The recent decision by the DMERC medical directors in their proposed Local Coverage Determination (LCD) for power mobility devices to require a Assistive Technology Provider certified by RESNA (Rehabilitation Engineering and Assistive Technology Society of North America) has stirred considerable discussion in the industry. Controversy aside, this is an opportunity to revisit the issue of professional standards and credentialing. There are now two organizations that have established standards and/or credentials for clinicians and rehabilitation technology suppliers, RESNA and the National Registry of Rehabilitation Technology Suppliers (NRRTS).

RESNA
Three years after NRRTS was established, RESNA developed two credentialing programs, the Assistive Technology Practitioner (ATP) and the Assistive Technology Supplier (ATS). NRRTS was instrumental in the development of these programs by contributing $50,000 and countless hours of volunteer time to develop content questions for the credentialing examination.

Why Is This Important?
The recently released LCD for power mobility devices (PMDs) draft proposal includes a requirement that Medicare beneficiaries who may require a power wheelchair with a powered tilt and/or recline seating system, or with alternative driving controls, be evaluated (in person) by a RESNA ATP. This is the first time in memory that a credential other than a primary professional license (MD, OT, PT) has been a requirement for obtaining a wheelchair accessory component. It is therefore important to understand what the ATP is.

In my opinion, requiring educational training and/or experience for those involved in evaluating people who need advanced technologies like powered seating or alternate drive controls is a positive concept. Perhaps one solution is to establish a phase-in timeline for this requirement to allow those experienced clinicians sufficient time to obtain their ATP credential.

It seems particularly odd that the RESNA ATS has been completely overlooked in the policy language for PMDs and related accessories. The DMERC Medical Directors should include language in the LCD that would be inclusive of the ATS. For example, requiring that a RESNA ATS and a licensed OT/PT be involved in the evaluation of an individual who needs powered tilt or recline or alternative driving controls. This might be a viable alternative for the shortage of ATPs needed to fill the current proposed requirement. Few clinicians would recommend advanced seating or mobility technologies without the involvement of a qualified RTS such as a RESNA ATS.

There are other standards for RTSs other than the RESNA ATS. Most notable is the NRRTS registrant or the CRTS. Some have argued that the NRRTS registrant standard is not a “true credential,” because it has not been validated by the National Organization for Competency Assurance (as the RESNA ATP, ATS, and RET has). Or that the NRRTS registry is not open to those manufacturers who do not make use of an independent supplier distribution network. Although this is true, that does not make the standard any less significant.

When teamed with the RESNA credentialing program, these standards are the most rigorous professional standards in the industry to date. DP

Dan Lipka, CRTS®, ATS, OTR, works for Miller’s Sales Rental and Service in northeast Ohio. He is a past president of NRRTS and a former RESNA Board member, and can be reached via e-mail: ddl@millers.com.