Posts Tagged ‘Texas’

ADA and More: Limitations of ADA Law With Respect to the Home Environment

Wednesday, October 19th, 2011

By Adam Horton,
Home Access Division Manager
Active American Mobility

The American’s with Disabilities Act (ADA) was passed July 26, 1991. It was created to prevent discrimination against individuals or groups that have disabilities, either mental or physical. While the ADA was passed to prevent discrimination against individuals in the workplace, public settings, buildings, restaurants, etc., it did not cover anything in the home environment. There are, however, guidelines that are put in place that in the event that a home is being built to ADA guidelines. The problem with this is that it is a mere guideline and not a requirement that can be enforced by code specifically for ADA.

The ADA guideline for a finished door opening is 32”. Most doors in a home are 24”-30”. Exterior doors do have to be wider with one exterior door a minimum of 36”. Other doors in the home are sometimes wide enough, but this is typically the master bedroom and master bathroom doors. A typical hallway is 36” wide, but should be 48” wide to meet ADA requirements. Also, most homes come with a concrete entry walk that joins to a porch with a step up to the porch and also a step into the home. ADA requirements call for a minimum of one no-step entrance into a home for ease of access for mobility equipment. Light switches and thermostats should be a minimum of 48”-54” from the floor and 40” if they are over a counter top. The list of changes goes on and on. The problem with all of this is none of it is required in a typical home setting. It is recommended but not required.

Most home builders will make the changes to a home to meet ADA standards, but it all comes at a cost. Builders will charge a fee most of the time they deviate from the original plan. However, these changes don’t cost much money at all, and if managed properly will only make the home more accessible and accommodating living area.

On a positive note, one organization is making a mark in becoming the “ADA” of the home environment. Accessible Home Improvement of America™ is a new organization that addresses the gaps for home owners that ADA leaves behind. AHIA™ consists of a nationwide network of independently owned and operated , certified providers and contractors dedicated to providing accessible home modifications and related services.

AHIA™ also offers the CEAC (Certified Environmental Access Consultant) credential. This credential brings professionalism and diversity to current businesses. The CEAC™ credential certifies that the consultant is a specialist in independent living strategies, universal design, barrier free access and design, assistive technology, retrofitting, home modifications, and medical remodeling.

Active American will be CEAC certified in the coming months and we look forward to supporting AHIA™

For more information contact Active American Home Access and Construction.


Urgent Reminder: Physicians Must Enroll In Medicare PECOS System

Wednesday, October 19th, 2011

As if physicians didn’t have enough to worry about with the perennial cliffhanger of Medicare pay cuts — this year’s 21% reduction is only on hold — many of them were at risk of not being paid at all starting on Jan. 1.

That’s why the Centers for Medicare & Medicaid Services did the right thing by postponing a deadline for physicians to make sure they are signed up properly with Medicare’s newest enrollment system. Doctors who order Medicare services or refer patients for such services now have until April 5 to determine whether they are up to date in the program’s Provider, Enrollment, Chain and Ownership System, known as PECOS. CMS had warned that it would stop paying claims at the beginning of the year for those who had not complied with the new enrollment policy.
■See related content
■Topic: Medicare
It’s not enough that practices have their own records in order. If a doctor lists a referring physician on a claim for a particular patient and that referring physician is not in PECOS, the billing doctor will not get paid.

If a physician has never heard of PECOS, there’s a good chance that he or she will need to contact the appropriate Medicare contractor or visit the PECOS Web site to re-enroll. The American Medical Association and dozens of other physician organizations who argued for the delay estimated that as many as 200,000 doctors fit into that category — about 30% of those to whom the directive applies. Many of these physicians enrolled in Medicare before 2003, when CMS started using the new system.

CMS says the re-enrollment process is simple, but the penalty for not updating the records with Medicare can be severe.

Starting in October 2009, Medicare contractors began including informational edits on claims listing physicians who were not properly enrolled in PECOS, letting the billing physicians know that they had until the end of 2009 to fix the issue or risk seeing their Medicare cash flow dry up.

But those who did not see or did not understand the informational notes on their claims were left in the dark about what to do. And physicians hardly can be blamed for overlooking Medicare’s own housekeeping issues with so much at stake in the national debate over health system reform and the threatened draconian cut to physician pay.

Quick action by the AMA and other members of organized medicine prevented a potential New Year’s disaster for many billing Medicare for services or listing referring physicians on their claims. But while an additional three months might seem like plenty of time for one doctor to file a paper Medicare application or use Internet-based PECOS enrollment, that might be a tight timeline for a larger practice that needs to sign up multiple doctors. The AMA already has asked CMS for additional time to comply and will continue to monitor the situation closely.

With a few exceptions, doctors who are not signed up with PECOS will need to re-enroll with Medicare. That includes pediatricians, dentists and others who may see few Medicare beneficiaries. Those who see or refer patients through the Dept. of Veterans Affairs, the Public Health Service or Tricare also will need to comply.

CMS is recommending that all physicians ensure that their enrollments are up to date and compliant by contacting their Medicare contractors or viewing their records online. A current record is one that is in the PECOS database with all the correct information, including National Provider Identifier, or NPI.

Physicians also can obtain more Medicare enrollment information on the AMA’s regulatory advocacy Web site (

With some advance planning — and if Medicare contractors and CMS meet their own responsibilities — doctors can ensure that the government keeps paying them, on time, for all the work they do for their patients.