Access Denied: Consequences of Federal Policy on Seating and Wheeled Mobility
One of the guest editorials in this information-packed issue of the JRRD, whose title is noted above, was written by Simon Margolis CO, ATS, ATP. Simon is a prolific contributor to the fledgling field of custom seating, and a long-term advocate for the use of clinically proven orthotic principles in the provision of seating systems. He is also the current President of the Rehabilitation Engineering and Assistive Technology Society of North America [RESNA], the premiere multidisciplinary organization in this practice area.
Mr. Margolis writes persuasively of the potential harm to beneficiaries if national competitive bidding is implemented for highly customized devices, and provides specific constructive suggestions to insure that consumers are not denied access to appropriate care despite stern cost-containment measures. He notes in detail the "catch-22" situation that currently exists because the Centers for Medicare & Medicaid Services [CMS] has adopted a definition of "non-ambulatory" that is in conflict with the Social Security Administration [SSA] definition. The orthotic and prosthetic field suffers from similar errors on the part of CMS, who seem to have only a partial understanding of the impact of custom prostheses and orthoses on Medicare beneficiaries.
I encourage all CPOs to read and heed the alarm Simon is sounding: if CMS is successful in preventing appropriate access to custom seating and wheeled mobility services, it will be a simple matter to implement similar draconian measures eliminating access to prosthetic and orthotic care too. I agree with Mr. Margolis' thesis that it is now time for concerned professionals and patient advocates to raise their voices to Congress so that well-intentioned legislation such as the Medicare Modernization Act of 2003 [MMA] does not inadvertently balance the budget on the backs of citizens with disabilities. Readers can read the entire editorial at www.vard.org/jour/04/41/4/margolis.html .
