I doubt you have much of an option for getting reimbursement on the
present system.  I do notice that the My TObii has some rental/trial
options.  If that is how the family got it, then you might be able to go
ahead with the evaluation and recommendation.  However, Medicare might
easily come back and say that the patient get a cheaper eyegaze system.  I
think this is somewhat underhanded by Tobii, since their brochure for the
My Tobii system is absolutely plastered with statements that this is
Medicare approved.  They should either be advising people in the proper
procedure or have a plan in place that doesn't violate that procedure.

I also sympathize with the family.  This is a very expensive system and
getting funding can take a very long time when your loved one doesn't have
a lot of time left and needs the device now.  But, I think that is what a
rental agreement would be for and the vendor should have recommended that
so that proper procedure could be followed.

On Tue, 11 Dec 2007, Molly Doyle wrote:

<blockquote style="border-left: #5555EE solid 0.2em; margin: 0em; padding-left: 0.85em">We have had these types of requests in the past (not necessarily for
this product).  I assume the PALS is using the equipment & its meeting
his needs.  I empathize with the PALS and the family about wanting to
get reimbursed but our center does not evaluate a person for a specific
product particularly after that product has been received.  We follow
the steps outlined by Lew.

Molly Doyle MS CCC
CART-Rancho Los Amigos National Rehabilitation Center
Downey CA 90242
www.rancho.org/cart

Please be advised that we cannot guarantee confidentiality of email communications.

<blockquote style="border-left: #5555EE solid 0.2em; margin: 0em; padding-left: 0.85em"><blockquote style="border-left: #5555EE solid 0.2em; margin: 0em; padding-left: 0.85em"><blockquote style="border-left: #5555EE solid 0.2em; margin: 0em; padding-left: 0.85em">Alisa Brownlee <xxxxxx@xxxxxxxxx> 12/10/07 1:06 PM >>>
</blockquote></blockquote></blockquote> A question for the AAC specialists of the group....

 We have a patient in NJ that paid out of pocket (and without an SLP evaluation) for a My Tobii System from a local vendor.  Now, the family wants to apply to Medicare for partial reimbursement. (the 80% that Medicare would pay for this device)  The vendor is now asking one of the SLP's that work with my Chapter to perform an AAC assessment based on this system then submit the claim to Medicare.  Has anyone on this list had this type of request?  Can a beneficiary request reimbursement for Medicare after the fact?? (the patient has had the device for a few months)

 I asked Lew Golinker for advice (he is an attorney with the AT Law Center) and he states the process of getting an eval, then script, then submission of device has not been followed.  However, I am wondering if anyone else have faced this problem?  I can't believe this is an isolated incident and I was curious if anyone has any input to this or a similar situation?  (or has someone successfully done this type of "back ordering" before?)

 Thanks
 Alisa

 Alisa Brownlee, ATP
Assistive Technology Specialist
ALS (Lou Gehrig's Disease) Association, Greater Philadelphia Chapter

 Assistive Technology Consultant, ALS Association, National Office

Direct Phone Number: 215-631-1877

---------------------------------
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Alisa Brownlee, ATP
Assistive Technology Specialist
ALS (Lou Gehrig&#39;s Disease) Association, Greater Philadelphia Chapter

Assistive Technology Consultant, ALS Association, National Office

Direct Phone Number: 215-631-1877

---------------------------------
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</blockquote>
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