April 2010 O&P Almanac by AOPA

Almanac OP The American Orthotic & Prosthetic Association

APRIL 2010

WWW.AOPANET.ORG

THE MAGAZINE FOR THE ORTHOTICS & PROSTHETICS INDUSTRY

CARE That

ENDURES

Months after the devastation, practitioners in Haiti detail a lasting need for O&P support

What HEALTH-CARE REFORM Means to You Billing Tips for Returned and Refused Devices

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O&P Almanac APRIL 2010, VOLUME 59, NO. 4

COLUMNS

COVER STORY

Care That Endures

By Kim Fernandez Januaryâ&#x20AC;&#x2122;s earthquake in Haiti has created an unprecedented number of amputees in need of on-going care for the rest of their lives. Hear from practitioners first in the field about the care they provided and what will be needed from the O&P community long term.

Reimbursement Page How to manage returned and refused devices

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DEPARTMENTS

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FEATURE STORY

CONTENTS

Health-Care Reform: Myths and Realities By Tom Fise, JD AOPAâ&#x20AC;&#x2122;s executive director explains the ever-changing U.S. health-care reform process and offers some observations about its effects on the O&P industry.

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ONLINE

Visit O&P Almanac online at www.AOPAnet.org.

AOPA Contact Page How to reach staff

In the News Updates and company announcements

AOPA Headlines News about AOPA initiatives, meetings, member benefits, and more

AOPA Membership Applications Marketplace Products and services for O&P

Jobs Opportunities for O&P professionals

Calendar

Upcoming meetings and events

Ad Index

O&P Almanac (ISSN: 1061-4621) is published monthly by the American Orthotic & Prosthetic Association, 330 John Carlyle St., Ste. 200, Alexandria, VA 22314; 571/431-0876; fax 571/4310899; e-mail: almanac@AOPAnet.org. Yearly subscription rates: $59 domestic; $99 foreign. All foreign subscriptions must be prepaid in U.S. currency, and payment should come from a U.S. affiliate bank. A $35 processing fee must be added for non-affiliate bank checks. O&P Almanac does not issue refunds. Periodical postage paid at Alexandria, VA, and additional mailing offices. Postmaster: Send address changes to: O&P Almanac, 330 John Carlyle St., Ste. 200, Alexandria, VA 22314. For advertising information, contact Dean Mather, M.J. Mrvica Associates Inc. at 856/768-9360, e-mail: dmather@mrvica.com. APRIL 2010 O&P ALMANAC

AOPA CONTACT INFORMATION AMERICAN ORTHOTIC & PROSTHETIC ASSOCIATION (AOPA) 330 John Carlyle St., Ste. 200, Alexandria, VA 22314 AOPA Main Number: 571/431-0876 AOPA Fax: 571/431-0899 www.AOPAnet.org EXECUTIVE OFFICES

MEMBERSHIP AND MEETINGS

Thomas F. Fise, JD, executive director, 571/431-0802, tfise@AOPAnet.org

Tina Moran, CMP, senior director of membership operations and meetings, 571/431-0808, tmoran@AOPAnet.org

Don DeBolt, chief operating officer, 571/431-0814, ddebolt@AOPAnet.org O&P ALMANAC Thomas F. Fise, JD, publisher, 571/431-0802, tfise@AOPAnet.org Josephine Rossi, editor, 703/914-9200 ext. 26, jrossi@strattonpublishing.com

Kelly Oâ&#x20AC;&#x2122;Neill, manager of membership and meetings, 571/431-0852, koneill@AOPAnet.org Steven Rybicki, communications manager, 571/431-0835, srybicki@AOPAnet.org Michael Chapman, coordinator, membership operations and meetings, 571/431-0843, mchapman@AOPAnet.org

OP Almanac &

PUBLISHER Thomas F. Fise, JD EDITORIAL MANAGEMENT Stratton Publishing & Marketing Inc. ADVERTISING SALES M.J. Mrvica Associates Inc. DESIGN & PRODUCTION Marinoff Design, LLC PRINTING United Litho Inc.

BOARD OF DIRECTORS OFFICERS President James A. Kaiser, CP, Scheck & Siress, Chicago, IL President-Elect Thomas V. DiBello, CO, FAAOP, Dynamic O&P, LLC, Houston, TX

Catherine Marinoff, art director, 786/293-1577, catherine@marinoffdesign.com

Erin Kennedy, office, meetings administrator, and associate editor, AOPA in Advance, 571/431-0834, ekennedy@AOPAnet.org

Dean Mather, advertising sales representative, 856/768-9360, dmather@mrvica.com

AOPA Bookstore: 571/431-0865

Steven Rybicki, production manager, 571/431-0835, srybicki@AOPAnet.org

GOVERNMENT AFFAIRS

Immediate Past President Brian L. Gustin, CP, BridgePoint Medical Inc., Suamico, WI

Kathy Dodson, senior director of government affairs, 571/431-0810, kdodson@AOPAnet.org

Executive Director/Secretary Thomas F. Fise, JD, AOPA, Alexandria, VA

Erin Kennedy, staff writer, 571/431-0834, ekennedy@AOPAnet.org

Visit O&P Almanac online at www.AOPAnet.org.

Devon Bernard, reimbursement services coordinator, 571/431-0854, dbernard@AOPAnet.org Joe McTernan, director of reimbursement services, 571/431-0811, jmcternan@AOPAnet.org Reimbursement/Coding: 571/431-0833, www.LCodeSearch.com a

Vice President Bert Harman, Otto Bock Health Care, Minneapolis, MN Treasurer James Weber, MBA, Prosthetic & Orthotic Care, Inc., St. Louis, MO

DIRECTORS Kel M. Bergmann, CPO, SCOPe Orthotics and Prosthetics Inc., San Diego, CA Rick Fleetwood, MPA, Snell Prosthetic & Orthotic Laboratory, Little Rock, AR Russell J. Hornfisher, Becker Orthopedic Appliance Co., Troy, MI Alfred E. Kritter, Jr., CPO, FAAOP, Hanger Prosthetics & Orthotics Inc., Savannah, GA Anita Liberman-Lampear, MA, University of Michigan Orthotics and Prosthetics Center, Ann Arbor, MI Mahesh Mansukhani, MBA Ossur Americas, Aliso Viejo, CA

2010 EDITORIAL ADVISORY BOARD Rick Bowers Amputee Coalition of America

Joel J. Kempfer, CP, FAAOP Kempfer Prosthetics Orthotics Inc.

Rick Fleetwood Snell Prosthetic & Orthotic Laboratory

Tabi King Ossur North America

Steve Hill, CO Delphi Ortho

Anita Liberman-Lampear, MA University of Michigan Orthotics and Prosthetics Center

Russell J. Hornfisher Becker Orthopedic Appliance Co. Fran Varner Jenkins Fillauer Companies Inc.

O&P ALMANAC APRIL 2010

David Rotter, CO, CP, LO, LP, L.Ped Scheck and Siress Gary Steren, CPO Cornell Orthotics & Prosthetics Inc.

John H. Reynolds, CPO, FAAOP, Reynolds Prosthetics & Orthotics Inc., Maryville, TN Lisa Schoonmaker, CPO, FAAOP, Tandem Orthotics & Prosthetics Inc., Sartell, MN Frank Vero, CPO, Mid-Florida Prosthetics & Orthotics, Ocala, FL Copyright 2010 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 AOPA, nor does the association necessarily endorse products shown in the Almanac. The Almanac is not responsible for returning any unsolicited materials. All letters, press releases, announcements, and articles submitted to the Almanac 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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In the News

Photo: AP Photo/Ramon Espinosa

Surgeon Challenges Routine Amputations in Haiti

In this photo, taken February 18, Petersen Hilan is carried by a friend through the rubble of his earthquake-destroyed home after being hospitalized in Port-au-Prince. Hilan lost his leg when his house collapsed in the quake.

TRANSITIONS

Dr. Radu Litiu has joined Orthocare Innovations as software architect. Most recently, he was a senior software engineer for aQuantive (now Microsoft Advertising). He previously held software development positions at both Amazon.com and Microsoft Corp., as well as at Valaran, a software startup in Princeton, New Jersey.

O&P ALMANAC APRIL 2010

injuries, which may not be necessary. Earthquake-related injuries, especially for young patients, may have more healthy tissue surrounding the damage. If victims can be seen in time, plastic surgeons can cooperate with orthopedic surgeons to save patients’ limbs and avoid unnecessary amputations. It’s critical, however, that doctors treat patients as soon as possible after they are injured. If infections set in, saving limbs is much less viable. Also, saving limbs is particularly important in a country like Haiti, where amputees are more likely to face ostracism and extreme poverty. For more information, visit www. washingtonpost.com.

PEOPLE IN THE NEWS

Christopher Lange, CPO, has been promoted to practice manager of Hanger Prosthetic & Orthotics patient-care centers in Ithaca and Horseheads, New York. Lange joined Hanger in 1995 and has been delivering clinical care to patients at Hanger facilities in Geneva, Auburn, Syracuse, and Johnson City, New York. He also works on the National Ski Patrol at local ski areas.

Many orthotics and prosthetics practitioners and businesses have made generous commitments of materials or volunteer time to aid the thousands of Haitians who suffered limb loss as the result of the January earthquake. Thousands of Haitians also have reportedly undergone amputations. But a team of British plastic surgeons and orthopedic surgeons, who arrived soon after the quake, have focused on efforts to limit or prevent amputations. Part of the emergency response team sent to Haiti by the British medical charity, Merlin, Dr. Waseem Saeed, a plastic surgeon, reports that earthquake injuries are too often treated like battle

Litiu also was a visiting research professor at Rutgers University, researching utility-based adaptation in mobile-computing applications and game theoretic approaches for building adaptive mobile applications. Litiu received his PhD in computer science and engineering from the University of Michigan. Ashli Speicher, CO, has joined Hanger Prosthetics and Orthotics in its Lafayette, Colorado, patientcare center. Speicher earned her bachelor’s degree from the University of Phoenix and her certificate in orthotics from the Northwestern Feinberg School of Medicine’s Prosthetics-Orthotics Center.

Robert Sutton, CO, brings more than 20 years of patient-care experience to Hanger Prosthetics and Orthotics’ patient-care center in Tallahassee, Florida. Sutton attended Central Florida Community College and Santa Fe Community College. Brian Tallman, CPO, has been promoted to practice manager of Hanger’s patient-care center in Vancouver, Washington. Tallman holds bachelor’s degrees in both chemical engineering and in prosthetics and orthotics from the University of Washington. He began his career in 2005 with residencies at Hanger’s facilities in Connecticut.

In the News Amputee-Athletes Set the Pace for Prosthetic Advances

Not many amputees can hope to match the running prowess of athleteamputee Oscar Pistorius. But, advances in prosthetic technology developed for elite athletes like Pistorius may well benefit many amputees who are eager to just stand and walk. Recent such advances include: • Energy-storing feet accelerate forward motion for amputee-athletes.

IN MEMORIAM One of the earliest certified prosthetists in the field, Howard V. Mooney, CP (E), of Lowell, Massachusetts, age 96, died peacefully at his home on Dec. 23, 2009. He is survived by his wife, Alberta (Ringer) Mooney, with whom he celebrated 68 years of marriage in August 2009. Mooney was born March 25, 1913, and began his apprenticeship in 1937. He became the 45th prosthetist certified by ABC. Mooney served as president of the New England Society of Orthotics and Prosthetics and was named manager of Boston Artificial Limb Company in 1956. In 1972, he achieved the designation of qualified prosthetist under the then new Veterans Administration rating, receiving VAQ #402. A prosthetic consultant at various amputee clinics for more than 30 years, Mooney also lectured at numerous universities in his area and contributed to many professional and scientific journals. He retired in 1981 after 44 years in the field, and was awarded emeritus practitioner status by the New England Chapter of the American Academy of Orthotists and Prosthetists. 8

O&P ALMANAC APRIL 2010

TRANSITIONS

• Strong, thin, lightweight materials, like carbon graphite, enable athletes to run faster and also can improve daily activities for any amputee. • Silicone gel liners that increase athlete comfort while in action also have become an industry standard to help decrease skin ulcerations during everyday activities for amputees. Learn more at www.lerresourceguide.com.

BUSINESSES IN THE NEWS

The American Board for Certification in Orthotics, Prosthetics & Pedorthics (ABC) is seeking nominees for three positions on its board of directors. Each position is for a four-year term, beginning Dec. 1, 2010. The directors will be voting members of the board and will participate in overseeing general management of the organization’s affairs, including policy development, governance, and budgetary matters. Nominees for the open positions must be ABC-certified orthotists, prosthetists, or pedorthists with a record of volunteer involvement with ABC or the former Board for Certification in Pedorthics. All submitted nominations will be evaluated by the nominations committee and the board of directors. This selection process follows norms set for certification boards and is fully compliant with the standards of the National Commission for Certifying Agencies. The deadline to submit nominations is June 1. For more information or to formally submit a nomination, please contact Steve Fletcher, CPO, at sfletcher@ abcop.org or 703/836-7114, ext. 216.

The city of Austin, Texas, has agreed to pay a $500,000 incentive to Hanger Orthopedic Group Inc., to move its headquarters to Austin from Bethesda, Maryland. In turn, Hanger will invest $7.65 million and create 300 jobs in the next six years. The state also is providing a $1.5 million Texas Enterprise Fund grant. The International African American Prosthetic & Orthotic Coalition, in cooperation with Physicians for Peace, is collecting donations of used prosthetic devices, feet, parts, and prosthetics socks. These donations will be shipped to Haiti, where they will be used in a pre-existing facility supported by Physicians for Peace. Donations can be sent in care of the American Orthotic & Prosthetic Center, 1521 Technology Drive, Chesapeake, VA 23320. Orthocare Innovations LLC, has completed a significant equity investment with Schooner Capital, LLC, a Boston-based private investment group. The investment supports the commercial launch of Orthocare’s new product pipeline.

