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  • Reports

    Preparing Letters of Medical Justification (2007) -- Available formats: pdf rtf
    This Winter 2006 AT Advocate focuses on the key components that will support the need for durable medical equipment through Medicaid and other third party insurers. The issue includes Who Will Review the Letter or Report, Establishing the Professional Appearance of the Report, Getting Started: Five Key Principles forWriting Letters of Medical Justification, Consider the Funding Source and the Criteria It Will Follow, Using Medicaid Coverage Categories Other Than DME to Fund Specialized Equipment, and Drafting the Report.

    The National Coverage Decision for Mobility Assistive Equipment (2007) -- Available formats: rtf
    This document comes from the National Coverage Decisions Manual, governing Medicare Claims and represents the National Coverage Decision (NCD) governing mobility assistive equipment, including power wheelchairs and scooters. It is available on the Centers for Medicare and Medicaid Services (CMS) website at: www.cms.hhs.gov/manuals/downloads/ncd103c1_Part4.pdf.

    Medicaid and Assistive Technology: A Fresh Look at Medicaid as an AT Funding Source (2006) -- Available formats: word
    This article presents an overview of Medicaid and the funding available for AT under Medicaid for both children and adults.

    Medicaid and Persons with Disabilities - Part 1: The Regular State Medicaid Program Part II: A Focus on Home and Community-Based Services (HCBS) Waivers (2006) -- Available formats: word
    This handout provides an overview of how the regular state Medicaid program operates. This includes some discussion of the range of services covered or potentially covered by the regular Medicaid program.This handout will then discuss, in Part Two, HCBS waivers and what they can offer to individuals with disabilities who have specialized health care and related needs. This will include some discussion of the range of possible waiver provisions that would allow individuals to establish eligibility for Medicaid despite income or resources of responsible parents or spouses. It will then provide state-specific examples of how waivers are being used to benefit persons with disabilities, with an emphasis on assistive technology available through the waivers.

    Medicaid, Assistive Technology, and the Courts: An Updated Summary of AT-Related Federal and State Court Decisions (2006) -- Available formats: word
    This article summarizes many of the most important AT-related court decisions going back to the mid 1980s, with most of these decisions published during the 1994 - 2003 period (i.e., since the Protection and Advocacy for Assistive Technology or PAAT programs have been funded). The great majority of these cases involved attorneys from P&A programs or attorneys who could be identified as part of our extended AT advocacy network. Given the limitations of space, this article does not highlight unreported court decisions (i.e., not reported in either official reporters or Westlaw) or court settlements, except insofar as later reported cases relied on the unreported or settled case in some way.

    Private Insurance Contracts & Assistive Technology: Part II (2006) -- Available formats: word
    In this article we will discuss special policy provisions, such as a durable medical equipment provision, which determine what AT items are covered under an insurance policy. Next, we will discuss what criteria must be met for the insurer (i.e., the insurance company or other entity providing insurance) to determine that an AT device is medically necessary. We will then discuss how one appeals a denial of AT by a private insurer. We will close with a limited discussion of the applicability of the Americans with Disabilities Act to private insurance companies.

    Proactive Intervention for Hearing Impaired Infants, Preschoolers, and Adults: A Discussion of Funding Sources for Hearing Aids (2006) -- Available formats: word
    This provides the justification for funding personaly prescribed devices, namely cochlear implants and hearing aids.

    State Child Health Insurance Program Provides Health Care to Uninsured Low-Income Children (2006) -- Available formats: word
    Health insurance is a pressing issue for many families with limited income. This is especially true when the family has a child with a disability who needs assistive technology (AT) or other expensive services. The poorest of these children will qualify for Medicaid. What about uninsured children from families with income that is too high for Medicaid? The State Child Health Insurance Program (SCHIP) may be the answer. This article explores how that can be done.

    Suggested State Strategies for Private Health Insurance Initiatives and Assistive Technology and Private Health Insurance Consensus Principles (2002) -- Available formats: html
    The RESNA Technical Assistance Project hosted a one-day meeting May 17, 2002 in Hartford, Connecticut for representatives of statewide assistive technology (AT) programs and private health insurance companies. The purpose of this meeting was to begin a dialog between these groups to: (1) promote a greater understanding of assistive technology (AT) and durable medical equipment (DME), (2) clarify current private insurance coverage of AT/DME; (3) identify information needed to broaden coverage of AT/DME, and (4) explore mechanisms for starting a long-term dialog among AT advocates and insurance industry representatives. As a result of this meeting, Consensus Principles and Suggested State Strategies for private health insurance and assistive technology were developed by the RESNA Technical Assistance Project.

