Assistive technology has the potential to enhance many aspects of an individual’s life. For example, augmentative and alternative communication (AAC) systems ranging from simple communication boards and wallets to sophisticated electronic communication devices enable people to communicate more effectively with care givers and peers. Mobility aids can vary from long white canes for people with visual impairments to powered wheelchairs. Devices to enhance greater computer access include expanded or adapted keyboards, touch windows, and speech recognition systems. Visual aids include magnification devices and computer screen-reading adaptations. These and similar AT devices all contribute to the ultimate goal of helping people with disabilities succeed in inclusive environments. If healthcare professionals are not aware of these and other potential contributions AT can make in the lives of their customers with disabilities, then those customers with disabilities are unlikely to realize their full potentials.
An AT service is defined as "...any service that directly assists an individual with a disability in the selection, acquisition, or use of an assistive technology device." " (Individuals with Disabilities Education Act Amendments of 1997, P.L. 105-17, 20 U.S.C. §1401, 1997).
An AT device is defined legally as: " ... any item, piece of equipment, or product system ... that is used to increase, maintain, or improve the functional capabilities of people with disabilities" (Individuals with Disabilities Education Act Amendments of 1997, P.L. 105-17, 20 U.S.C. §1401, 1997)
Medicaid can also be used to provide AT equipment if that device is identifiable as durable medical equipment (DME). As is the case with the term medically necessary, definitions of DME vary from state to state and program to program. However, typical guideline questions to determine whether a device qualifies as DME include the following:
1. Is the piece of equipment able to withstand repeated use?
2. Is the piece of equipment primarily used for medical purposes?
3. Is the piece of equipment generally not useful to a person in the absence of illness or injury?
4. Is the piece of equipment appropriate for home use? (Assistive Technology, Inc., 1998).
Decision-making by funding sources regarding, the provision of funds for AT often plays a crucial role in service delivery. Most funding streams require that eligibility be established prior to the submission of a claim. When submitting a claim to Medicaid or private insurance, families and clinical personnel should include all information necessary to facilitate a favorable decision by the reviewer of the claim. The following documents often are required:
1. A prescription from the customer’s primary care physician outlining the exact equipment required.
2. A letter or certificate of medical necessity from the physician or therapist.
3. A written evaluation from the therapist describing the customer's diagnosis, prognosis, capabilities, functional ability, and need for device
4. Customer's date of birth, complete address, and phone number
In general, the more documentation that is provided, the better the opportunity for funding. Some Medicaid and insurance offices may require a trial rental period, a comparison between the requested device and other devices, and/or photos or videos of the customer using the device (Assistive Technology, Inc., 2000).
The federal Medicaid regulations require that "each service must be sufficient in
amount, duration, and scope to reasonably achieve its purpose" (Early and Periodic Screening, Diagnostic, and Treatment Services Final Rule, 1993 [42 C.F.R. 440.230(b)]). Individual state legislation may also provide supplementary provisions that offer further direction (Sheldon & Hager, 1997). General guideline questions in most state Medicaid programs include the following:
1. Is the proposed AT device and/or service medically appropriate for the symptoms, diagnosis, or treatment provided for the symptom, condition, illness, disease, or injury?
2. Is the proposed AT device and/or service the most cost-effective means that can safely be provided?
3. Is the proposed AT device and/or service accepted medical practice and state of the art?
4. Is the proposed AT device and/or service not primarily for the convenience of the person insured, provider, or professional?
In summary, AT provides people with disabilities services and equipment that directly assist each individual. The concept of AT is defined in the IDEA act of 1997. Private insurance and Medicaid are the primary funding sources for AT but, certain regulations must be met. It is up to the customer, physician and therapist to provide information regarding the customer’s needs regarding assistive technology.
Information for this article was found at: http://www.disabilityinfo.gov/digov-public/public/DisplayPage.do%3fparentFolderId=500 , in an article by Nicole Grace