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Reimbursement Page By Devon Bernard, AOPA government affairs department

Managing Refused and Returned Devices Three questions help you determine next steps

his month, we will examine billing issues related to returned and refused devices, and provide tips and guidelines to help you with these situations—and any similar questions you may have. Here are some questions we routinely receive at AOPA: • I have a patient who is refusing to pick up his or her device; am I able to bill Medicare? • If I am able to bill Medicare, how do I submit the claim? • I have a patient who’s returned his or her device; do I have to refund Medicare?

longer medically necessary, ask yourself three questions, which will help determine your course of action and also clarify if you have the right to bill Medicare. • First, is the device you were to provide an off-the-shelf item, or is it a custom-fabricated device? If the item is an off-the-shelf product, you may not bill Medicare because you are able to return the item to stock and can reuse it. • Second, if you were providing a custom device, was the fabrication of the device completed, or were you still in the midst of fabrication?

Refused Devices First, it’s important to establish a definition for “refused,” especially as it relates to Medicare billing. The simplest definition is the patient just doesn’t want the device and never comes back to your office to pick it up. A device also may be considered refused if the patient no longer needs it, or the item is no longer medically necessary. The change in medical necessity, or refusal, may be the result of a change in a patient’s condition. For example, you were going to provide a patient with a knee orthoses (KO), but before you were able to deliver the KO, the patient decided to have surgery. Since the patient chose a different means of treatment, the brace may no longer be needed, or medically necessary. The device has now just been refused. Similarly, if a patient dies before you are able to deliver the device, it is no longer medically necessary, and the device is refused. Once you are aware that a patient has refused a device, or the device is no 12

O&P ALMANAC APRIL 2010

If you are providing a custom device, and you have not finished fabrication when you learn of the refusal, you may only bill for the work that you have completed. The answer to this question will determine how much you are able to bill. If you have completed fabrication, you may bill for the complete device—well, almost. You must first determine if any of the parts used in the fabrication may be salvaged and reused. This may be a rare situation, because most parts in a custom device are altered in a way that makes them useful only for one specific patient. However, if there are parts that can be salvaged and

reused, you may not bill for those components. If you are providing a custom device, and you have not finished fabrication when you learn of the refusal, you may only bill for the work that you have completed. You would submit your claim with an estimated cost of your services. Once again, you must subtract the cost of any parts that may be salvaged and reused. What about prefabricated items? These devices may not necessarily be off-the-shelf items or custom items. You would follow the rules for a custom-fabricated device, only if you have altered components of the prefabricated device so that it can no longer be used for a different patient. If you did not alter the prefabricated device, treat it as an off-the-shelf item, return it to stock, and do not bill for the device. • Third, when did you learn about the refusal? The date you learned about the refusal, or the date you learned the device was no longer medically necessary, will become your date of service when billing. If the patient has died, your date of service is the date of the patient’s death. If you use a date of service that is after the date of the patient’s death, your claim will be denied. If the patient has truly refused the item and just will not pick it up, your date of service would be the last day you attempted to deliver

Reimbursement Page

The EDUCATION You Need From The EXPERTS You Require 2010 Telephone Audio Conferencing During these one-hour sessions, AOPA experts provide the most up-to-date information on the following topics. Perfect for the entire staff—one fee per conference, for all staff at your company location ($99 Member/$199 NonMember). A great team-building, money-saving, educational experience! Sign up for the entire series and get two conferences FREE. Entire Series ($990 Member/$1,990 Non-Member).

UPCOMING AUDIO CONFERENCES: April 14

Documenting for Success: Chart Notes, Prescriptions and Physicians’ Records

May 12

New Rules for HIPAA: Are You Still Compliant?

June 9

When Disaster Strikes: Implementing a Contingency Plan

July 14

Medicare Appeals Strategies

August 11

Medicare’s Knocking: How Good Is Your Compliance Plan?

September 8 Missed Billing Opportunities: Are You Billing Everything You Can? October 13 You’re Going To Pay Me WHAT?...Hints on Managed Care Contracting November 10 The Ins and Outs of Billing in a Part A Setting: Hospital, SNF and Hospice December 8 2011 New Codes and Medical Policies

O&P ALMANAC APRIL 2010

the item. Be sure to document all attempts you made to deliver the item. There is no minimum or maximum number of attempts required to declare a device refused, but we recommend at least three attempts. If patients still refuse to pick up the item, you may wish to notify them of your intent to bill for the item. It is not necessary, but using a certified letter to inform them of your intent to bill will provide documentation such as a signed receipt of the letter, which confirms that you communicated with them about opportunities to pick up the device and that you are billing for the item.

It is vital that you not destroy the refused device after you have billed for the item. Once you have obtained the answers to the three questions above, submit your claim as if the item was not refused. No special modifiers are required. Just document in your records that the device was refused. It is vital that you not destroy the refused device after you have billed for the item. If the patient decides he or she wants the item, or it becomes medically necessary again, you must be able to provide the patient with the device since you have billed and collected payment for that device. If you don’t have the item, you will have to provide an exact item, but you will not be able to charge the patient for the second one. Retaining the device for its useful lifetime would be ideal, but this may not be practical. If not, at least hold onto the device for as long you feel is appropriate or until you believe the patient will no longer want the item.

Returned Devices Handling returned devices is a little trickier than refused devices. First, you must comply with the supplier standards. According to Supplier Standard 15, a supplier must accept returns from beneficiaries of substandard or inappropriate items. If the patient is trying to return an item, saying that it is substandard, the onus is on you to prove that the item is not substandard and was appropriate for what was ordered. To help you prove an item is not substandard, be sure to document all encounters with the patient, including all attempts that you made to make the device satisfactory to the patient’s needs. This documentation should begin with the initial delivery of the item. Consider having patients sign the delivery slip, indicating they were satisfied with the item at the time of delivery. And if they had concerns, make sure to document those concerns and what you did to address them. If the device cannot be adjusted to satisfy the patient and he or she still returns the item, you are under no obligation to make a refund to the patient. The only time you must refund the money is if Medicare sends you a formal request for a refund. You may then appeal the refund, and show that you provided what was ordered and made a good-faith attempt to satisfy the patient. This is where your documentation of how you tried to satisfy the patient will come into play. It is also a good idea not to destroy the device in case the patient changes his or her mind. Just remember, even if a device was refused or returned, you have the right to bill. After all, you did the work, and you should collect for your services. a Devon Bernard is reimbursement services coordinator for AOPA. Reach him at dbernard @AOPANet.org.

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O&P ALMANAC APRIL 2010

Quick with crisis response, the O&P industry commits to long-term care for amputees

ust days after the devastating earthquake in Haiti left thousands of people missing, dead, or alive but seriously injured, some brave and dedicated members of the O&P community touched down amidst the rubble to help. ”Upon first arriving in Port-au-Prince, I thought a war had started—minus the gunshots—with the large numbers of helicopters swirling around the airport and military personnel and equipment on the tarmac and airfield,” says Al Ingersoll, CP, Healing Hands for Haiti International Foundation. He was dropped off in the middle of the airfield alone and was quickly left there by the pilot who had to be back in the air almost immediately. “My colleagues were nowhere to be found, my phones didn’t work, and the one contact name I had didn’t know where to pick me up. Fortunately the Canadian Broadcasting Corporations equipment was on the same plane as me, and they came looking for it—and rescued me,” he explains. “We saw some awful things down there, as you can imagine,” says Kevin Carroll, CP, FAAOP. “We saw a huge need for help, and a tremendous commitment from everyone in the field.” Carroll, who is vice president of prosthetics for Hanger Prosthetics & Orthotics, spent days talking with physicians and patients in hospitals to assess equipment needs, ways that O&P practitioners could best assist, and the special considerations to ensure longterm support for injured Haitians. “We really have to think about

people who are being discharged,” he says. “Where are they being discharged to? They’re not going home, because there is no home to go to. They’re going to a tent somewhere.” Doctors in Haiti estimate that more than 200,000 people will have been left without at least one limb by the time infrastructure rebuilding begins, and the country’s resources were already stretched thin before the earthquake.

More than 200,000 people will have been left without at least one limb by the time infrastructure rebuilding begins. “Eighty percent of people coming into the hospital in Haiti have orthopedic injuries,” says Kendra Calhoun, CEO of the Amputee Coalition of America based in Knoxville, Tennessee. “Almost 70 percent of those people have lower-limb injuries and among that percentage, above-the-knee amputations are the majority.” This means a massive need for help and equipment. “As clinicians across the O&P community, this is what we do every day,” says Carroll. “And now we’re reaching into our pockets and asking when we can go down there to help. And it’s all heartfelt.”

Launching a sustainable effort for long-term care, he says, is key to making a significant difference in Haiti. And a large group of orthotists and prosthetists already is working to make that happen.

Helping Hands In February, Hanger’s philanthropic organization, The Hanger Ivan R. Sabel Foundation, announced the formation of the Haitian Amputee Coalition. Founded in partnership with Physicians for Peace, the Harold & Kayrita Anderson Family Foundation, and Donald Peck Leslie, MD, of the Shepherd Center, the coalition is establishing a long-term care center for amputees at the Hôpital Albert Schweitzer, an undamaged hospital about 60 miles from Port-au-Prince. “Before the Haiti tragedy, the mission of the foundation was to provide O&P services, products, and education to underserved parts of the world on a sustainable basis,” says founder Ivan R. Sabel, chairman of the board and retired CEO of Hanger. “Through the years, no one has effectively created real sustainable projects or a sustainable presence anywhere else. And along comes the tragedy in Haiti and we really had a mission to rally around. “Our 3,800 associates have raised money and lots of donations in terms of people who are willing to volunteer their time or give materials,” says Sabel. They also immediately began securing space in the hospital to open a permanent O&P clinic.

APRIL 2010 O&P ALMANAC

“My goal is to get this clinic stocked, running, and operational as quickly as possible,” says Jay Tew, CP, who will be the lead practitioner at the clinic and has committed to a longer stay in Haiti. “I’d like to start evaluating and treating patients the first week, if at all possible. I want someone to be up and walking that week.” A temporary lab was already in place, and equipment for a permanent lab had been secured and shipped prior to Tew’s arrival in Haiti to set things up and begin treating patients. Tew and a technician will spend three months at the hospital, and volunteer practitioners will join him on a rotating basis, with most spending about two weeks in Haiti and some committing to more. As of early March, Hanger had sent teams to Haiti for three site visits and had shipped a mobile lab, donated by Otto Bock, to the hospital. That will allow practitioners to reach out to the community around Port-au-Prince and help people who couldn’t be treated at the hospital for whatever reason. The mobile lab was originally created as a show trailer, says Jeremy Driskell, Otto Bock’s sales and

O&P ALMANAC APRIL 2010

marketing manager. “It has all of the equipment needed to be a fully functional lab, but we were originally using it to go around from state to state and location to location to do demonstrations and help teach. When the earthquake happened, we saw what we had.” The mobile lab was shipped to the Dominican Republic, and from there to Haiti, where it is helping practitioners and doctors treat patients. “It has everything—small tools, dust extractors, routers, work benches, casting devices, and a diesel generator,” says Driskell. “You turn on the generator and have power for all of the equipment, and they’re doing casting every day with it.” While the O&P equipment is standard, practitioners did need to be trained on the generator and how to get things moving once that kicked in. As of late March, the lab was parked near a hospital, and while it may move around the country as needed, it will stay in region indefinitely. Otto Bock also provided the Johanniter International, a nonprofit association based in Belgium, with a

Photo by Jay Fletcher, www.haiti-earthquake.us

Ron May, SPS president, visits with children in Haiti in late January 2010

functional lab and components and materials to fit below- and abovethe-knee patients. The company has coordinated efforts with Healing Hands for Haiti to transport four fully equipped office-style containers as well. Similarly, other industry organizations also have recognized their “responsibility,” as Össur President and CEO Jon Sigurdsson describes it, to donate funds and devices to support what will be an on-going need. Össur is coordinating efforts to donate products, including orthopedic braces, supports, and prosthetics, with AOPA and Project Medishare, which was already working in Haiti prior to the quake and has direct access to the Port-au-Prince airport and medical personnel treating the injured. “Many different P&O organization are helping in Haiti, with estimate numbers pretty consistently around 20,” Ingersoll says. He, along with representatives from the International Committee of the Red Cross and Handicap International assessed the current facilities, organizations involved, and mid-term plans. A national plan for O&P education also has been drafted, he says.

Devastating Injuries Broken bones, open wounds, and resultant infections are the most common conditions Ingersoll witnessed. “Guillotine amputations happened initially but are now being revised,” he adds. Initially, prefabricated splinting and support orthotics were in huge demand, but because so many of the injured have not yet healed, the need for long-term orthotic usage is still hard to determine. Beyond that, patients also are in need of physical and occupational therapy to helping with strengthening, stretching, gait training, and more, says Ingersoll. Many Haitians who need prosthetics are the victims of crushed limbs or non-surgical amputations, which have left them with non-optimal remaining limbs for prosthetics. “We’re dealing with irregular shaped ends, abnormally

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shaped limbs, bulbous Overwhelming endings—all the things Response you don’t want to see post-operative,” says Sabel says the Tew. “We’re going response to his call for to come across those volunteers to visit Haiti sorts of things far more has been nothing short frequently than we do in of incredible. the States.” “We’ve been over“We’ve seen people whelmed by the with self-amputations response we’ve gotten,” they were forced to do he says. “We’ve raised to get out of the rubble,” a considerable amount Calhoun says. “There of money for this effort, are different types of and we’ve had more non-surgical devices volunteers than we’ll being used. We have be able to use,” he says. pediatric urologists “The response has been performing amputations. very heartwarming.” It’s not optimal.” “Our first point of They also face patients contact has always said who’ve been forced into ‘yes’ to anything we’ve self-care for their injuries, asked for,” says Carroll. which can complicate “There has never been the proper fitting of a ‘no’. I saw down there prostheses. a bag of food that was “The problem is labeled ‘Food from the that there are so many American People.’ That amputees,” says Carroll. was very touching. Liv Pou Moun-n Ki “The surgeons are doing I’m sort of envisioning Gin Pié Ki Koupé-yo their work, but people ‘Limbs from the Amerare just everywhere and ican People.’ they have to take care of “People are coming themselves in some cases. together and really “Many of them are working to help,” he laying in bed with continues. “It’s incredTop: Frank Shirley, CO, (left) and Al Ingersoll, CP, (back right) at Port-au-Prince’s General their limbs flexed—in a ible to watch and see. Hospital fetal position—and we’ve And the people there Left: Self-care brochure translated into been trying to show them to are amazing. Even at French Creole keep their legs straight and their worst moment, and other sources. “A lot is lost stretched and bandaged correctly,” they’ll still look at you with a smile and in translation,” says Carroll, “and he says. But that’s not easy, given tell you they appreciate you’re there. I we knew we had to come up with language barriers and patients who haven’t seen any anger.” something with lots of pictures.” may leave quickly following treatment. “I initially volunteered in Haiti Carroll started work on the After his first trip to post-eartheight years ago after being asked to brochure on a Sunday morning. After quake Haiti, Carroll began looking join a Healing Hands for Haiti Minnelearning about the project, the printer for ways to communicate to patients sota team that Mark Kroll, CO, was did a rush job, enabling the brochures about self-care. He decided to create leading,” says Ingersoll. Since then, to be available in Haiti on Monday, a brochure featuring both illustrahe’s led two teams and started coordiready to be distributed to patients in tions and text in native French Creole nation of the Healing Hands for Haiti and out of hospitals. on how to care for an amputation (see O&P clinic in Port-au-Prince. “It usually takes, what, a week to above left). Ingersoll stresses the importance do something like that?” he says. “We “We had a Haitian physician help of coordinating volunteer efforts with had it done in 24 hours. People have us translate into French Creole,” he existing organizations’ teams. “The really responded to this effort, and it’s says, and a volunteer artist helped problem right now is that so many been amazing.” clean up illustrations found in books teams are booked that finding an open Katolik Medikal Misyon Bòd