    Report on CPT Codes and Assistive Technology (2001) -- Available formats: html
    Medical and related service personnel to determine reimbursement use Current Procedural Technology (CPT) codes. It is important that assistive technology (AT) professionals understand CPT (Common Procedural Terminology) Codes and how they impact reimbursement for AT in both the public and private insurance systems. This document provides an overview of CPT codes to AT professionals, including AT service providers and those involved in policy related to AT.

  • Profile

    EPSDT & AT - May 13, 2010 Powerpoint (2010) -- Available formats: ppt
    Diana Straube presents information about the Medicaid Early and Periodic Screening, Diagnosis, and Treatment Program (EPSDT). She describes the main components of the program, what DME is covered and what AT services can be covered. Also included are two case studies.

    Health and Human Services Panel - Overview (2008) -- Available formats: ppt
    This describes the process that the Nebraska program uses to respond to human service requests. It discusses home and community based waivers, the process that the project uses, and lists some of the AT that was acquired through this process.

  • Teleconferences

    Collaborations with Money Follows the Persons Program - March 25, 2010 Transcript (2010) -- Available formats: html
    Laurie Brooks from the Oregon Statewide AT Act Program, Arlene Lugo from the Connecticut Statewide AT Act Project, Bil Roby from Nebraska's Department of Health and Human Services - Division of Medicaid and Long-Term Care and Lauren Rock from the Nebraska Assistive Technology Partnership shared information on collaborations their programs have created with Money Follows the Person initiatives throughout their state.

    EPSDT & AT - May 13, 2010 Powerpoint (2010) -- Available formats: ppt
    Diana Straube presents information about the Medicaid Early and Periodic Screening, Diagnosis, and Treatment Program (EPSDT). She describes the main components of the program, what DME is covered and what AT services can be covered. Also included are two case studies.

    EPSDT & AT - May 13, 2010 Transcript and MP3 (2010) -- Available formats: html mp3
    Diana Straube from Neighborhood Legal Services presented information on the special requirements of the Medicaid Early and Periodic Screening, Diagnosis, and Treatment Program (EPSDT) and how they can be used to meet unique AT-related needs for children under the age of 21.

  • Meetings

    Developing Collaborative Partners for AT/DME Reutilization (2009) -- Available formats: ppt
    This presentation provides data on the funders of reused AT, provides tips on collaborating, and offers suggestions on potential partners.

    Health and Human Services Panel - Overview (2008) -- Available formats: ppt
    This describes the process that the Nebraska program uses to respond to human service requests. It discusses home and community based waivers, the process that the project uses, and lists some of the AT that was acquired through this process.

    A Year in Review (2007) -- Available formats: rtf
    This presentation surveys some of the most interesting and potentially important developments that have informed or may inform the work of State AT Projects, P&A programs, and their partners. It is a sampling of developments and seeks to address each development in ways that emphasize its potential for the users of AT on behalf of whom we work, and from the standpoint of opportunities or risks it may create or adumbrate for AT advocates.

    Money Follows the Person Rebalancing Demonstration Section 6071 of the Deficit Reduction Act 2005, (2007) -- Available formats: ppt html
    The Money Follows the Person program is described as a long term care option for those seeking to transition out of institutional settings.

    Preparing Letters of Medical Justification (2007) -- Available formats: pdf rtf
    This Winter 2006 AT Advocate focuses on the key components that will support the need for durable medical equipment through Medicaid and other third party insurers. The issue includes Who Will Review the Letter or Report, Establishing the Professional Appearance of the Report, Getting Started: Five Key Principles forWriting Letters of Medical Justification, Consider the Funding Source and the Criteria It Will Follow, Using Medicaid Coverage Categories Other Than DME to Fund Specialized Equipment, and Drafting the Report.

