Phone: (651) 644-9770

Published in Complex Rehab on Friday, December 20, 2019

Great news for the DME/CRT Industry! Today, President Trump signed the spending bill that will fund the government through fiscal year 2020, avoiding a budget showdown. Included in the bill is the complex rehab technology legislation that will exclude manual complex rehabilitative technology (CRT) wheelchairs from the Competitive Bidding Program and will stop Medicare from applying competitive bidding rates to manual CRT wheelchair accessories for 18 months.

The VGM Government Relations team and many industry leaders plan to reach out to CMS after the new year to ensure these changes take effect.

This seals the deal! Thank you to everyone who reached out to their legislators on behalf of DME and CRT in 2019.

Make Your Voice Heard: Help Protect Your Access to Medical Equipment

Monday, December 30, 2019 @ 11:12 AM  posted by jbuytaert

courtesy of People for Quality Care

A decade of reimbursement cuts, regulatory restrictions, excessive and unreasonable audits, and other poor legislative decisions have led to a significant loss of medical equipment providers across the country. Some states have lost nearly 50% of their suppliers as businesses have been forced out of business.

When medical equipment providers close their doors, you and countless others are directly affected. Much-needed equipment like wheelchairs, canes, and oxygen become even more difficult to access. Now, you can take action and help us stop these attacks.

We have a pre-written letter that you can send to your congressional representatives to show your support for the Protecting Home Oxygen & Medical Equipment Act of 2019. This bill helps provide relief for durable medical equipment providers in rural areas of the country where reimbursement has been slashed. When we act, we can protect your access to the equipment and services that are critical to your well-being.

Ask your member of Congress to support this bill.

Take action today!

Date Night with an Ostomy

Wednesday, December 18, 2019 @ 08:12 AM  posted by jbuytaert

Courtesy of Andy Snyder and ConvaTec

Are you feeling nervous at the thought of date night after ostomy surgery? You’re not alone. With a little planning ahead, you can be sure to have a great night out.

My first question would be, what are your plans for the evening? Plans might be different for a first date versus dining with a long-term partner or spouse. You might be considering an event to follow dinner, such as a show, opera, sporting event or maybe a concert. Or you may need to keep in mind if there is a potential for intimacy at the end of the night.

Keep in mind where you will be throughout the evening. Will you be in a place where you won’t have access to a bathroom, or do have access, but have concerns about odor? There are certain foods or drinks that will cause an increase in output, gas and a potential embarrassing smell. Check out tips and tricks for diet here, but keep in mind that everyone will react differently; so you will need to try things out. I don’t entirely follow all the “food rules”, but I do limit carbonated drinks and monitor how much I eat.  I’m lucky, my stomach can handle most foods. I do not get blockages and am not too concerned about potential odors.

If you fear odor that may accompany emptying your pouch, I recommend carrying a small bottle of odor eliminating toilet spray. You spray it in your toilet before you empty, and it helps hide the odor. Now that doesn’t solve the problem entirely, but in combination with a lubricating deodorant you can empty with more confidence.

If you do end up having a little more output than expected without access to a bathroom, I find using one of the Ostomysecrets® wraps to both hide the potential bulge from your shirt or leverage extra support in case you fear an accident. The wrap can also prevent self-consciousness if your shirt “accidentally” comes off during the date or evening.

If you are hoping to avoid the bathroom altogether, keep in mind, how much you eat will also drive output. If you eat a lot, then you could potentially be in and out of the bathroom all night.

Bottom line: plan ahead thinking about where you’re going, what you’re plans are and you’ll be able to face the evening with even more confidence!

~ Andy Snyder

Tuesday, December 17, 2019 @ 12:12 PM  posted by jbuytaert


Commentary: Focus greater attention on structural barriers to inclusion for people with disabilities

By Sue Schettle

Published by the Minneapolis Star Tribune on 12/14/2019 (original publication here)

The latest article in the Chaotic Care series (Disabled Minnesotans Often Live in Costly Isolation, 12/08/2019) had the opportunity to continue the series’ constructive look into the current challenges Minnesotans with disabilities face in having the opportunity to live their best lives. Unfortunately, several core issues were glazed over, and some ignored, in exchange for painting a negative picture of group homes where hundreds of Minnesotans in fact do receive the support and services they need for a high quality of life.