O&P ALMANAC APRIL 2010

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O&P Community Unites Within days of the earthquake in Haiti, the O&P community coordinated efforts to fulfill the needs of those affected by the tragedy. The American Orthotic and Prosthetic Association and the American Academy of Orthotists and Prosthetists combined what had been separate information appearing on their respective Web sites into one unified O&P Haitian Relief information site accessible from the home pages of each organization (www.oandp.org and www.AOPAnet.org ). This one-stop site enables members of the O&P community and the general public to register their response to the tragedy ranging from donations of cash and used components to volunteering their time. The list below contains the names of those responding as of March 26, 2010. Thanks to all who have responded to date and to those who will open their hearts to the needs in Haiti in the future. Dennis Acton, NEBCO Foundation - Haiti Amputee Rehab Team Karen Acton, PT, CO, New England Brace Company Amanda Barizo, George Brown College, P&O Jon Batzdorff, CPO, Sierra Orthopedic Lab Jeremy Bilow, CO, Dynamic Orthotics and Prosthetics Greg Birkholz, World Hope Foundation George Breece Michael Caputo, JK Prosthetics and Orthotics Laura Childs Keith Cornell, CP, Cornell Orthotics and Prosthetics Don DeBolt, American Orthotic & Prosthetic Association K. Dhanasekaran Heather Dressler, WestMed Rehab Inc Anne DuBois, O&P Student- St. Petersburg College Sarah Dunton, CPO, Cornerstone Prosthetics and Orthotics Melanie Dye, CO, J&K Orthopedics Robert Emerson, CP, NOPCO David Falk, CPO, Falk Prosthetics and Orthotics Inc. Keith Frost, CPO, Methodist O&P Bryan Fust Gabriel Galster, Sr., BOCPO, New Hope Prosthetic and Orthotic Services Inc. Kevin Gilg, CP, Gilg Prosthetics Inc. John Griffin, CPO, Orthopedic Rehab Systems Richard Grisard, CO Steven Hamontree, CPO, Prosthetic Care Inc Teresa Hayes, Braintree Rehabilitation Hospital Hilmo Hodzic, CP, Fidelity Orthopedic Inc. John Horne, CPO, Independence ProstheticsOrthotics, Inc. Mark Horwitz, CPO, OrPro P+O Toby Janowitz, CPO, Antelope Valley Orthotics and Prosthetics James Kaiser, CP, Scheck & Siress Prosthetics Inc. William Leimkuehler, CPO, Leimkuehler Orthotic and Prosthetic Center Inc. Vladimir Lemus, SCOI-California Lerman and Son Michael Lewis, CPO, Acme O&P Lab Karen Lundquist, Otto Bock HealthCare 22

O&P ALMANAC APRIL 2010

Linda Martin, RTP, Farrell Prosthetics Jesse Mejorada, CP, LP, Bardach - Schoene Company Inc. Robin Merriam, CPO, Merriam Prosthetics Orthotics Steven Mirones, CPO, C.Ped, Arimed Orthotics Prosthetics Monroe BioTechnology Inc. Michael Murphy, CPO Sander Nassan, CPO, FAAOP, Prosthetic - Orthotic Associates Warren Nelson, CO, Suburban Orthotics and Prosthetics Erin O’Brien, Dynamic Orthotics and Prosthetics Raphael Ogunyemi, RPT, Kesler Rehab O&P Department Michael Richard, CPO, Advance Prosthetics and Orthotics Inc. Mike Russell, CPO, Lexington Prosthetics and Orthotics Inc. Erich Schulze, CPO, C.Ped, Northern Prosthetics and Orthotics David Sisson, Sisson Mobility Restoration Center Inc Paulette Stefanik Leslie Swanker, CFm, Mercy Health Partners Orthotics & Prosthetics Debbie Sweeney, CPO Jason Tanner, CPO, Ark Valley Orthotics and Prosthetics Teresa Thorpe, CO, American Limb and Orthotic Center Inc John Tiess, SCOPe - Southern California Orthotics and Prosthetics William Truesdale, CP, East Carolina Brace & Limb Co Inc Doug VanAtta, CPO David Varnau, CPO, LP, Center for Prosthetics Orthotics Frank Vero, CPO, Mid-Florida Prosthetics & Orthotics Matthew Walle Thomas Walsh, L, Abilities In Motion Stuart Weiner, CPO, Nouveau Prosthetics and Orthotics Cindy Whitehurst, Riverside Prosthetics

slot can be difficult,” he points out. He also suggests practitioners with international experience start training and supporting first timers. “We’ve had a lot of people contact us to see what they can do,” says Limbs for Life Executive Director Craig Gavras. He says the outpouring of offers of equipment and volunteer time from the O&P community has been outstanding, with phone calls and e-mail coming to his office steadily since the earthquake.

“To go into a situation like that and practice always feels like the purest form of what we do. You meet amputees and realize they need that leg not only for their quality of life, but also to actually save their life.” –JAY TEW, CP

Like many volunteers, Tew says he simply felt called to go. He volunteered at a clinic in Mexico several years ago and says he’s missed that kind of work. “Since them, I’ve felt like I was missing something,” he says. “To go into a situation like that and practice always feels like the purest form of what we do. You meet amputees and realize they need that leg not only for their quality of life, but also to actually save their life. In these countries, it’s well known that if you can’t take care of yourself, nobody else is going to take care of you. A lot is riding on these people being able to take care of themselves and take care of their children.”

Photo by Jay Fletcher, www.haiti-earthquake.us

“I was at home with my wife as the situation in Haiti unfolded,” says Tew. “I looked at her and said, ‘I think I’m going to go to Haiti.’ It just happened. I had this feeling I was going to go.” When he heard about the Sabel Foundation’s goal to open a sustainable clinic, he signed up for the challenge. “I volunteered like everyone else,” he says. “The doors have opened, and I just keep walking Kevin Carroll, Hanger’s through them. I feel like this vice president of is an opportunity for me. orthotics, visits with Everything that has stood a child in Haiti in late in my way since then has January 2010 dissolved, by no act of mine. I feel like I’m being led, and I’m going to keep following.” for some time. “I think we’re going Sabel says many practitioners feel to see a lot of secondary infections the same way and have signed up to and limbs that couldn’t be saved,” help on the foundation’s Web site: he says. “I think we’re going to www.hanger-sabelfoundation.org. see amputations for awhile. It’s a “People outside Hanger can contact minimum five-year project.” us and volunteer anything they’d like,” he says. “We’re looking for services, equipment, money—anything. This is Making a Difference open to anyone and is not just solely Those who go to Haiti should be a Hanger effort. We’re in the midst of prepared not only to make a tremencreating an independent board of direcdous difference in the lives of their tors for this effort, and we hope people patients, but also to see often shocking will see this as a viable opportunity to conditions, says Carroll. get involved in philanthropic efforts.” “You do see bodies in the streets,” “We’re looking for local people we he says. “You never know how you’re can teach to fabricate prosthetics,” says going to react to that until you get Tew. “We’re going to bring people back there and see it. For me, the biggest to the States to learn central fabricaeffect of that was to think about what I tion and for higher levels of training. can do to help this group put together Eventually, we hope this center will a lot of money, and my next big push be run by the Haitian people with will be to find finances to continue the support of Hanger and the Sabel with this venture.” Foundation.” Tew says he took time to before his “The person who’s there a year from departure to Haiti trying to prepare now is as equally critical as the people himself for the experience. “I talked who are there this week,” says Carroll. to the doctors who told me a bit about “This is a sustainable effort. Several what to expect. I’ll do the best I can, schools have made offers to us to help and I realize that no matter what we get Haitian people here and trained, have to do, it’ll get done. The good which is also going to be critical.” that we’re doing will outweigh any of Gavras agrees that the need for the bad we have to deal with.” O&P help in Haiti will continue Calhoun says there are plenty of

opportunities to help even for those who can’t commit to several weeks of hands-on work in Haiti. “There is a huge need for all types of mobility devices for amputees in Haiti right now,” she says. “We’re looking for prosthetic devices, and also for wheelchairs and crutches—anything that can help.” Hanger has drop-off points at all of its locations for any kind of device. Tew says that beyond the personal fulfillment of the work he’ll do in Haiti, he thinks the earthquake provides a unique call to the entire industry. “Due to the injuries there, this is the only time I can ever recall that we’re going to be able to go in and offer hands-on help,” he says. “With our professional skills, we have a unique opportunity. We’re a small demographic of the health-care spectrum, but we’re going to be a major component of helping people there.” “This is bigger than me and bigger than all of us,” he says. “I don’t see how this is something you can do and come home as the same person. You won’t have the same outlook on life.” a Kim Fernandez is a contributing writer for O&P Almanac. Reach her at kim@kim fernandez.com.

APRIL 2010 O&P ALMANAC

Health-Care Reform: Myths and Realities After a roller-coaster year, AOPA’s executive director contemplates enactment of health-care reform, its implementation, and follow-up future legislative efforts By Tom Fise, JD, AOPA’s executive director

hen I wrote the first draft of this article, I said that it reminded me of the very old song by Peggy Lee called, “Is That All There Is?” with its disillusionment that there isn’t something more to life. Then, I was wondering—after a year of bills, proposals, votes, town hall meetings, Christmas Eve sessions of Congress, an election in Massachusetts, and literally billions of dollars spent by special interest groups on direct lobbying (a very small portion of which was AOPA’s tab) to try to shape public opinion—Is that it? Is it over?

O&P ALMANAC APRIL 2010

Well, obviously, the game wasn’t over. Now I sit re-writing this article on Sunday, March 21, as I watch the U.S. House, committed to a course which later today will have them voting to enact a health care form law—initially, being the House’s reluctant endorsement of the precise bill enacted in December by the U.S. Senate. The expectation is that a series of fixes, or revisions, embodied in a budget reconciliation bill, (once it passes in the House) also will gain approval by the

Senate and correct several perceived shortcomings in the December Senate health-care reform bill. While much will change with that action, the game still won’t be over. In essence, enactment of healthcare reform is just the beginning of a new phase—one of implementation, rule-making, and new structures to transform these concepts into action.

First and foremost, with or without health-care reform, there is still at least one 800-pound gorilla looming—the “doc fix.” This is the perennial shortterm legislative “fix” to postpone a 21 percent reduction in physician fees that was mandated by previously passed legislation. Congress regularly passes legislation to postpone the reduction, and they did it again this session, postponing the fee reduction a couple of months. Because fixing the current default rules would reduce the physician fee schedule each year, roughly $200 billion, Congress chose not to include this fix into the health-care reform law.

In early March, Congress faced the real threat that without some sort of “doc fix,” those across-the-board 21 percent Medicare payment cuts to physicians would actually take effect March 1. Many think that this would be the shot heard round the world—not the sort of thing you’d want to have happening when much of the population was already worried about the prospect of big Medicare cuts as a side effect of health-care reform. Congress promptly placed a provision in a jobs bill that did what it tends to do with this issue year after year—it kicked the can down the road a bit farther.

There has been an effort to build the temporary increase in physician Medicare rates back up to what they were at the end of 2009 in the Congressional jobs bill. With health-care reform enacted, Congress will have to face up to this automatic Medicare fee schedule reduction. Because it won’t want to jitter the public with another $200 billion price tag, Congress almost certainly will pass a modest Medicare bill to temporarily fix the physician fee schedule—perhaps for six to nine months—and then have to tackle the whole issue again in advance of the November elections.

[ Their Take ]

O&P Almanac recently caught up with Kendra Calhoun, president and CEO of the Amputee Coalition of America, and Tom Scully, senior counsel for Alston & Bird and former administrator of the Centers for Medicare & Medicaid Services to gauge their thoughts on the health-care reform process to date.

Question: What is your reaction to the reform efforts so far?

Calhoun: The health reform effort has been a roller coaster ride— and still is. The Senate bill currently at play includes “habilitative and rehabilitative services and devices” in its basic benefit set language. But this language is less robust than the House language, which we preferred. The House language specifically included “prosthetic and orthotic devices.” Scully: Insurance reform and universal coverage are long overdue, although I might not go about them the way Congress is proceeding. The spending is far more than is need— especially during a time of $1.6 trillion per year deficits, which is about

10 percent of the annual U.S. gross domestic product. So, I worry about how we afford all this. In general, it’s bad for taxpayers because of all the new taxes and fees. But for the health sector, including O&P, there will be many more people with insurance and many more people who can afford appropriate insurance. But, I’d be happier if we weren’t just issuing bonds—and borrowing from China to pay for it!

Question: What aspects of the

legislation are the most critical? Calhoun: The most critical aspect for our health-reform efforts has been the inclusion of prosthetic and orthotic devices. While both the House and the Senate reform bills include devices in the basic benefits, specific language regarding parity was not included in either of the health-reform bills. We continue our efforts to move H.R. 2575 (the prosthetic and orthotic parity bill) forward and to introduce the prosthetic and orthotic parity bill in the Senate.

