January 2010 O&P Almanac

Almanac OP The American Orthotic & Prosthetic Association

JANUARY 2010

& &

PROGRESS

CHANGE

AND

WWW.AOPANET.ORG

THE MAGAZINE FOR THE ORTHOTICS & PROSTHETICS INDUSTRY

Technology, consumer attitudes are already changing the direction of O&P

PROFESSIONALS DISCUSS NEW JOB ROLES NEW HIPAA UPDATES FOR 2010

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O&P Almanac JANUARY 2010, VOLUME 59, NO. 1

COLUMNS

COVER STORY

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Progress and Change

By Scott Briscoe While health-care reform dominates the news, experts say many social and economic trends are already changing health care in fundamental ways.

Discover what new challenges and opportunities await the O&P industry.

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Where We’re Headed You’ve heard from the experts, now three seasoned professionals discuss how their job functions are changing and what skills will be crucial for future success.

HIPAA data breach notifications

Technician’s Corner Laminating tips for the Propio Foot

DEPARTMENTS

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FEATURE STORY

Reimbursement Page

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CONTENTS

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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

Marketplace Products and services for O&P

Jobs Opportunities for O&P professionals

Calendar Upcoming meetings and events

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NEW!

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

AOPA Membership Applications

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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.

JANUARY 2010 O&P ALMANAC

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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 O’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: 571/431-0804

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

Devon Bernard, reimbursement services coordinator, 571/431-0854, dbernard@AOPAnet.org

NEW!

Joe McTernan, director of reimbursement services, 571/431-0811, jmcternan@AOPAnet.org

Visit O&P Almanac online at www.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.

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O&P ALMANAC JANUARY 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

SmartHand Pioneers Sense of ‘TOUCH’

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new prosthetic device called SmartHand is not only capable of such intricate tasks as writing but also appears to offer a sense of touch, according to the Swiss amputee who is the first—and, as yet, only—user.

The device has four electric motors and 40 sensors, which activate when SmartHand touches an object. The user reports “feeling” in his fingertips again. The current model’s “bones” and wires are visible, but the plan is to provide a prosthetic skin covering, which may increase the sensations delivered by the device.

TRANSITIONS

PEOPLE IN THE NEWS

Natalie Bacha, CO, has joined Hanger Prosthetics & Orthotics’s Oakland, California, patient-care facility. Bacha holds a bachelor’s degree from Indiana University and attended the prosthetic and orthotic master’s degree program at Eastern Michigan University.

Brian Becker, C.Ped, has joined Hanger Prosthetics & Orthotics in Parkersburg, West Virginia. Becker attended Vincennes University and the Robert M. Palmer, MD, School of Biomechanics, Inc., Elwood, Indiana.

Jennifer Christy has begun her prosthetic residency at OrPro Prosthetics & Orthotics in Waldorf, Maryland. Christy recently earned a Bachelor of Applied Science degree in Orthotics & Prosthetics from St. Petersburg College in Florida.

Professor Yosi Shacham-Diamand of Tel Aviv University developed the interface between the device and the body’s nerves, which have functional endings at the site of a severed limb.

Shachum-Diamand, who heads a world-class lab for nano-bio-interfacing science, collaborated with a team of European Union (EU) scientists who built the device. The designers plan to study amputees equipped with SmartHands to determine further improvements.

Funding for the project is provided by the EU Sixth Framework Programme, ARTS Lab, Scuola Superiore Sant’Anna (Italy); Ossur (Iceland); Tyndall Institute (Ireland); SciTech Link HB (Sweden); and Aalborg University (Denmark).

For further information, see sciencedaily.com.

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O&P ALMANAC JANUARY 2010

Frank Coppolino, CP, is the new manager of the Richmond, Indiana, office of OrPro, Inc. Coppolino brings nearly 40 years of O&P experience, including patient care, sales and marketing, and practice management, most recently with Hanger Prosthetics & Orthotics in Evansville, Indiana.

Jeremy Crowell joins the Hosmer Dorrance Corp. and Center for Orthotics Design teams with 18 years of prosthetic and orthotic experience.

He is the new manager of central fabrication in Campbell, California.

Pete Grabaskas has been promoted to chief operating officer from vice president of operations and initiatives, also at Physiotherapy Associates. Grabaskas has

been a physical therapist for more than 25 years.

Susan Hoeflitch has joined Physiotherapy Associates as vice president of contracting and payer relations.

Hoeflitch has more than 16 years of experience in the areas of contracting, provider relations, operations, and credentialing. She was previously vice president of managed care contracting and reimbursements with U.S. Physical Therapy Inc. Aaron James, CO, is now a part of the Columbia, Missouri, team for Hanger Prosthetics & Orthotics.

James brings more than 10 years of O&P experience to his new position.

He earned his bachelor’s degree from New Mexico Highlands University.

Peter Limeri has been promoted to president of Physiotherapy Associates. He also will continue his current responsibilities as chief financial officer.

Guy Mayer has been appointed president and CEO of Ascension Orthopedics, Inc., in Austin, Texas.

Mayer joins Ascension after serving more than 30 years in leadership roles in the medical device industry. He holds a bachelor’s degree from the University of Ottawa.

Judith Trinkl is the new technical director for Euro International.

