State by State

STATE NEWS

State by State

A recap from the AOPA State Reps meeting at the 2018 AOPA National Assembly in Vancouver

Each month, we talk to O&P professionals about the most important state and local issues affecting their businesses and the patients they serve. This column features information about medical policy updates, fee schedule adjustments, state association announcements, and more.

Multiple State Alert Blue Cross Blue Shield (BCBS) Illinois, BCBS Montana, BCBS New Mexico, BCBS Oklahoma, BCBS Texas, and Health Care Service Corp. (HCSC) issued a draft policy that would limit access to microprocessor-controlled prosthetic technology. AOPA, as well as many other O&P organizations, including the O&P Alliance, issued comments on the draft policy, which was removed from the BCBS website on Monday, Oct. 1, 2018. AOPA’s comments are available for review on the AOPA Co-OP, and AOPA will continue to monitor this issue.

Arizona Several O&P providers in Arizona are exploring the possibility of expanding the scope of practice for orthotists and prosthetists in the state. The expanded scope of practice would include the ability to bill for Current Procedural Terminology (CPT) codes, specifically the four codes designated for prosthetic and orthotic training.

During the summer AOPA Board of Directors meeting, AOPA Executive Director Tom Fise, JD, recommended that AOPA develop a long-term plan to give serious consideration to expanding O&P’s scope of practice to include more patient-care services, billed through CPT codes. Certified orthotists and prosthetists are the only primary care providers who do not bill both CPT and Health-Care Common Procedure Coding System codes, according to Fise.

Arkansas Members from Arkansas reported concerns about Medicaid work requirements and the entry of new managed-care organizations beginning Jan. 1, 2019. Many of the states with work requirements have exclusions for individuals with disabilities, but Arkansas has not yet released its criteria.

California The California Orthotic and Prosthetic Association continues to push for increases to the MediCal fee schedule and is now working with a health economist to build its case.

Massachusetts AOPA members in Massachusetts reported a MassHealth (Massachusetts Medicaid) proposal, 101 CR 334.00: Payment Rates for Prostheses, Prosthetic Devices, and Orthotic Devices, which would cut the fee schedule for some O&P codes by as much as 17 percent. A public hearing was held on Aug. 17, 2018, for which AOPA submitted written testimony. Several

O&P organizations also attended the hearing to present testimony in person. As a result of the feedback received during the public hearing, MassHealth has delayed implementation, pending further review.

O&P providers continue to monitor the situation but have concerns that the proposed cuts may still go through due to the lack of detailed descriptions and documentation of time allotments associated with the provision of orthotic and prosthetic care. MassHealth has requested additional information with respect to the amount of time it takes to provide the services associated with the global payment of the L codes with proposed fee schedule cuts.

Minnesota AOPA members in Minnesota report a successful transition under the new licensure law, which went into effect Jan. 1, 2018. The law was intended primarily for patient protection purposes.

Minnesota planned to hold a vote on moving forward with pursuing the introduction of insurance fairness in the state in 2019 during its state meeting, held in conjunction with the Northern Plains Chapter Meeting, October 4-5.

EDITOR'S NOTE: To submit an update for publication, please email awhite@aopanet.org. For up-to-date information about what’s happening in O&P in your state, visit the AOPA Co-OP and join the conversation in the AOPA Google+ Community.

30 O&P News | September/October 2018

CALENDAR & CLASSIFIEDS

Meetings & Courses

2018

NOVEMBER 4-10

Health-Care Compliance & Ethics Week. AOPA is celebrating Health-Care Compliance & Ethics Week and is providing resources to help members celebrate. Learn more at bit.ly/aopaethics.

NOVEMBER 12-13

Mastering Medicare: Essential Coding & Billing Techniques. Las Vegas. Register online at bit.ly/2018billing. For more information, email Ryan Gleeson at rgleeson@AOPAnet.org.

2019

JANUARY 4-6

AOPA 2019 Leadership

Conference. The Scott, Scottsdale, AZ. For more information, email Ryan Gleeson at rgleeson@ AOPAnet.org.

JANUARY 9

Understanding the Knee Orthoses Policy. Register online at bit.ly/2019webinars. For more information, email Ryan Gleeson at rgleeson@AOPAnet.org.

FEBRUARY 13

Patient Outcomes: Best Practices & How To Use Them. Register online at bit.ly/2019webinars. For more information, email Ryan Gleeson at rgleeson@AOPAnet.org.

MARCH 13

Advanced Beneficiary Notice: Get To Know the ABN Form. Register online at bit.ly/ 2019webinars. For more information, email Ryan Gleeson at rgleeson@AOPAnet.org.

APRIL 10

Shoes, External Breast Prostheses, Surgical Dressings, and Other

Policies. Register online at bit.ly/ 2019webinars. For more information, email Ryan Gleeson at rgleeson@AOPAnet.org.

PRACTICE SALES & APPRAISALSWANTED!A few good businesses for sale.

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If you want to sell your business or just need to know its worth, please contact me in confidence.

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NOVEMBER 14

AOPA Webinar: Evaluating Your Compliance Plan & Procedures: How To Audit Your Practice. Register online at bit.ly/2018webinars. For more information, email Ryan Gleeson at rgleeson@AOPAnet.org.

DECEMBER 12

AOPA Webinar: New Codes, Medicare Changes, &

Updates. Register online at bit.ly/2018webinars. For more information, email Ryan Gleeson at rgleeson@AOPAnet.org.

Publisher Thomas F. Fise, JD Advertising Sales RH Media LLC Editorial Services Content Communicators LLC Design & Production Marinoff Design LLC Printing Sheridan

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Copyright © 2018 American Orthotic and Prosthetic Association. All rights reserved. This publication may not be copied in part or in whole without written permission from the publisher. The opinions expressed by authors do not necessarily reflect the official views of the publisher, nor does the publisher necessarily endorse products shown in O&P News. The O&P News is not responsible for returning any unsolicited materials. All letters, press releases, announcements, and articles submitted to the O&P News may be edited for space and content. The magazine is meant to provide accurate, authoritative information about the subject matter covered. It is provided and disseminated with the understanding that the publisher is not engaged in rendering legal or other professional services. If legal advice and/or expert assistance is required, a competent professional should be consulted.

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O&P News | September/October 201831