Scully: Critical provisions that impact O&P are the ones that advance competitive bidding, now limited to durable medical equipment but with a potential impact on orthotics. Early returns indicate very substantial Medicare savings, making this a trend in Medicare virtually inevitable. Also, all Medicare providers including O&P are subject to “productivity adjustments” that would reduce fee schedule payments. Neither of these things is good for O&P, but they are small in the context of the huge cost of the health bill. I think it is a shame they seem to be dropping the best provisions, such as the “Cadillac Tax” in the Senate, and adding more and more spending, mainly in Medicaid. It’s a sloppy process, but it is very likely to happen, and people need to plan for it. The insurance reforms and exchanges are totally on target, but much of the rest of the bill is far bigger than it needs to be.

APRIL 2010 O&P ALMANAC

Spending vs. Saving Even if health-care reform legislation had not been enacted, some very nefarious possibilities still would have loomed. In assembling the healthcare reform bill, the administration and Democrats aggregated about $800 billion in “savings” that could be enacted in the health-care system to “pay for” the costs of reform and providing universal coverage. If not expended on health-care reform, these cuts wouldn’t have been frozen. Those “savings” are not going to sit fallow. At least some portion of those savings, including a portion of the $500 billion in projected Medicare savings during the next 10 years, would have been enacted—but to reduce the deficit. In that event, the country might have been better off with a lessened deficit saddling our nation and our children in years ahead. Conversely, however, the health-care sector would be reluctant to pay the price in terms of taxes and potential reductions in fees and other revenues without the offsetting benefit of improved insurance coverage that could expand markets (or at least reduce uncompensated care).

Impact for O&P In addition to trying to keep O&P fees from being lambasted on the chopping block (which AOPA was reasonably successful in doing), AOPA has a couple of targets that, if comprehensive health-care reform were going to be enacted, we would have liked to have seen be part of it: the Medicare O&P Improvements Act and a federal orthotic and prosthetic parity bill. Neither of these measures is included in the health-care reform law, however, so we are forced to become more creative in our outlook for both. We are thankful that some of the very bad things that could have so adversely affected the O&P field, patients, patient-care facilities, and manufacturers did not happen. Postacute care bundling, which might have channeled all O&P payments through rehab hospitals and other providers contracted with O&P providers, was one distinct threat.

O&P ALMANAC APRIL 2010

Still, there are items in the new law placing fees at some risk. Because of some ambiguities in the language defining health-care benefits, we have to fight our way through arguments in potential regulations that will assure O&P benefits are included in all insurance policies. O&P and all other provider groups will now be subject to annual productivity adjustments that can negatively impact fee schedules. Although the Senate bill provision that established a medical device excise tax provided for a an exemption for devices regulated by FDA as Class I medical devices, the eventual manager’s amendment for the budget reconciliation bill attempts to reverse that policy and impose this additional tax on Class I medical devices (which comprise most component parts and final devices used in orthotic and prosthetic care). The Medicare O&P Improvements Act would effect some measures to fight fraud, assure provider qualifications, and link reimbursement to those qualifications. It would actually save the government money. AOPA is looking at ways it could be worked into the annual federal budget bill, and there also is the possibility of the guts of this bill being adopted as a regulation by The Centers for Medicare and Medicaid Services to fight fraud and abuse. And, if CMS is not inclined to generate these improvements, patient protections, and budgetary savings, the Office of Management and Budget might mandate the agency to do so. By the time you read this, I hope we will have a Senate version of the parity bill. It got caught up in health-care reform, but once it is introduced, it will provide a basis to register our support

for this important step. To that end, the O&P community should beware of all the talk about the benefits of allowing insurers to sell insurance across state lines. Great public relations have made this sound populist. In truth, it is one of the insurance companies’ fondest dreams because it allows them to avoid a plethora of unfriendly state requirements. If accomplished via health-care compacts (as incorporated into the Democratic health-care reform bill), this device (which also has strong GOP support) creates a mechanism to have insurance regulation fall to the bottom—the least common denominator. For example, Maryland passed a parity bill, but Delaware and Pennsylvania have not. If companies licensed in Delaware can sell into Maryland, they will do so in a way that essentially rescinds the parity protections imposed on Maryland insurers. Bottom line: This concept sounds smart, but it has great perils for the parity efforts already enacted in 18 states. So, the big grandiose phase of major 2010 health-care reform is drawing to a close. Like the proverbial cat, it seems to have enjoyed nine lives—down and seemingly out several times, it has revived to become the law of our nation. Now we move into the stage in which we fight to ensure O&P benefits are included in all insurance policies. Fights about the annual productivity adjustments that can negatively impact fee schedule the medical device excise tax, as well as fights for fraud and abuse reform in O&P and O&P parity enactment, will continue. Come to the AOPA Policy Forum (May 26-27) at the Hyatt Regency Washington on Capitol Hill, where you can get the latest updates and advocate your position with your representatives. a Tom Fise, JD, is executive director of AOPA. Reach him at tfise@aopanet. org.

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Facility Spotlight By Deborah Conn

FACILITY: BioDesign Inc.

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Christopher Hoyt, CP, and Kimberly Hoyt, CP

HISTORY:

14 years in business

Kim Hoyt, CP, and her husband Chris, CP, with a transfemoral patient

O&P ALMANAC APRIL 2010

Achieving a Home-Practice Balance An intentionally small facility helps a Colorado couple care for patients and family

ioDesign, Inc., in Denver, Colorado, is a prosthetics practice owned by Christopher and Kimberly Hoyt, both certified prosthetists. The two met in the 1980s in California at the Uiversity of California Los Angeles Prosthetics Education Program, where Chris was an instructor and Kim a certificate student. After Kim graduated, the two began dating. By the time they married, in 1992, the UCLA program had closed, and Chris had a small private practice and taught courses around the world in ischial containment, a method of treating transfemoral amputees developed at UCLA. When Kim’s employers were bought out by a large practice in the early 1990s, she and Chris decided to set out on their own. Although neither Hoyt had connections in Denver, they liked the area’s outdoor lifestyle and knew that the growing community had a need for prosthetists. They leased office space and started knocking on doctors’ doors. They began attracting referrers, thanks to Chris’s expertise and international reputation in treating transfemoral

amputees and Kim’s private practice experience and clinic involvement with the U.S. Department of Veteran’s Affairs, Shriners Hospitals for Children, and Kaiser Permanente.

Kim and Chris designing custom swim fins for bilateral patient who hopes to compete in the Paralympics

“A good connection that happened for us was a vascular surgeon who joined a practice in Denver about the same time we arrived,” says Kim. “Together, we developed an immediate post-operative system that has offered superior contouring and protection, enabling the majority of our new patients to receive their preparatory limbs within six to seven weeks after amputation. We became part of the vascular surgery team, and that really got our practice moving.”

A Narrow Focus The Hoyts take pride in their success in building a strictly prosthetics practice from the ground up. “We would have been far more marketable if we did orthotics as well as prosthetics, but focusing on prosthetics has actually made us more desirable,” says Kim. BioDesign is a full-service prosthetic facility that has developed

part-time and enables both to spend evenings with their children. At times, they have had to establish a waiting list or temporarily close their practice to new patients, and they have declined contracts in which reimbursement had been driven too low. “Our justification is that we cannot provide the level of care we require of ourselves if we have too many patients,” Kim says. “Everyone loses if we take on more work than we can handle.”

Left: Kim checking height of Akshira Weiser, a bilateral knee disarticulation patient Right: BK training using a Wii Fit

a strong reputation in the Rocky Mountain area for fitting challenging transfemoral, upper extremity, bilateral, and “non-ordinary” limbs. These include relatively rare conditions, such as hip disarticulations, in which the entire lower limb is removed at the hip level; hemi-pelvectomies, in which half the pelvis is amputated along with the leg; and rotationplasties, typically performed on children with congenital defects or tumors, in which the leg is amputated above the knee, and the lower portion of the leg is rotated 180° and reattached. The ankle then performs the function of a knee, allowing better range of motion and an easier prosthetic fit. In the early days, Kim and Chris saw an equal number of patients. Chris did most of the fabrication, and Kim took care of most administrative tasks. Eventually, they were able to bring on an administrative assistant, Melinda Coleman, and two technicians, Ish Tamachi and Mike Frontiero. BioDesign is still in its original location, although the company expanded into more space as the Hoyts hired staff, and as they continue to do all their own fabrication. Both prosthetists interview new patients during their initial consul-

O&P ALMANAC APRIL 2010

tation and determine if they have a preference for seeing a male or female practitioner. “If there is no preference, we decide who takes each case based upon scheduling,” explains Chris. “More often than not, we work together, especially during the diagnostic and dynamic alignment phases.”

Family First The Hoyts’ first child, Anna, was born in 2002. “I worked until my due date, and then, with a baby, we had to make decisions about the practice,” says Kim. The two had spent many late nights building their practice and developing their reputation, but with a growing family (their second daughter, Renée, was born in 2005), the Hoyts needed to modify their priorities. “We tried changing the format of the practice,” says Kim. They hired additional practitioners, but after about two years realized they were more comfortable working on their own. “We didn’t feel in control of the outcomes if we weren’t doing it ourselves,” she explains. “No one else can have the love you do for your own business, or the same commitment to quality. So we came back to our original vision.” The result is an intentionally small practice that allows Kim to work

Kim testing a new prosthesis with Tony Rivera, a Vietnam War veteran

In addition, the Hoyts have chosen not to offer a residency program at this stage, although, says Chris, “we both had wonderful mentors and residencytype experiences when we graduated from the UCLA program. But we have discovered that recent graduates need significant clinical hands-on education and, with the demands of our practice, we are unable to provide the extra education and mentorship that the students deserve.” Because the Hoyts make an effort to control the size and scope of their practice, they believe they have found a balance between their practice and their children. “At the end of the day, we feel we’re doing the best we can for both families—ours at home and ours at work,” Chris says. “We plan to take great care of both for as long as we can.” a Deborah Conn is a contributing writer for O&P Almanac. Reach her at debconn@ cox.net.

AOPA Headlines WASHINGTON WATCH

AOPA Policy Forum Call to Action Mark your calendar for May 26-27 and plan to attend this important event

he old axiom that 90 percent of success is just showing up rings especially true for political activity. Showing up is what the AOPA Policy Forum is all about: making the orthotics and prosthetics community visible to members of Congress and their staffs, and maintaining this visibility year after year.

to Capitol Hill. ACA involvement also will enable us to benefit from ACA members’ expertise in lobbying for state parity laws. It’s that expertise that can help fuel the AOPA’s licensure passage effort at the state level. Amputees will undoubtedly identify with licensure’s huge patient care benefit.

Even when a hot issue like healthcare reform isn’t on the front burner for Congress, it still makes good sense to bring the O&P community to Washington, D.C., each year. It’s an opportunity to convert the media coverage the O&P industry receives from responding to natural disasters like Haiti into a more personalized education effort. It’s an opportunity to help policy makers understand the importance of the day-in and day-out, life-transforming services that victims and patients depend on from the O&P community. In addition to being a catalyst for the health-care issues that AOPA champions, this year’s Policy Forum will focus on state licensure as a ready solution to help curb fraud and abuse, and ensure that quality patient care is delivered by qualified professionals. An invitation will be extended to members of the Amputee Coalition of America (ACA) to join the O&P community in making visits

The AOPA Board of Directors has designated licensure as a top priority for 2010 and 2011, and identified six states as candidates for aggressive efforts to enact licensure. All six states have passed parity legislation, and the ACA members invited to the AOPA Policy Forum will offer their firsthand experience gained from making parity happen in their state. It’s that experience that AOPA hopes to draw on to educate the O&P community on ways to get licensure enacted in their states. Past Policy Forums have assembled a talent pool from a wide range of Washington political experts and those knowledgeable about O&P issues. This year’s Forum will be just as exceptional. In addition to the two high-level lobbying firms AOPA retains, participants can count on seeing members of Congress who have championed critical O&P issues such as federal parity and the O&P Medicare Improvement Act. To make the best use of program time for AOPA members, the Policy Forum

O&P ALMANAC APRIL 2010

will kick off at 1 p.m., Wednesday, May 26, with a legislative briefing by AOPA lobbyists Tom Scully of Alston & Bird and Nick Littlefield of Foley Hoag. Their unique connections to the power centers of both the Democratic and Republican sides of the aisle will offer the most up-to-date political insights. A review of the issues, complete with talking points and tips on how to make the case for O&P, will further arm participants with the firepower to make a difference during their Congressional visits. With a special focus on licensure, the program will include actual case studies on successful licensure advocacy—what are the drivers that capture the policy makers’ commitment to passing “good” licensure laws? A dinner Wednesday evening will bring everyone together for a shared experience that will further augment skills in delivering the O&P message to the policy makers. A Congressional fundraiser breakfast Thursday morning will be followed by transporting those attending to the appropriate Congressional offices for scheduled appointments with lawmakers and staff. It’s almost impossible to overstate the importance of clearing your calendar so you can join your peers at the 2010 AOPA Policy Forum—it’s the one thing every member of the O&P community can do to preserve the opportunity for delivering continued, quality patient care. The stakes are so high that members of the O&P community no longer have the luxury of saying, “Let George Do It,”— it is truly a hands-on effort and the Policy Forum is truly a time for all hands on deck! a

mobility WITH ENTEGRITY

ENTEGRASV from Hosmer • • • • • • • • 1.800.251.6398

Independently adjustable hydraulic knee Rugged thru-bolt design Lightweight aluminum alloy frame Maintenance-free Oilite® sleeve bearings 135° range of motion Integrated kneeling pad ISO tested and rated for 220 lb (100 kg) • +46 8 505 332 00

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AOPA Headlines

Plan Now to Attend the 2010 Policy Forum The 2010 AOPA Policy Forum, including our annual lobby day, will be held in Washington, D.C. on May 26-27. Join your colleagues in explaining to legislators what your business is facing in these trying times, and what they might do to help. This year’s forum will be held in a new location: The Hyatt Regency Washington on Capitol Hill. More information is available at www.AOPAnet.org.