    The National Coverage Decision for Mobility Assistive Equipment (2007) -- Available formats: rtf
    This document comes from the National Coverage Decisions Manual, governing Medicare Claims and represents the National Coverage Decision (NCD) governing mobility assistive equipment, including power wheelchairs and scooters. It is available on the Centers for Medicare and Medicaid Services (CMS) website at: www.cms.hhs.gov/manuals/downloads/ncd103c1_Part4.pdf.

    Keeping and Seeking Opportunities for AT in Today's Medicaid Programs (2006) -- Available formats: ppt html
    This presentation describes the CMS waiver system. It details the home and community based waiver and how to become involved in your state.

    Medicaid and Assistive Technology: A Fresh Look at Medicaid as an AT Funding Source (2006) -- Available formats: word
    This article presents an overview of Medicaid and the funding available for AT under Medicaid for both children and adults.

    Medicaid and Persons with Disabilities - Part 1: The Regular State Medicaid Program Part II: A Focus on Home and Community-Based Services (HCBS) Waivers (2006) -- Available formats: word
    This handout provides an overview of how the regular state Medicaid program operates. This includes some discussion of the range of services covered or potentially covered by the regular Medicaid program.This handout will then discuss, in Part Two, HCBS waivers and what they can offer to individuals with disabilities who have specialized health care and related needs. This will include some discussion of the range of possible waiver provisions that would allow individuals to establish eligibility for Medicaid despite income or resources of responsible parents or spouses. It will then provide state-specific examples of how waivers are being used to benefit persons with disabilities, with an emphasis on assistive technology available through the waivers.

    Medicaid, Assistive Technology, and the Courts: An Updated Summary of AT-Related Federal and State Court Decisions (2006) -- Available formats: word
    This article summarizes many of the most important AT-related court decisions going back to the mid 1980s, with most of these decisions published during the 1994 - 2003 period (i.e., since the Protection and Advocacy for Assistive Technology or PAAT programs have been funded). The great majority of these cases involved attorneys from P&A programs or attorneys who could be identified as part of our extended AT advocacy network. Given the limitations of space, this article does not highlight unreported court decisions (i.e., not reported in either official reporters or Westlaw) or court settlements, except insofar as later reported cases relied on the unreported or settled case in some way.

    Private Insurance Contracts & Assistive Technology: Part II (2006) -- Available formats: word
    In this article we will discuss special policy provisions, such as a durable medical equipment provision, which determine what AT items are covered under an insurance policy. Next, we will discuss what criteria must be met for the insurer (i.e., the insurance company or other entity providing insurance) to determine that an AT device is medically necessary. We will then discuss how one appeals a denial of AT by a private insurer. We will close with a limited discussion of the applicability of the Americans with Disabilities Act to private insurance companies.

    Proactive Intervention for Hearing Impaired Infants, Preschoolers, and Adults: A Discussion of Funding Sources for Hearing Aids (2006) -- Available formats: word
    This provides the justification for funding personaly prescribed devices, namely cochlear implants and hearing aids.

    State Child Health Insurance Program Provides Health Care to Uninsured Low-Income Children (2006) -- Available formats: word
    Health insurance is a pressing issue for many families with limited income. This is especially true when the family has a child with a disability who needs assistive technology (AT) or other expensive services. The poorest of these children will qualify for Medicaid. What about uninsured children from families with income that is too high for Medicaid? The State Child Health Insurance Program (SCHIP) may be the answer. This article explores how that can be done.

    Suggested State Strategies for Private Health Insurance Initiatives and Assistive Technology and Private Health Insurance Consensus Principles (2002) -- Available formats: html
    The RESNA Technical Assistance Project hosted a one-day meeting May 17, 2002 in Hartford, Connecticut for representatives of statewide assistive technology (AT) programs and private health insurance companies. The purpose of this meeting was to begin a dialog between these groups to: (1) promote a greater understanding of assistive technology (AT) and durable medical equipment (DME), (2) clarify current private insurance coverage of AT/DME; (3) identify information needed to broaden coverage of AT/DME, and (4) explore mechanisms for starting a long-term dialog among AT advocates and insurance industry representatives. As a result of this meeting, Consensus Principles and Suggested State Strategies for private health insurance and assistive technology were developed by the RESNA Technical Assistance Project.