Page 25 - Mobility Management, August 2017

JAY J3 HV Back
Skin temperature is important
to your client’s well-being and could help avoid skin breakdown, yet it is difficult to manage. By combining the comfort and reliability of the JAY J3 Back with heating/ventilation (HV) tech- nology, your clients will be able to manage their own microclimates and be more comfortable.
Is a client hot or sweating? Flip the switch to turn on ventila- tion. Internal microfans cycle fresh air throughout the back to dissipate moisture. The JAY J3 HV Back optimizes airflow via the use of 3DX spacer fabric and specially designed vents.
Is your client cold? Flip to turn on heating and gently warm the entire back. The heating system is equipped with an auto- matic shutoff so the client stays warm and secure. The HV Back safely works in all environments, including unexpected watery conditions. Years of automotive industry design experience are
“If they’re looking at titanium as not being a funded option, then what about the heavy-duty (HD) package for chairs? HD chairs typically use a thicker wall tubing, and that thicker wall tubing has more cost to it. HD chairs are beefier — nuts and bolts, caster housings, even the types of casters, something that’s going to support more weight and heavier use. But the way that Medicare is interpreting this is that those are changes to the frame — and the frame should be covered in any configuration. What happens with a reinforced frame for a power add-on system? This can propagate into something much larger very quickly.”
Goetz agreed. “The longer this goes on and the longer the industry allows it to happen, it’s going to give the message to CMS and contractors that this is something the industry is willing to accept. And therefore, they’re going to try to move into other areas and try to restrict that access, too.”
A Funding Domino Effect
Goetz said that other payors are likely to follow Medicare’s lead. “While this is an immediate effect on those who are Medicare
eligible, it is also going to trickle down to other payors,” he noted. “Medicaid follows Medicare policy, and when Medicaid updates its policy, it’s going to start restricting access to [titanium], but also private insurers who follow Medicare coverage policies are going to do the same thing.”
Will Medicare be content to stop at titanium, or will the agency push to further reduce payments for ultralight chairs?
“It’s going to snowball,” Anderson said. “You can get an ultralightweight chair in aluminum. You might not be able to get it as light as with a titanium [chair], it might not have the same level of durability or comfort, but okay, you can get it in aluminum. Maybe then CMS thinks, ‘Chromoly chairs were less expensive than aluminum, so we’re not going to fund aluminum as a material anymore. And the HD package, the power-assist package, those are changes to the frame, and all frames are covered as one reim- bursement.’ All that goes away.
“Now you have somebody who really needs that HD chair, and MobilityMgmt.com
incorporated into the JAY J3 HV Back, and it has been tested to wheelchair industry standards for conditions outside of a vehicle. The HV insert is powered by a rechargeable battery for eight hours of continued use.
The HV insert is not coded; the J3 PA Back is E2613; the J3 PL Back is E2615; the J3PD Back is E2620.
Sunrise Medical
(800) 333-4000
sunrisemedical.com
TEK RMD
Matia Robotics is dedicated to the creation of innovative robotic mobility devices. The TEK Robotic Mobilization Device (TEK RMD) is sold exclusively in the United States by Numotion. It’s a compact motorized standing movement device created to add more freedom to the lives of individuals with paralysis, allowing them to live in places not designed for them, move more inde- pendently, and interact with the world at eye level. It covers less than half the space of a small wheelchair, which allows users to pass through many narrow spaces. The upright position leaves
they can’t get it. They’re put into a regular chair that they’re going to break in three months. Somebody has a power add-on system and they can’t put it on their new chair. Where does it stop?”
Goetz said Permobil submitted a Freedom of Information Act (FOIA) request, seeking documentation to determine whether titanium was actually taken into consideration when manual wheelchair codes and allowables were established in 1993, a time when titanium wasn’t widely available in the industry.
“Our initial FOIA came back with zero results,” Goetz said. “They said there were no documents [proving there were discus- sions about titanium].”
Permobil has submitted a second FOIA request for a much wider range of correspondence to ask whether titanium was part of the 1993 funding conversation. “We want to be airtight in saying, ‘Your internal documents show that this was not the case,” Goetz said. “We’ve not gotten that second FOIA back yet. We’re saying, ‘You say [titanium] was part of it; prove it.’”
Anderson pointed out that ironically, the consumers being denied upgrade access “are the ones who have really done their research. They understand the benefits, they’re spending 12 to 14 hours in the chair, so it’s reducing their fatigue. This is the kind of person that I think the system really wants to help. They are contributing to the system because they’re working, more than likely. They want to return to a completely active lifestyle, and we’re making that more difficult for them. We’re not asking for Medicare to pay for a titanium upgrade, just to keep the access available for those individuals that recognize the benefit.”
Permobil is urging consumers to contact Congress (http://hub.permobil.com/advocacy) to personally voice opposi- tion to Medicare’s decision.
Regardless of whether you prefer titanium in your ultralight frames or not, Goetz said the issue now is fairness.
“At this point, it’s about your rights to get what you want to have. If I want to go and purchase something with the money I’ve saved, I should be able to. Why does a Medicare beneficiary not have the same rights?” m
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