Learn Insider Tips for Documenting Success The next AOPAversity audioconference, “Documenting for Success: Chart Notes, Prescriptions and Physician’s Records,” will be held on Wednesday, April 14 from 1-2 p.m. EST. Join us for this informative session to learn: • the most vital pieces of documentation necessary to support your claim • the best time to document • words to avoid in progress notes • how to make prescription Medicare compliants • how to dual date prescriptions • how to obtain information from physician records • tips to ensure referral sources are documenting properly. The cost to participate is just $99 per line for members ($199 for non-members), and an unlimited number of your employees may participate on a given line. Those who need continuing education can earn 1.5 credits by returning the provided quiz within 30 days and scoring at least 80 percent. Register online at www. aopanet.org. For more information, contact Erin Kennedy at ekennedy@AOPAnet.org or 571/431-0876.

O&P ALMANAC APRIL 2010

Coding & Billing Seminar Set for Pittsburgh AOPA’s second seminar of the 2010 series of “Mastering Medicare: Advanced Coding & Billing Techniques” will be held in Pittsburgh, May 24-25. Hundreds of your O&P colleagues have already benefited from this advanced, comprehensive seminar given by AOPA’s coding experts and members of the AOPA Coding & Reimbursement Committee. At this seminar, you will: • learn how to code complex devices, including repairs and adjustments, through interactive discussions with AOPA experts and your colleagues • join in-depth discussions on compliance with Medicare billing rules and documentation expectations • understand how to assess and address compliance risk areas • learn successful appeal strategies and hints on avoiding claim denials • participate in break-out sessions for practitioners and office staff • get detailed information on hot-topic O&P issues • earn 14 continuing education credits in two days. Seminar attendees stay at the Hyatt Regency Pittsburgh Airport for just $105/night. The seminar cost is $525 for members/$725 for non-members, if you register by April 23. After the early bird deadline, the cost goes up by $25 per person. Any additional attendees from the same office get a $50 discount: just $475 for members and $675 for nonmembers. Join us in Pittsburgh, bring your toughest coding questions, and spend an informative two days with AOPA’s experts and your colleagues. Register online at www.aopanet.org. For more information, contact Erin Kennedy at ekennedy@AOPAnet. org or 571/431-0876.

AOPA Headlines AOPA Continues to Accept Offers of Help for Haiti Stories about Haiti may no longer be daily front-page news, but the needs of the victims of January’s earthquake will continue for years. Thousands of people have lost limbs and need help adapting to life with their new body. Many in the O&P community already have pledged assistance and support, either on their own or through AOPA’s Web site, but the need is still great. If you wish to donate components or are willing to travel to Haiti to provide O&P services, please visit AOPA’s Web site at www.AOPAnet.org and provide the requested information for further details.

AOPA, COPL Now Accepting GRANT PROPOSALS AOPA, working in conjunction with the Center for Orthotics and Prosthetics Learning and Outcomes/ Evidence Based Research, is seeking proposals for one-time grants in amounts up to $7,500 for one year (2010-2011). AOPA is interested in funding original pilot research that will lead to larger trials that may qualify for government or other research funding support. Areas for submission are • AFO treatment of stroke—appropriateness of the five custom criteria for custom device use • microprocessor knees and functional value for K 2 patients • residual limb and socket interface selection criteria • vacuum-assisted socket research • prosthetic foot/ankle mechanisms assessment of current functional classifications.

O&P ALMANAC APRIL 2010

Preference will be given to grants that address evidence-based clinical applications in orthotics and prosthetics. To learn more about eligibility requirements, visit www.aopanet.org/2010_RFP_Outcomes_OP_Research. pdf or contact AOPA Executive Director Tom Fise at tfise@ AOPAnet.org or 571/431-0802. a

IDENTIFY

INNOVATE

INDIVIDUALIZE

The College Park Ideal is at the core of everything we do. It’s our commitment to go beyond minimal requirements and provide the ideal fit, ideal form and ideal function in every product we create. It’s how we identify both the patient and practitioner’s needs and produce innovative and highly adjustable products. Our ideal focuses on human variability, custom building each foot from thousands of possibilities to provide individualized solutions. You can always trust CPI to create your patient’s CPIDEAL.

800.728.7950

I college-park.com

AOPA Applications

The officers and directors of the American Orthotic & Prosthetic Association (AOPA) are pleased to present these applicants for membership. Each company will become an official member of AOPA if, within 30 days of publication, no objections are made regarding the company’s ability to meet the qualifications and requirements of membership. At the end of each new facility listing is the name of the certified or state-licensed practitioner who qualifies that patient-care facility for membership according to AOPA’s bylaws. Affiliate members do not require a certified or statelicensed practitioner to be eligible for membership. At the end of each new supplier member listing is the supplier level associated with that company. Supplier levels are based on annual gross sales volume: Level 1: equal to or less than $1 million Level 2: $1 million to $1,999,999 Level 3: $2 million to $4,999,999 Level 4: more than $5 million

Alignmed LLC 2400 S. Pullman St. Santa Ana, CA 92705 949/251-5123 Fax: 949/251-5128 Category: Supplier Level 1

Alliance Orthotics & Prosthetics LLC 800 E. California St. Gainesville, TX 76240 940/668-1118 Fax: 940/668-1123 Category: Patient Care Facility Phyllis McNiel, CPO

O&P ALMANAC APRIL 2010

Carolina Prosthetics & Orthotics Inc.

Shriners Hospital for Children

110 Liner Dr. Greenwood, SC 29646 864/942-7001 Fax: 864/942-7008 Category: Patient Care Facility William T. McCrea, CPO

3160 Geneva St. Los Angeles, CA 90020-1199 213/639-3481 Category: Affiliate Parent Company: Shriner’s Hospitals for Children Headquarters, Tampa, FL

Florida Bracing Centers Inc.

Shriners Hospital for Children

500 SE 17th St. Fort Lauderdale, FL 33316 954/917-5655 Fax: 954/917-7225 Category: Affiliate Parent Company: Florida Bracing Centers, Fort Lauderdale, FL

3551 N. Broad St. Philadelphia, PA 19140 215/430-4069 Category: Affiliate Parent Company: Shriner’s Hospitals for Children Headquarters, Tampa, FL

Orthopedic Associates of Michigan - Business Office

2425 Stockton Blvd. Sacramento, CA 95817-2215 314/432-3600 Category: Affiliate Parent Company: Shriner’s Hospitals for Children Headquarters, Tampa, FL

230 Michigan St. NE, Ste. 200, O&P Division Grand Rapids, MI 49503-2550 616/457-7101 Fax: 646/954-6482 Category: Affiliate Parent Company: Orthopaedic Associates of Grand Rapids, Grand Rapids, MI

Shriners Hospitals for Children Headquarters 2900 Rocky Point Dr. Tampa, FL 33607 813/281-8492 Category: Patient Care Facility Ralph T. Lewkowicz

Shriners Hospital For Children 2425 Stockton Blvd. Sacramento, CA 95817 916/453-2170 Category: Affiliate Parent Company: Shriner’s Hospitals for Children Headquarters, Tampa, FL

Shriners Hospital for Children 6977 Main St. Houston, TX 77030-3701 713/793-3866 Category: Affiliate Parent Company: Shriner’s Hospitals for Children Headquarters, Tampa, FL

Shriners Hospital for Children

Shriners Hospital for Children 12502 Pine Dr. Tampa, FL 33612-9499 813/972-2250 ext. 7607 Category: Affiliate Parent Company: Shriner’s Hospitals for Children Headquarters, Tampa, FL

Shriners Hospital for Children 950 W. Faris Rd. Greenville, SC 29605 864/240-8761 Category: Affiliate Parent Company: Shriner’s Hospitals for Children Headquarters, Tampa, FL

Shriner’s Hospital for Children 3100 Samford Ave. Shreveport, LA 71103 318/222-4279 Category: Affiliate Parent Company: Shriner’s Hospitals for Children Headquarters, Tampa, FL

Shriner’s Hospital for Children

Shriners Hospitals for Children

1310 Punahou St. Honolulu, HI 96826-1099 808/951-3690 Category: Affiliate Parent Company: Shriner’s Hospitals for Children Headquarters, Tampa, FL

2025 E. River Pkwy. Minneapolis, MN 55414-3604 612/596-6203 Category: Affiliate Parent Company: Shriner’s Hospitals for Children Headquarters, Tampa, FL

Shriner’s Hospital for Children

Shriners Hospitals for Children

3101 SW Sam Jackson Park Rd. Portland, OR 97201-3095 503/241-5090 ext. 1105 Category: Affiliate Parent Company: Shriner’s Hospitals for Children Headquarters, Tampa, FL

Fairfax Rd. at Virginia St. Salt Lake City, UT 84103 801/536-3611 Category: Affiliate Parent Company: Shriner’s Hospitals for Children Headquarters, Tampa, FL

Shriners Hospitals For Children

ORLANDO

516 Carew St. Springfield, MA 01104-2396 413/787-2000 Category: Affiliate Parent Company: Shriner’s Hospitals for Children Headquarters, Tampa, FL

SAVE thE DAtE

Rosen Shingle Creek Resort

September 29 – OctOber 2, 2010

We look forward to seeing you at the AOPA 2010 National Assembly September 29–October 2, 2010, at the Rosen Shingle Creek Resort in Orlando, Florida! For more information, visit our Web site at www.AOPAnet.org.

APRIL 2010 O&P ALMANAC

Marketplace

ORTHOTIC MANAGEMENT OF GENU RECURVATUM COMBINED WITH FOOTDROP Allard USA introduces COMBO, a thigh cuff/knee brace attachment for ToeOFF or BlueRocker that offers lightweight, low profile, functional orthotic solution for the management of genu recurvatum or chronic knee instability, accompanied with footdrop. Combine COMBO with ToeOFF or BlueRocker to fabricate a KAFO, customized to meet your patient’s needs. Uprights with dual axis joints are easily shaped and adjusted to optimum height for the patient. Adjustable knee control popliteal interface for genu-recuvatum control. Modular components allow you to accommodate variances in thigh and calf circumferences. For more information call 888/6786548, e-mail info@allardusa.com or visit www.allardusa.com.

APIS FOOTWEAR PRESENTS THE NEW BUNION/EMEDA SHOES

Apis Footwear is proudly presenting the new Bunion/Emeda shoes that are available off-the-shelf. The entire collar of the shoe is made of expandable elastic foam fabrics, designed to conform to the shape of the ankle and significantly reduce Achilles

O&P ALMANAC APRIL 2010

pressure. The leather counter will reflex which allows for more flexibility for support or for release. With built-in flex area on medial and lateral side of the shoes, this unique design will accommodate mild or severe bunion and bunionette situations. The Lycra top will allow more room in the shoe for claw or hammer toes. The outsole is constructed with total EVA materials so that the practitioner can modify the bottom very easily, whether for a wedge, out flare, lift, or rocker. More questions? Please call our friendly customer service at 888/9372747.

ACCENT YOUR LIFE WITH COLLEGE PARK

COMFORT PRODUCTS INTRODUCES SPECTRACARBARALON™ STOCKINETTE

Just what the practitioner would order: • easy workability, wets out well, strength and fatigue resistant • light weight, contours superbly, no delaminating • people-friendly material; mitigates skin irritation • tubular goods facilitates ease of usage • available in 5-yard and 25-yard rolls • comes in 2-3-4-5-6 in. and 8 in. widths • half the cost of carbon material • can be modified using a heat gun without delaminating. For more information call Comfort Products, the innovation leader in knitted orthotic and prosthetic products, at 800/822-7500.

CONNECTION ADAPTER FOR CHILDREN WITH ADJUSTMENT CORE The Accent foot from College Park provides a service-free option for individuals who desire a cosmetically appealing foot with an easy-to-adjust heel height. A simple push of a button provides the wearer their choice of footwear. Features include: • 2 in. (51mm) user-adjustable heel height • dynamic pylon and integrated pyramid options • ankle fairing for superior finishing • sandal-toe foot shell, with narrow and wide width options • service-free • three firmness choices. For more information, call 800/7287950 or visit college-park.com.

The Connection Adapter from Euro International allows you to combine an adult pyramid to pediatric componentry. For example, an adult foot can now be combined to a pediatric pylon. The Connection Adapter has a build height of 18 mm and is made from durable stainless steel and is weight rated up to 132 lbs. For more information about the Connection Adapter, please call us at 800/378-2480 or visit our Web site at www.eurointl.com.

THE ORTHOKID INSOLE FROM EURO INTERNATIONAL The Ortho-Kid is a lightweight, heat moldable UCBL style insole. Its design lifts the medial, longitudinal and lateral arch and its deep heel cup ensures an ideal fit. The Ortho-Kid can be used to correct pes valgus, club foot, pes adductus and flat feet. It is available in double sizes from 19/20 to 33/34. For more information about the OrthoKid Insole, please call us at 800/378-2480 or visit our Web site at www.eurointl.com.

OHIO WILLOW WOOD C-FAB SERVICES: LAMINATIONS Ohio Willow Wood’s Custom Fabrication team provides highquality craftsmanship and prompt turnaround for prosthetic fabrication jobs. Definitive BK and AK sockets are completed within one to four days, based on the order: • single wall laminations––one-day turnaround • double wall and Exoskeletal–– three-day turnaround • LimbLogic® VS sockets––four-day turnaround • Flexible inner sockets with laminated frames––four-day turnaround Laminated sockets may also be personalized. Customers may send in fabric when submitting orders. Ohio Willow Wood will incorporate the fabric into the lamination at no extra charge. For information, contact Ohio Willow Wood at 800/848-4930 or visit www.owwco.com.

ROD BAIL KIT FOR STEPLOCK

INTRODUCING KISS SUPERSLIDER™

OTS Corporation has redesigned the StepLock handle to accept the Rod Bail Kit. OTS had previously asked practitioners to avoid a stiff connection between the two sides of a StepLock pair to avoid breakage. The Rod Bail Kit allows some movement between the two sides, and is a good looking and inexpensive way to add a Bail Kit to a StepLock or an InterLock. Use of other manufacturer’s bail kits will still void the StepLock warranty. For more information, call 800/2214769, e-mail infor@ots-corp.com or visit www.ots-corp.com. Obtain a password on our Web site and order online.

The Superslider™ simplifies test socket dynamic alignment. It allows linear alignment changes, in the transverse plane, and slides one inch in all directions. It is durable and reusable. Combine with KISS Superhero™ damage-free test socket plate, with pyramid or receiver, and achieve superior test socket slide and angular adjustment. • KISS Superslider™ Part #: CMP28/A. • KISS Superslider™ KIT (includes KISS Superhero™) Part #: CMP29/A. Contact KISS Technologies at 410/663-KISS (5477) or visit www.kiss-suspension.com.

