill that would have excluded the area from the Medicare bidding program.
However, he adds, “this is still a critical issue, and it's equally important for the states to see the federal government set a precedent for carving out rehab so they treat it differently as well.”
With more than a 30-year career in rehab, Margolis most recently spent seven years as vice president of clinical and professional development for National Seating & Mobility, Nashville, Tenn. He is a founding member of NCART, the National Coalition for Assistive and Rehab Technology, and a past president of RESNA, the Rehabilitation Engineering and Assistive Technology Society of North America.
