Clinician Task Force Strategic Priorities for 2013
- Secure Separate Medicare Benefit Category for Complex Rehab Technology– Support from the clinical community, especially those experienced in the field of seating and wheeled mobility brings meaningful credibility to this initiative. This is particularly important in our efforts to have Congress pass legislation. CTF representatives are involved through the steering committee, coding and coverage committees as well as the supplier standards committee. The voice of the clinical community is present for each of the critical components of this important effort.
- Provide detailed clinical guidance and recommendations to CMS and CMS Contractors- Participate and generate timely responses on topics including but not limited to the CMS proposed Power Mobility Device (PMD) E- Clinical Template, K0009 Reverification process, the Power Mobility Device Prior Authorization Demonstration Project, Competitive Bidding, Functional Limitation Reporting for Therapy Services, etc.
- Work with APTA and AOTA to define professional standards and continued competencies in the practice area of CRT to ensure a prepared clinical workforce to meet the public need for CRT services
- Develop a CRT Resource Toolbox for Clinicians– The CTF will develop a “CRT Toolbox” of resources and identify a sustainable long term dissemination plan to reach the largest numbers of clinicians. Resources for the toolbox will prepare clinicians for appropriate evaluation, thorough documentation, presentation of policy requirements and resources to keep current, etc.
- Develop educational resources for CMS, CMS contractors, Medicaid program, and Prior Authorization staff about CRT evaluation, technologies, clinical indicators, selection process- matching people/technology, documentation, etc.
- Develop a long term strategy to address evidence based practice policies impacting coverage and payment for CRT. Payers are increasingly denying access to technologies such as standing equipment and seat elevation. They are pointing to a lack of clinical evidence to demonstrate the products are effective in treating illness or injury. It is vital that standards for appropriate and achievable levels of evidence be established for CRT products. The same levels applied to pharmaceuticals cannot be applied to CRT devices. The CTF will explore grant funding to advance this initiative.
- Engage APTA, AOTA and other professional organizations in advocating for consumer access to CRT for individuals with disabilities– Again, the voice of the clinical community lends significant credibility to the separate benefit initiative.