DYCOR

TAKING THE NEXT STEP... Introducing Dycor's Single and Double Ended Advanced Composite DRP Pylon System

Dycor's dynamic response pylon systems are available in 5 different wall dimensions to match strength and flexibility with weight and "K" level when used with Dycor's ADL AFP flexible keel, DR dynamic response and K SERIES feet. The single ended variant is used only with Dycor's AFP flexible keel feet and is available with integrated uni- and multi-axial ankles aligned in neutral. Custom single ended pylon systems are available to accommodate angular adjustments at the ankle during dynamic alignment with a loaner AFP foot. Simply call Dycor's Technical Assistance Dept. toll free number at 1-800-794-6099 with your specifications, and Dycor will provide the appropriate pylon system with pre-aligned foot and ankle components. Allow 4 working days for processing. Wt. limit is 286 lbs. and total installation weight of the single ended, single axis pylon system including foot and socket adaptor is 1.5 lbs. Custom single ended pylon systems are available at no extra charge with free ground shipping. For more information please contact our Technical Support Dept. or visit our website at www.dycormfg.com

. APRIL 2010 O&P ALMANAC

Marketplace

OPTEC NOW OFFERS KAFO OPTEC’s KAFO is custom-made to your specific requirements. There are numerous design options available that make usage of the KAFO both functional and comfortable. KAFO is a long-leg orthosis that spans the knee, the ankle, and the foot in an effort to stabilize the joints and assist the muscles of the leg. Features: • custom for many full leg orthopaedic indications • unsurpassed craftsmanship • free motion, adjustable, or drop-lock knee joints allow for specific rangeof-motion and functional knee control • lightweight, durable components. For more information, contact OPTEC at 888/982-8181 or sales@ optecusa.com.

STEALTH X – GLIDE TO WARP SPEED RECOVERY

Continuing in the tradition of excellence, OPTEC is pleased to introduce the Stealth X, our newest and most revolutionary streamline design. The four-panel design provides saggitalcorronal support that can’t be matched. The closure system glides like butter and provides smooth compression, which can be regulated by your patients. Your patient will actively

O&P ALMANAC APRIL 2010

participate in their rehabilitation by adjusting compression and support to the desired level, thus enhancing comfort and patient compliance. Our unique, durable, flexible, closure system with polymer straps provides additional reinforcement and support to the posterior for complete rehabilitation. Stealth X combines the benefits of a post-op and rehab brace, all into one innovative design. For more information, contact OPTEC at 888/982-8181 or sales@ optecusa.com.

ÖSSUR LAUNCHES NEW RHEO KNEE® WITH MULTIPLE ADVANTAGES The new and improved RHEO KNEE, the latest addition to Össur’s innovative Bionic line, now offers a higher weight limit (275 lbs.), increased torque, faster swing speed, and improved aesthetics. Thanks to its low build height, the RHEO KNEE is compatible with the entire Össur Flex-Foot line. Together they deliver maximum dynamics and a natural gait experience. As always, the RHEO KNEE recognizes and responds immediately to changes in speed, load, and terrain, restoring the user’s ability to walk naturally, comfortably, and confidently at any speed. For more information, please call 800/233-6263 or visit our Web site at www.ossur.com.

LESS IS MORE- HARMONY® P3 BY OTTO BOCK Elegant design with maximum functionality! The P3 is lighter with a smaller overall height and width than its predecessors. Appropriate for amputees who are moderate to high activity level and want to ensure optimized fit. Like previous generations of the mechanical Harmony devices, the P3 is waterproof to support your patients in a number of environments. The P3’s Functional Ring provides vacuum generation, vertical shock absorption and torsion, all in one simple component. To find out how to get your patients into Harmony P3 today, call 800/3284058 or visit www.ottobockus.com.

ADJUST K2 FOOT MOBILITY WITH STABILITY, NEXT-GENERATION IN K2 FOOT DESIGN

Eliminate the need for realignment or painstaking adjustments and help improve your patient’s stability, with the 1M10 Adjust. Designed specifically for the K2 walker, the Adjust foot provides a stable center of gravity, allowing you to make adjustments, even change the heel strike stiffness with the Adjustable Heel Function, without realignment. To find out more about Adjust, call 800/328-4058 or visit www.1M10Adjust. com for more information.

1-888-937-2747

Introducing the Mt. Emey 801, 802 Shoes The O&P Industry Most Trusted Last for Patient Care

• Supra(triple) depths • 3 layers of removable inserts • Extended strong medial & lateral counter

Sizes & Widths: D: 5,5.5-11.5,12-17 EEEE(4E): 6,6.5-11.5, 12-17 6E: 7,7.5-11.5, 12-17 9E: 7,7.5-11.5, 12-17

801 Black High Instep/ Swelling Severe

802 Black

Pronated/ Flat Foot

Bunions

Severe

Hammertoes Severe

Partial Foot Yes

801 Brown

AFO Weight Yes

12 oz.

Closure Lace/Hook & Loop

802 Brown

Leather linings for comfortable fit Top grain leather uppers eliminates heat build-up

Pre-molded counter provides maximum stability and accommodates AFO’s & KAFO’s, etc.

Wide, high, extra room toe box provides extra comfort & limits toe pressure

Triple layer removable inserts for flexible width fitting & adjustments

High density flexible EVA outsole, easy to modify

Marketplace

FUSION™ FOOT FROM PEL SUPPLY Offering “function without compromise”, the Ohio Willow Wood Fusion™ Foot is available for immediate shipment from PEL Supply. The Fusion Foot’s design allows the carbon fiber shank, heel and foot plate to work together through each step rather than independently. This integrated design yields superb performance and strong energy return all in one mechanism. Practitioners can customize the Fusion Foot’s inversion/eversion, heel stiffness, and overall trim height for wearer comfort. Two diameters of snubbers are

provided with each foot. These may be switched out to provide more or less inversion and eversion. The snubbers also allow the bottom of the composite shank and composite heel to run parallel to the foot plate. This allows both plate to bend and flex, delivering medial/lateral stability on uneven terrain. The Fusion Foot comes standard with two interchangeable heel wedges that may be quickly and easily changed during an office visit. Also, the shank of the Fusion Foot may be trimmed to suit the patient’s limb length without drilling holes. Smooth heel-to-toe motion, significant inversion/eversion, strong energy return, and vertical shock compression all combine to give active amputees the performance they need. It all ads up to function without compromise. For more information on the Fusion Foot, or any quality products

THREE LOCK BOX DETACHABLE KAFO The Three Lock Box is a quick disconnect device that can convert a KAFO to an AFO in one easy step. The thickness of box is 1cm. There are no bars left on the AFO when the KO section is removed. The Three Lock Box is self contained; there are no parts that can be lost. The Three Lock Box is available through major distributors. For more information call 812/552-6328. A demonstration video is available on our Web site at www.threelockboxinc.com.

The Three Lock Box is for

PEDIATRICS and

ADULTS

O&P ALMANAC APRIL 2010

from Ohio Willow Wood, call your friendly PEL customer service rep at 800/321-1264, fax your order to 800/222-6176, e-mail customerservice@ pelsupply.com or order online at www. pelsupply.com.

10% DISCOUNT ON ENTIRE CALIFORNIA LINE AT SPS

Just when you need it most, SPS is offering an additional 10 percent limited-time promotional discount on Orthomerica’s® CALIFORNIA™ line of prefabricated spinal orthoses. This limited-time offer is extended SPS purchase orders through June 30, 2010 and is available exclusively through SPS. • includes all sizes and configurations of the ECO, Soft Spinal System, Mid-Profile, Chairback, Compression, Compressor, Compressor Combo C3, CPO, LOMBAR™, Low Profile, CEO™ Cruciform, Corset Brace, COSMIC™, Kydex® Chairback and Knight Taylor brace as well as LIDO2® Cervical System • specifically excludes AirBack® Spinal System, MRI Extended Cervical Orthosis, Supra-Lite™ Cervical Orthosis, TORSO Lite™ Spinal System and TORSO™ Spinal System. Contact SPS Customer Service at 800/767-7776 x 3 or your SPS sales manager for pricing details. a

DEMAND THE BEST Your patients do! Why shouldn’t you?

ABC facility accreditation is the BEST. We offer the: :: Best value :: Highest standards :: Longest track record for excellence in the orthotic, prosthetic and pedorthic professions

We Can Help The American Board for Certification in Orthotics, Prosthetics and Pedorthics Inc. 330 John Carlyle St., Ste. 210 Alexandria, VA 22314 703-836-7114

ABC facility accreditation isn’t just about meeting the minimum standards—it’s about you and the quality of care you provide. Accreditation from ABC tells your patients that the highest standards in the profession have been met. Contact us today at 703-836-7114 and join the best in the profession. Download the accreditation guidelines and an application at www.abcop.org.

www.abcop.org

BEST :: DEMAND THE BEST :: DEMAND THE BEST :: DEMAND THE BEST :: DEMAND THE BEST :: DEMAND THE BEST DEMAND THE BEST

Jobs Northeast

INCREASE EXPOSURE AND SAVE!

Place your classified ad in the O&P Almanac and online on the O&P Job Board at jobs.AOPAnet.org and save 5 percent on your order. BONUS! Online listings highlighted in yellow in the O&P Almanac.

- Northeast - Mid-Atlantic - Southeast - North Central - Inter-Mountain - Pacific Use our map to find which region you fit into!

CLASSIFIED RATES Classified advertising rates are calculated by counting complete words. (Telephone and fax numbers, e-mail and Web addresses are counted as single words.) AOPA member companies receive the member rate. Member Non-member Words Rate Rate 50 or fewer words $140 $280 51-75 words $190 $380 76-120 words $260 $520 121 words or more $2.25 per word $5.00 per word Specials: 1/4 page, color 1/2 page, color

$482 $634

$678 $830

Advertisements and payments need to be received approximately one month prior to publication date in order to be printed in the magazine. Ads can be posted and updated at any point on the O&P Job Board online at jobs.AOPAnet.org. No orders or cancellations are taken by phone. Ads may be faxed to 571/431-0899 or e-mailed to srybicki@ AOPAnet.org., along with a VISA or MasterCard number, the name on the card and the expiration date. Typed advertisements and checks in U.S. currency made out to AOPA can be mailed to P.O. Box 34711, Alexandria, VA 22334-0711. Responses to O&P box numbers are forwarded free of charge. Company logos are placed free of charge. JOB BOARD RATES Visit the only online job board in the industry at jobs.AOPAnet.org!

Member Rate $80

Non-member Rate $140

Save 5 percent on O&P Almanac classified rates by placing your ad in both the O&P Almanac and on the O&P Job Board, online at jobs.AOPAnet.org.

O&P ALMANAC APRIL 2010

CPO CO Board-Eligible Orthotist or Prosthetist BOCO or BOCPO C.Ped Maine • Are you looking for something more? • Do you want to be more than a number? • Do you want a great life and a great job? • We are a terrific practice looking for some nice people. Is this you? We are a well-established, patient-oriented, ABC-accredited facility seeking to strengthen our staff. Competitive salary offered, with bonuses commensurate with productivity, and renumeration for required educational credits. Offices located in picturesque Maine, just a short distance from our coast and mountain regions. Learn more about joining our team of dedicated specialists by contacting:

O&P Ad 25356, O&P Almanac 330 John Carlyle St., Ste. 200 Alexandria, VA 22314 Fax: 571/431-0899

Inter-Mountain

CO/CPO El Paso, Texas Locally owned and operated family O&P business, we offer a competitive salary and exceptional benefits package and retirement plan. Please send or fax resume to:

Susan M. Guerra, RN Total Orthotic & Prosthetic Solutions Inc. 900 E. Yandell Dr. El Paso, TX 79902 Phone: 915/541-8677 Fax: 915/541-8678

Orthotist and/or Pedorthist Hot Springs, Arkansas Small busy company established 43 years seeking a motivated certified practitioner. Prefer 2 or more years experience, will consider a new practitioner. Pleasant working conditions, completive salary and attractive benefits. Send resume to:

Felix Brace and Limb Co. 310 Higdon Ferry Hot Springs, AR 71913 Fax: 501/321-0849 E-mail: fbl@cablelynx.com

Mid-Atlantic

Certified Prosthetist and/or Certified Orthotist (licensed or eligible) Cincinnati Head for the Ohio Valley Jazz Festival, the Thanksgiving Day race, the Cincinnati Masters! And, don’t forget the major sports teams of the Cincinnati Reds and Bengals! Since 2000, Cincinnati is reinventing itself and has received many accolades…”Best City in Ohio for Young Professionals”; included in the top 10 “Cities that Rocks”; the new “Banks,” a 24-hour urban neighborhood along the riverfront! We are searching for a well-rounded practitioner…someone with great organizational and communication skills along with excellent patient-care experience. We offer a very attractive salary and benefit package, which includes relocation assistance and signing bonus. Ready to make a change? Join the Hanger Team! If interested, please contact, in confidence:

Sharon King Hanger Prosthetics & Orthotics, Inc. Phone: 678/455-8865 Fax: 678/455-8885 E-mail: Sking@hanger.com www.hanger.com/careers

Certified Prosthetist/Orthotist Philadelphia Culture, arts, history, and architecture…not to mention cuisine! Philly has it all! It is the country’s fifth-largest city comprised of art museums and galleries, serious shopping, all four major sports, University of PA. And, can’t forget the Philly cheese steak! If you want more than a job and are ready to make a move, we would love to discuss your goals. We offer a very competitive salary and benefit package accompanied by relocation assistance and sign-on bonus potential…plus much more. If interested, please contact, in confidence:

Sharon King Hanger Prosthetics & Orthotics, Inc. Phone: 678/455-8865 Fax: 678/455-8885 E-mail: Sking@hanger.com www.hanger.com/careers

CO, CPO, BOCO or BOCPO Pittsburgh (Area) Immediate opening for a hardworking, motivated practitioner with strong clinical skills in a well-established, accredited practice with multiple locations in the Southwestern Pennsylvania area. We offer a generous compensation package, paid continuing education and recertification fees. We have well-equipped, modern facilities located in a region renowned for its rich history, recreational and cultural activities, great schools, and a low cost of living. Submit resume in confidence to:

