Power mobility device provision: Understanding medicare guidelines and advocating for clients
Power mobility device provision: Understanding medicare guidelines and advocating for clients
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DOI：
10.1016/j.apmr.2007.03.024
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发表时间：
2007-06-01
影响因子：
4.3
通讯作者：
Tovey, Elyn
中科院分区：
文献类型：
--
作者：
Dicianno, Brad E.;Tovey, Elyn
2005年5月，医疗保险和医疗补助中心（CMS）发布了一项新的全国范围的行动辅助设备（MAE），包括轮椅。CMS随后于2006年4月发布了最终规则，概述了MAE处方文件所需的重大变更。其他保险提供者后来采用了非传染性疾病标准，有时还进行了修改，并开始根据自己的解释适用这些标准，因为其中一些标准模糊不清。在这份报告中，我们介绍了一个案例，以显示CMS非传染性疾病标准的组成部分，什么是打算，但在语言中描述不佳，保险提供者如何可能误解或改变标准，以及临床医生如何可以作为倡导者。
The Centers for Medicare and Medicaid (CMS) issued a new national coverage determination (NCD) for mobility assistive equipment (MAE) including wheelchairs in May 2005. CMS then issued a Final Rule in April 2006 that outlined significant changes required for documentation for prescribing MAE. Other insurance providers have since adopted and sometimes modified the NCD criteria and have begun to apply these criteria according to their own interpretations because some of the criteria are vague. In this report, we introduce a case example to show the components of the CMS NCD criteria, what was intended but poorly described in the language, how insurance providers may misinterpret or alter the criteria, and how clinicians can act as advocates.