Minnesota’s relatively large number of group homes is a manifestation of being one of the first states to close all state institutions housing people with disabilities. Beginning as early as the late 60’s and early 70’s, Minnesota led the nation in a commitment to the community integration of people with intellectual and developmental disabilities. Minnesota closed its institutions, establishing the alternative of group homes as the most individualized and community-based support setting conceived at the time. To this day, Minnesota is one of only 17 states with no state institutions.

However, this history is just for context, because progress never stops. Fifty years ago, the list of options for community-based services was short. Today, group homes are part of a spectrum of residence and support options for people with disabilities. This is a great advancement that offers the potential for people to customize the support they need with the independence they want.

I say potential because as the article calls out, too many still lack access to those opportunities. Yet centralizing group homes as the problem is a disservice to addressing the true factors preventing more people from living their best lives.

The article failed to address the lack of affordable housing or discriminatory zoning ordinances and tenant policies which limit options even in the most progressive of counties. Continue Reading…

An Inherent Conflict of Interest—ATP Scribing for LCMP

Monday, November 18, 2019 @ 10:11 AM  posted by jbuytaert

Courtesy of Dan Fedor; U S Rehab

Several months ago I wrote an article titled “The ATP Dilemma” regarding an ATP scribing for an LCMP during the wheelchair (specialty) evaluation. At the time of the article, there were pieces of the puzzle where one could conclude that this is an unacceptable practice for several reasons as noted in the article. However, due to the lack of direct confirmation of the information available, some concluded that this practice was acceptable. Therefore, a pointed question was submitted to the DME MACs (both Noridian and CGS) in hopes of obtaining a clear answer regarding this practice. The DME MACs responded to the question with a concise, written answer during the quarterly Medicare Council meeting which was held on Nov. 12 and 13 in Nashville. The answer from Medicare confirms that this practice is not acceptable as there is an inherent conflict of interest since the supplier and LMCP can’t have any financial relationship, and by scribing for the LCMP, this is providing something of value (in kind) which violates the LCD. This can also lead to a possible Anti-Kickback violation.

Here is the exact question submitted to the DME MACs and their joint response:

Q: Is it acceptable for the supplier’s employed ATP to act as a scribe for the LCMP during the specialty evaluation?

DME MAC Response: This is not an acceptable practice. For the LCDs with LCMP evaluation requirements (power mobility devices, manual wheelchairs, wheelchair options/accessories and wheelchair seating), each profession has a separate and distinct role in the process to document the medical necessity of the item to be ordered. Each LCD clearly states the role and function of each professional evaluating the beneficiary. The LCDs specifically indicate that the “licensed certified medical professional,” such as a PT or OT, or a practitioner who has specific training and experience in rehabilitation wheelchair evaluations and that documents the need for the device in the beneficiary’s home. In addition, the LCDs indicate that there should be no financial relationship between the supplier and the LCMP. The ATP is hired by the supplier. If the ATP is scribing for the physical therapist, there is an inherent conflict of interest. Moreover, by serving as a scribe, the ATP makes the therapist more “efficient” by saving time, thus allowing them to see more patients, what is often described as “in kind” assistance. The requester may wish to seek an advisory opinion from the Office of Inspector General (OIG) to confirm.

End of DME MAC Response

Since it is now directly confirmed from all four DME MACs that having the ATP scribe for the LCMP during the specialty evaluation is not an acceptable practice, suppliers must be prepared to help educate LCMPs about the documentation requirements for complex rehab wheelchairs and accessories so they can efficiently prepare a comprehensive specialty evaluation with the necessary content for qualified patients to receive the ordered equipment in a timely manner.

It is a challenge to educate LCMPs on these requirements with consideration of their internal productivity requirements to see patients. However, a small investment of their time will yield ongoing results that will enable them to efficiently and effectively write a detailed specialty evaluation that addresses the LCD requirements. U.S Rehab is here to help with this education with materials, as well as a two-hour CEU course titled, “Documentation LIFE Preserver,” which is geared toward educating the LCMP with key points that must be addressed in their specialty evaluation. Please contact me directly at or 570-499-8459 about more details on offering this course in your area.

Dan Fedor

O: 844-794-8459
C: 570-499-8459