Michael P. Serenari, CO Enduracare Orthotic & Prosthetic Services, LLC Fax: 724/941-8831 E-mail: michaelserenari@gmail.com

Bulow BioTech Prosthetics, based in Nashville, TN with satellite clinics in Cookeville and Clarksville, TN, is expanding to other locations. We are currently seeking energetic, caring, and talented certified prosthetists to open clinics in selected cities in the southeastern United States. Following the successful completion of a 6-12 month evaluation period, the prosthetist will be prepared to open and operate a new clinic for Bulow Biotech Prosthetics. A successful candidate will work under the clinical direction of our founder, Matt Bulow, a 1991 graduate of the Northwestern Prosthetic Certificate Program with over 18 years of clinical experience. Matt is a BK amputee, 3 time paralympian, and former long-jump world record holder. A minimum of 1-3 years experience and a passion for prosthetic patient care excellence is required. Prior management experience is preferred. Our company is unique in that we specialize in prosthetic patient care services only, allowing us to provide customized, one-on-one care for each of our amputee patients. Position includes excellent benefits and pay based on salary plus performance. For more information on our company please visit www.bulowbiotech.com. Interested individuals please e-mail resume to chris.casey@bulowbiotech.com

APRIL 2010 O&P ALMANAC

Jobs Southeast

CPO Rome, Georgia Walker O&P is a privately owned practice in Rome, GA, one hour northwest of Atlanta. We have an immediate opening for a CPO in our expanding facility. We are seeking a hard-working and self-motivated practitioner with good clinical and interpersonal skills. A minimum of three years of clinical experience is preferred. We offer a competitive salary based on experience and benefits including health insurance, vacation and personal time, and 401(k). Forward your resume, in confidence, to:

Walker Orthotics and Prosthetics 205 Redmond Rd Rome, GA 30165 Phone: 706/232-4383 Fax: 706/232-4667 E-mail: lancwa@comcast.net

CPO/CO North Central Florida Enjoy North Central Florida. We are looking for an existing or future “qualified” Florida Licensed CO/CPO to join our growing multi-location practice in our Ocala office. All of our offices are a short drive from Orlando as well as both beaches on the east and west coasts of Florida. If you are an ethical, professional team player with either a minimum of 2-5 years of experience or have recently completed residency, we have a great opportunity for you. Join and grow with us and learn from our experienced practitioners if a recent graduate. Pediatric experience is a plus, along with attention to detail, computer and fabrication skills. Salary and signing bonus available, based on qualifications along with a competitive benefit package and friendly work environment. Please forward resume to:

Frank Vero 2300 SE 17th St., Suite 401 Ocala, FL 34471 Fax: 352/351-3267 E-mail: Ocala@midflpros.com

O&P ALMANAC APRIL 2010

Certified Prosthetists and Orthotists Florida Come to Sunny Florida! Due to recent growth and expansion, we are adding to our Florida team! If you have excellent clinical, organizational, and communication skills and possess or are eligible for Florida licensure, we would love to speak with you. Management experience a plus! These positions are accompanied by top compensation and benefits, relocation assistance, paid certification dues, stateof-the-art education, sign-on bonus, and much more! If you have what it takes, the sky is the limit!

Sharon King Hanger Prosthetics & Orthotics, Inc. Phone: 678/455-8865 Fax: 678/455-8885 E-mail: Sking@hanger.com www.hanger.com/careers

Certified Prosthetist, Orthotist, Certified Fitter, Certified Pedorthist, Certified Tech Florida and U.S. Virgin Islands Come to sunny South Florida and the U.S. Virgin Islands! Doctor’s Choice Medical has immediate openings for our expanding business. We are a family-run business with more than 10 years’ experience. Doctor’s Choice has ABC-certified clinics in South Florida and the U.S. Virgin Islands. Excellent salary and benefits. ABC or BOC certified, Florida licensed or eligible. Send or fax resume to:

Peter King Doctor’s Choice Medical 2914 N. State Road 7 Margate, FL 33063 Phone: 954/987-8600 Fax: 954/978-8688

Certified Orthotist and/or Prosthetist Jackson, Mississippi The crossroads of the South. A college town where there’s always something to do! Parks, museums, cultural events, historic sites, sports and major downtown project improvements. If you want more than a job and are ready to make a move, we would love to discuss your goals. We offer a very competitive salary and benefit package accompanied by relocation assistance and sign-on bonus potential…plus much more! If interested, please contact, in confidence:

Sharon King Hanger Prosthetics & Orthotics, Inc. Phone: 678/455-8865 Fax: 678/455-8885 E-mail: Sking@hanger.com www.hanger.com/careers

Pacific

O&P Technician Honolulu Immediate opening for an O&P tech with three years of minimum experience. Applicant must be self-motivated and complete projects on time. We are a privately owned, well-established O&P practice with more than 65 years in the business. Salary will be commensurate with experience. E-mail or fax resume to:

Fax: 808/791-1025 E-mail: rae@crnewton.com

CPO Salem, Oregon Summit Orthotics and Prosthetics is seeking a full time CPO to join it’s Salem, Oregon Office. Candidates should be able to work independently and as an active team member. Effective communication and interpersonal skills are necessary. Must be well rounded in both disciplines. Submit resume in confidence to:

Todd Nelson, president E-mail: Todd@Summitonp.com

Why do I work at Hanger?

Chad Simpson, BOCP, LP, Practice Manager

In a word, access. At Hanger, I have access to the very latest technologies and that keeps me on the leading edge in my clinical practice. I also have access to the depth of knowledge that comes with being part of a national network of skilled practitioners. In today’s uncertain economy, I have job security. I benefit from the strength of an established company, and at the same time, enjoy the freedom I find in my work as a local practice manager.

For more information visit www.hanger.com/careers

AVAILABLE POSITIONS Orthotist Rancho Mirage, CA Stockton, CA Jacksonville, FL Tampa, FL Aurora, IL Springﬁeld, IL Evansville, IN Jackson, MI Roswell, NM

Fairﬁeld, OH Toledo, OH NW PA/NE OH San Antonio, TX Richland, WA Milwaukee, WI Morgantown, WV Wheeling, WV

Orthotist/Prosthetist Hollywood, FL Thomasville, GA

El Paso, TX

Prosthetist Orange Park, FL Hattiesburg, MS Jackson, MS

Jefferson City, MO Enid, OK Morgantown, WV

Prosthetist/Orthotist Cameron Park, CA Denver, CO Washington, DC Marietta, GA Farmingdale, NJ Sante Fe, NM

Contact, in confidence:

Sharon King, Director, Recruitment 5400 Laurel Springs Pkwy., Suite 901 Suwanee, GA 30024 Tel: 678-455-8865, Fax: 678-455-8885 sking@hanger.com www.hanger.com Hanger Orthopedic Group, Inc. is committed to providing equal employment to all qualified individuals. All conditions of employment are administered without discrimination due to race, color, religion, national origin, sex, age, disability, veteran status, citizenship, or any

Philadelphia, PA Oak Ridge, TN Fort Worth, TX Alexandria, VA Bremerton, WA Lakewood, WA

Certiﬁed Pedorthist Mesa, AZ Albuquerque, NM Toledo, OH

Tacoma, WA Wheeling, WV

other basis prohibited by federal, state or local law. Residency Program or Certificate Primary Education Program Info, contact: Robert S. Lin, CPO/Dir. of Academic Programs. Hanger P&O / Newington O&P Systems, Ph. 860.667.5304 • Fax 860.667.1719 APRIL 2010 O&P ALMANAC

Calendar

2010 ■■

PROMOTE EVENTS IN THE O&P ALMANAC

CALENDAR RATES Telephone and fax numbers, e-mail addresses and Web sites are counted as single words. Refer to www.AOPAnet.org for content deadlines. Words

Member Non-member Rate Rate

25 or less 26-50 51+

$40 $50 $2.25 per word

$50 $60 $3.00 per word

Color Ad Special: 1/4 page Ad $482 1/2 page Ad $634

$678 $830

BONUS! Listings will be placed free of charge on the Attend O&P Events section of www.AOPAnet.org. Send announcement and payment to: O&P Almanac, Calendar, P.O. Box 34711, Alexandria, VA 22334-0711, fax 571/431-0899, or e-mail srybicki@AOPAnet.org along with VISA or MasterCard number, the name on the card, and expiration date. Make checks payable in U.S. currency to AOPA. For information on continuing education credits, contact the sponsor. Questions? E-mail srybicki@AOPAnet.org.

AOPA-sponsored activities appear in red.

O&P ALMANAC APRIL 2010

■■ APRIL 6: Ultraflex: Adult UltraSafeStep™ Continuing Education Course, via WebEx, 11:00 am – Noon ET. Focuses on normalizing adult pathological gait with the utilization of Adjustable Dynamic ResponseTM (ADRTM) knee & ankle technology. Instructor: Taffy Bowman, CPO, Register at www.ultraflexsystems. com, 800/220-6670. ■■ APRIL 8: Ultraflex: Pediatric UltraSafeGait™ Continuing Education Course, via WebEx, 11:00 am – Noon ET. Covers assessment of pediatric pathological gait and influencing shank kinematics with the new Adjustable Dynamic ResponseTM (ADRTM) technology. Instructor: Taffy Bowman, CPO, Register at www.ultraflexsystems.com, 800/220-6670. ■■ APRIL 14: AOPA Audio Conference: “Documenting for Success: Chart Notes, Prescriptions and Physicians’ Records.” To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org.

■■ APRIL 14: Ultraflex: Complex Orthopedic Rehabilitation Continuing Education Course, via WebEx, 11:00 am – Noon ET. Focuses on Ultraflex combination dynamic and static stretching orthosis for addressing complex orthopedic rehabilitation goals and restoring range and function. Instructor: Taffy Bowman, CPO. Register at www.ultraflexsystems.com, 800/220-6670.

■■ APRIL 14-17: Texas Association of Orthotists and Prosthetists State Meeting. South Padre Island, TX. Sheraton South Padre Island Beach Hotel. Contact Elizabeth Carlstrom at 512/266-8600 or ejcarlstrom_ opbs@att.net.

APRIL 15-16 Transfemoral Optimization Methods Workshop, Hosmer Dorrance Corp., Campbell, CA. Course includes: Address the challenges of fitting transfemoral prostheses. Discussion and comparison of ischial containment fitting fundamentals, alignment methods, voluntary control and various knee designs. Relative benefits of shock/ torque absorption, stance flexion, and rotation. To register, contact Clay Bergren at 800/827-0070. ■■

APRIL 16: Wisconsin Society of Orthotists, Prosthetists and Pedorthists State Meeting. Madison, WI. Sheraton Madison. Contact Andrea Pavlik, CO, at 920/803-9610 or andrea.pavlik@physiocorp.com. ■■

APRIL 17: Ohio AAOP Chapter Annual Spring Technical Meeting. Columbus, OH. Hilton Columbus Hotel. Contact Richard Butchko at 614/6590197 or richardbutchko@ ohiochapteraaop.com. ■■

■■ APRIL 20: Ultraflex: Pediatric Spasticity Continuing Education Course, via WebEx, 11:00 am – Noon ET. Covers clinical assessment of the pediatric neuromuscular patient with spasticity and using R1 and R2 for determining orthotic design for maintaining and improving muscle length. Instructor: Taffy Bowman, CPO, Register at www.ultraflexsystems. com, 800/220-6670.

■■ APRIL 22-24: International African American Prosthetic-Orthotic Coalition. Memphis. Crown Plaza Hotel. For information contact Jack Steele, CO at 901/270-5471 or fax 901/7251114 or visit www.iaapoc.org. ■■ APRIL 22-24: Northwest AAOP Chapter Meeting. Seattle. Bellevue Courtyard Marriott. Contact Dan Abrahamson at 206/598-4026 or abrahams@u. washington.edu. ■■ APRIL 26-27: New York AAOP Chapter State Meeting. Albany, NY. Desmond Hotel. Contact Joann Marx, CPO, FAAOP, at 518/374-6011 or marx4nysaaop@aol.com.

APRIL 27: Ohio Willow Wood: Discover LimbLogic® VS via WebEx, 1:30PM EST. Critical components and operation discussed. Covers interpreting feedback from fob and basic fabrication processes for system. Credits: 2.5 ABC/ 2.0 BOC. To register online, visit www.owwco.com/webinar.php. ■■

■■ APRIL 28: Ohio Willow Wood: Clinical Tricks & Techniques with LimbLogic® VS via WebEx, 1:30PM EST. Discusses clinical treatment plans, fabrication processes, diagnostic process, patient education methods. Credits: 2.5 ABC/2.0 BOC. To register online, visit www.owwco.com/ webinar.php.

the eDuCAtion You need

from the experts You require

Webcast Online learning Courses designed for practitioners and office staff who need basic to intermediate education on coding and billing Medicare. Education does not get any more convenient than this. Learn at your own pace—where and when it is convenient for you. Earn up to

1.5 CE

Credits per Conference

Modules Currently Available AOPAversity Module 1

What is Medicare

AOPAversity Module 2

Filing Claims

AOPAversity Module 3

Medicare as Secondary Payer

AOPAversity Module 4

Administrative Documentation

AOPAversity Module 5

Hospital SNF Billing

AOPAversity Module 6

ABNs and EOBs

AOPAversity Module 7

O&P Coding Basics

AOPAversity Module 8

Orthopedic and Diabetic Shoes

AOPAversity Module 9

When Bad Things Happen

Earn up to

14 CE Credits

Mastering Medicare Advanced Coding & Billing Techniques Seminar ClassrOOm learning 3 Two full days of in-depth, advanced training Available three different dates at three different locations to serve you better. May 24-25, 2010 Pittsburgh

Oct. 14-15, 2010 Las Vegas

At this seminar, AOPA experts will provide the most up-to-date information to help O&P practitioners and office billing staff: • Learn how to code complex devices, including repairs and adjustments, through interactive discussions with AOPA experts and your colleagues; • Join in-depth discussion on compliance with Medicare billing rules and documentation expectations; • Learn how to assess compliance risk areas and deal with them; • Learn successful appeal strategies and hints on avoiding claim denials; • Break-out sessions for practitioners and office staff; • Detailed information on “Hot Topic” issues in O&P; and • Earn 14 continuing education credits in two days.

2010 Telephone Audio Conferencing

Earn up to

1.5 CE During these one-hour sessions, AOPA experts Credits per Conference provide the most up-to-date information on the following topics. Perfect for the entire staff—one fee per conference, for all staff at your company location ($99 Member/$199 Non-Member). A great team-building, money-saving, educational experience! Sign up for the entire series and get two conferences FREE. Entire Series ($990 Member/$1,990 Non-Member) DAte* January 13 February 10

telephone ConferenCe Red Flag Rules: Are You In Compliance? Hints on Passing Your Supplier Standards Inspection March 10 Billing for Refused/Returned Devices and Deluxe Features April 14 Documenting for Success: Chart Notes, Prescriptions and Physicians’ Records May 12 New Rules for HIPAA: Are You Still Compliant? June 9 When Disaster Strikes: Implementing a Contingency Plan July 14 Medicare Appeals Strategies August 11 Medicare’s Knocking: How Good Is Your Compliance Plan? September 8 Missed Billing Opportunities: Are You Billing Everything You Can? October 13 You’re Going To Pay Me WHAT?... Hints on Managed Care Contracting November 10 The Ins and Outs of Billing in a Part A Setting: Hospital, SNF and Hospice December 8 2011 New Codes and Medical Policies *Previously held telephone conferences are available on CD. Please visit the AOPA Bookstore for details.

www.AopAnet.org or call 571/431-0876 for more information.

Calendar

■■ MAY 3-7: Applied Technology Institute (ATi) Orthotic Fitter School. Philadelphia. Residence Inn Center City. Independent comprehensive course to prepare for certification exam. Approved entry-level school by NCOPE and BOC, and for continuing education by ABC and BOC. Contact: Lois Meier at lois@kasseledu.com or 888/265-6077 or visit www.kasseledu.com. ■■ MAY 5: Ultraflex: Pediatric UltraSafeGait™ Continuing Education Course, via WebEx, 1:00 pm – 2:00pm ET. Covers assessment of pediatric pathological gait and influencing shank kinematics with the new Adjustable Dynamic ResponseTM (ADRTM) technology. Instructor: Taffy Bowman, CPO. Register at www.ultraflexsystems.com, 800/220-6670. ■■ MAY 6: Ultraflex: Pediatric Spasticity Continuing Education Course, via WebEx, 1:00 pm – 2:00pm ET. Covers clinical assessment of the pediatric neuromuscular patient with spasticity and using R1 and R2 for determining orthotic design for maintaining and improving muscle length. Instructor: Taffy Bowman, CPO. Register at www. ultraflexsystems.com, 800/2206670. ■■ MAY 10-15: ISPO World Congress and International Trade Show for Prosthetics, Orthotics and Rehabilitation Technology: “Orthopadie + Reha-Technik 2010.” Leipzig, Germany. www.ispo-2010-leipzig.de.

O&P ALMANAC APRIL 2010

■■ MAY 12: AOPA Audio Conference: “New Rules for HIPAA: Are You Still Compliant?” To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org.

■■ MAY 13-15: WAMOPA/COPA Combined Meeting. Sparks/Reno, Nevada. Nugget Hotel. Combined meeting of Western and Midwestern Orthotic and Prosthetic Association and California Orthotic and Prosthetic Association. For information contact Steve Colwell at 206/440-1811 or Sharon Gomez at 503/5214541 or visit www.wamopa.com. ■■ MAY 14-15: Oklahoma AAOP Chapter State Meeting. Oklahoma City, OK. Francis Tuttle Technical Center. Contact Tom Ferguson at 405/271-3644 ext. 41028 or thomas-ferguson@ ouhsc.edu.

MAY 18: Ultraflex: Complex Orthopedic Rehabilitation Continuing Education Course, via WebEx, 1:00 pm – 2:00 pm ET. Focuses on Ultraflex combination dynamic and static stretching orthosis for addressing complex orthopedic rehabilitation goals and restoring range and function. Instructor: Taffy Bowman, CPO. Register at www. ultraflexsystems.com, 800/2206670. ■■

■■ MAY 19: Ultraflex: Adult UltraSafeStep™ Continuing Education Course, via WebEx, 1:00 pm – 2:00 pm ET. Focuses on normalizing adult pathological gait with the utilization of Adjustable Dynamic ResponseTM (ADRTM) knee and ankle technology.

Instructor: Taffy Bowman, CPO. Register at www.ultraflexsystems. com, 800/220-6670. ■■ MAY 19-22: Pennsylvania AAOP Chapter Spring Conference. Pittsburgh. Sheraton Station Square. Contact Beth or Joe at 814/455-5383.

MAY 20-22: Louisiana Association of Orthotist & Prosthetist Meeting. Lafayette Hilton. O, P & C.Ped credits. Come take in Louisiana’s creole culture and culinary delights! Contact Sharon Layman, 504/464-5577 or laymansh@yahoo.com or visit www.LAOP.org. ■■

■■ MAY 24-25: AOPA Mastering Medicare: Advance Coding and Billing Seminar. Pittsburgh. Hyatt Regency Pittsburgh International Airport. To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org. ■■ MAY 26-27: 2010 AOPA Policy Forum. Washington, DC. Hyatt Regency Washington on Capitol Hill. To register contact Erin Kennedy at 571/431-0876 or ekennedy@ AOPAnet.org. ■■ JUNE 2-5: Association of Children’s Prosthetic-Orthotic Clinics 2010 Annual Meeting. Clearwater, FL. Sheraton Sand Key Resort. For more information, call 847/6981637, e-mail acpoc@aaos.org, or visit www.acpoc.org. ■■ JUNE 4-5: PrimeFare East Regional Scientific Symposium 2010. Nashville. Nashville Convention Center. Contact Jane Edwards at 888/388-5243 or visit www.primecareop.com.

■■ JUNE 9: AOPA Audio Conference: “When Disaster Strikes: Implementing a Contingency Plan.” To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org.

■■ JUNE 10: Ohio Willow Wood: LimbLogic VS™ Applications Practitioner Course. Mt. Sterling, OH. Course covers various clinical aspects of LimbLogic VS applications: static and dynamic socket fitting, vacuum pump configurations, fob operation, system evaluation, liner options, alignment, and troubleshooting. Credits: 7.25 ABC/7.0 BOC. Registration deadline: May 20. Contact 877/665-5443. ■■ JUNE 10-11: Michigan Orthotics & Prosthetics Association (MOPA) Continuing Education Seminar. Mt. Pleasant, MI. Soaring Eagle Casino & Resort. For details visit www.mopa.info or contact Mary Ellen Kitzman at 248/615-0600 or e-mail MOPA_meeting@MOPA.info. ■■ JUNE 11-12: Ohio Willow Wood: LimbLogic™ VS Applications Technicians Course, Mt. Sterling, OH. Learn all aspects of fabricating LimbLogic VS for various applications: socket materials, controller configurations and care, fob operation, troubleshooting. Fabricate sockets following recommended techniques for airtight socket designs. Credits: 12.25 ABC/12.0 BOC. Registration deadline: May 20. Contact: 877/665-5443.

AOPA PRESENTS

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GET CONNECTED Contact Michael Chapman at (571) 431-0843 or mchapman@AOPAnet.org.

Manufacturers: Get your products in front of AOPA members! Contact Joe McTernan at (571) 431-0811 or jmcternan@AOPAnet.org.

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Calendar

■■ JUNE 11-12: Rehabilitation Institute of Chicago: The Foot: Evaluation and management of common disorders. Chicago. Featuring Thomas McPoil. 14.75 ABC credits. Contact Melissa Kolski at 312/238-7731 or vist www.ric. org/education. ■■ JUNE 24- 25: Advanced Orthotic Design Workshop, OTS Corp. Asheville, NC. Course includes: solutions and techniques that optimize gait. Address the new orthotic components that emphasize dynamic motion guidance. Presentation of case studies containing unique challenges and subsequent clinical solutions. To register, contact Tracy Ledford at 800/221-4769.

JUNE 25: TASTE OF CHICAGO and Bioness Training Course. Chicago. One-day course covers NESS L300 system evaluation and hands-on training. Instructed by John Michael, MEd, CPO/L. The NESS L300 is a user-friendly neuroprosthetic designed to improve gait for individuals experiencing foot drop. 7 MCE credits from ABC. Register at www.opga.com or 800/214-6742.

■■ JULY 15-17: Alabama Prosthetists and Orthotists Association State Meeting. Birmingham. Birmingham Hilton. Contact Fred Crawford at 205/2801666 or crawfordfc@huges.net or visit www.alabamapoa.org. ■■ AUGUST 4-5: Canadian Association of Prosthetists and Orthotists Meeting. Quebec City. Hilton Quebec. Contact Kathy Kostycz at 204/949-4970 or capo@mts.net. ■■ AUGUST 6-7: Texas Chapter of the American Academy of Orthotist and Prosthetist (TCAAOP), Annual meeting and Scientific Symposium. Austin, TX. Sheraton Austin Hotel. Contact Jonathon Cassens, CPO, at 979/255-5165 or ctoplp@aol.com.

■■

■■ JULY 8-10: Florida Association of O&P. Bonita Springs, Florida. Hyatt Regency Coconut Point. For information visit www.faop.org. ■■ JULY 14: AOPA Audio Conference: “Medicare Appeals Strategies.” To register contact Erin Kennedy at 571/431-0876 or ekennedy@ AOPAnet.org.

O&P ALMANAC APRIL 2010

■■ AUGUST 11: AOPA Audio Conference: “Medicare’s Knocking: How Good Is Your Compliance Plan?” To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org.

■■ AUGUST 13-14: Ohio Willow Wood: LimbLogic™ VS Applications Technicians Course. Mt. Sterling, OH. Learn all aspects of fabricating LimbLogic VS for various applications: socket materials, controller configurations and care, fob operation, troubleshooting. Fabricate sockets following recommended techniques for airtight socket designs. Credits: 12.25 ABC/12.0 BOC. Registration deadline: May 20. Contact 877/665-5443. ■■ AUGUST 20-21: Arkansas Orthotic, Prosthetic, & Pedorthic Association State Meeting. Little Rock, AR. Peabody Hotel. Contact Tonya Horton at 501/663-2908 or thorton@ hortonsoandp.com. ■■ SEPTEMBER 8: AOPA Audio Conference: “Missed Billing Opportunities: Are You Billing Everything You Can?” To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org.

SEPTEMBER 29OCTOBER 2 AOPA National Assembly. Orlando, FL. Rosen Shingle Creek Resort. Exhibitors and sponsorship opportunities, contact Kelly O’Neill, 571/431-0852, or koneill@ AOPAnet.org. ■■

■■ AUGUST 12: Ohio Willow Wood: LimbLogic VS™ Applications Practitioner Course. Mt. Sterling, OH. Course covers various clinical aspects of LimbLogic VS applications: static and dynamic socket fitting, vacuum pump configurations, fob operation, system evaluation, liner options, alignment, and troubleshooting. Credits: 7.25 ABC/7.0 BOC. Registration deadline: May 20. Contact 877/665-5443.

■■ OCTOBER 13: AOPA Audio Conference: “You’re Going To Pay Me WHAT? Hints on Managed Care Contracting.” To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org.

■■ OCTOBER 14-15: AOPA Mastering Medicare: Advance Coding and Billing Seminar. Las Vegas. Mandalay Bay Resort. To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org.

■■ NOVEMBER 10: AOPA Audio Conference: “The Ins and Outs of Billing in a Part A Setting: Hospital, SNF and Hospice.” To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org.

■■ DECEMBER 8: AOPA Audio Conference: ”New Codes and Medical Policies for 2011.” To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org.

2011 ■■ MARCH 28 - APRIL 2: Association of Children’s Prosthetic-Orthotic Clinics 2011 Annual Meeting. Park City, UT. The Canyons. For more information, call 847/698-1637, e-mail acpoc@ aaos.org, or visit www.acpoc. org. a

ORLANDO

SEPTEMBER 29 – OCTOBER 2, 2010 ORLANDO, FLORIDA

Rosen Shingle Creek Resort

SAVE THE DATE SEPTEMBER 29 – OCTOBER 2, 2010 We look forward to seeing you in Orlando! For more information, visit our Web site at www.AOPAnet.org.

Ad Index

For free product information from these advertisers, enter the advertiser name online at www.opalmanac.org/shop. Company

Page

Phone

Web site or E-mail

Allard USA Inc.

888/678-6548

www.allardusa.com

ALPS

800/574-5426

www.easyliner.com

Orthotics, Prosthetics & Pedorthics

703/836-7114

www.abcop.org

Apis Footwear

31, 43

888/937-2747

www.bigwideshoes.com

College Park Industries Inc.

800/728-7950

www.college-park.com

Daw Industries

800/252-2828

www.daw-usa.com

Dr. Comfort

5, C3

800/556-5572

www.drcomfortdpm.com

Euro International

7, 35

800/378-2480

www.eurointl.com

Fillauer Companies Inc.

800/251-6398

www.fillauercompanies.com

KISS Technologies LLC

410/663-5477

www.kiss-suspension.com

Ohio Willow Wood

800/848-4930

www.owwco.com

OPTEC

10, 11

888/982-8181

www.optecusa.com

OssurÂŽ Americas Inc.

800/233-6263

www.ossur.com

PEL Supply Company

800/321-1264

www.pelsupply.com

Spinal Technology Inc.

800/253-7868

www.spinaltech.com

Texas Assistive Devices LLC

800/532-6840

www.n-abler.org

Otto Bock HealthCare

800/328-4058

www.ottobockus.com

SPS

800/767-7776 Ext. 3

www.spsco.com

American Board for Certification in

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“my old knee controlled me. with my new rheo knee, i'm in control!” ®

Only the RHEO KNEE uses Artificial Intelligence to continuously adapt to the user's walking style and environment. The RHEO KNEE recognizes and responds immediately to changes in speed, load and terrain, restoring the user's ability to walk naturally, comfortably and confidently at any speed. The new RHEO KNEE now features a 275 pound weight capability, as well as reduced resistance for faster swing speed and improved user confidence.

try the new rheo knee today and enable your patients to walk their way.

Dave Leeka, 60, Vietnam Veteran and Retired University Administrator