She has more than 15 years experience in the O&P industry, including conducting clinical education courses.

Trinkl graduated from Bundesfachschule für Orthopädie-Technik in Dortmund, Germany, with a master’s degree in orthotics and prosthetics.

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In the News

Oscar Pistorius.

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hampion sprinter and bilateral amputee Oscar Pistorius was barred from the 400-meter dash at the 2008 Olympic Games in Beijing, and other able-body races. The reason is not that he’s an amputee, but that his Cheetah Flex-Foot prostheses provide significant advantages over nonamputee competitors. That was the contention of the International Association of Athletic Federations, which is responsible for barring Pistorius from competition. In addition, some have proposed that the lighter weight of specially designed sport prostheses facilitates a quicker swing of the leg.

But, a new study by six researchers shows that amputees who use runningspecific prosthetic legs have no performance advantage over counterparts who use their biological legs. The researchers measured forces exerted on the ground and leg “swing times”

TRANSITIONS

Didrick Medical Inc. has earned the 2009 Perfect Pitch Award for the X-Finger, an active-function artificial finger designed specifically for

O&P ALMANAC JANUARY 2010

Utah, and Rodger Kram of Colorado University(CU)-Boulder’s department of integrative physiology and its Locomotion Laboratory. Grabowski, lead author on the study, received her doctoral degree in integrative physiology at CU-Boulder under Kram in 2007.

More information is available at www.colorado.edu.

BUSINESSES IN THE NEWS

The Amputee Coalition of America has named its youth camp in honor of the organization’s former president & CEO, Patricia “Paddy” Rossbach. The Paddy Rossbach Youth Camp is a five-day traditional summer camp experience for children ages 10-17 who have lost arms and/or legs or who were born with limb differences. Since it began in 2000, the camp has hosted more than 450 young campers from 42 states and three countries.

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while the unilateral amputees ran on a high-speed treadmill. The runningspecific prostheses impaired the force production of runners by an average of 9 percent. Force production is generally believed to be the key factor behind running speed. No differences in leg swing times were measured.

The U.S. research team presented the findings in April 2008 to the Court of Arbitration for Sport in Lausanne, Switzerland, providing key evidence that resulted in the reversal of the ban on Pistorius.

The study was published Nov. 4, 2009 in Biology Letters, a journal of the Royal Society in London, and is co-authored by Alena Grabowski and Hugh Herr of the Massachusetts Institute of Technology, Craig McGowan of the University of Texas at Austin, William McDermott of The Orthopedic Specialty Hospital in Murray,

Photo: Ossur Americas

NEW STUDY: Prosthetics Don’t Accelerate Performance

partial finger amputees. The award was given at the Perfect Pitch 2009 Entrepreneur & Investor Conference held in October in Marina del Ray, California.

Didrick also is launching the World Hand Foundation, a non-profit foundation that seeks to increase access to prosthetic hand devices in communities around the world that aren’t able to invest in such devices. Didrick will donate a percentage of all X-Finger sales to the World Hand Foundation.

Ossur marked its 10th year of being publicly traded on NASDAQ OMX Iceland as well as its new dual listing on NASDAQ OMX Copenhagen by ringing the closing bell at NASDAQ in

New York. Jon Sigurdsson, president and CEO of Ossur, was on hand to do the honors.

PrimeCare Network launched its first Initiating Mobility Provider Relations Executives Seminar (imPRES). The event enabled provider relations executives, medical directors, and nurse life care planners to network with one another and with PrimeCare board members, and to learn more about prosthetics and orthotics. PrimeCare plans to hold imPRES annually. The inaugural seminar was held at the Westin Hotel in Memphis, Tennessee, in October.

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In the News Touch Bionics Launches Lifelike PROSTHETIC FINGERS

Photo: Touch Bionics

iLIMB maker Touch Bionics has launched ProDigits, self-contained fingers that are individually powered and controlled to help partial-hand patients who have lost one to five fingers as the result of congenital abnormality or amputation. Users can point ProDigits single digits for typing, hand gestures, or the use of a telephone, among other everyday tasks.

ProDigits, short for Prosthetic Digits, are appropriate for individuals who have had amputation at the trans-

E-8181-0110:E-8181-0110

12/4/09

metacarpal level or higher for one or more fingers. The new prosthetics can be powered using • myoelectric sensors that register muscle signals from the residual finger or palm • or a force-sensitive resistor (FSR), or touch pad, which relies on the remnant digit or tissue surrounding the metacarpal bone to provide the necessary pressure to activate the finger.

With the ability to bend, touch, pick-up, and point, ProDigits best reflect the function of a natural hand when used with a prosthesis. As with the iLIMB, a stall feature allows the device to detect when it has closed around an object, allowing users

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to configure the hand in various grip patterns. Different coverings are available, including one which displays the high-tech nature of the device. Touch Bionics’ LIVINGSKIN covering also is available to resemble human skin.

Because of special fitting needs for ProDigits, Touch Bionics is developing a clinical collaborator program in North America to partner with practitioners to properly fit patients.

It is estimated that 40,000 amputees in the United States and 1.2 million worldwide could benefit from this device.

To learn more, visit www.touch bionics.com/ProDigits. a

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By Devon Bernard, AOPA government affairs department

Be Aware of Key HIPAA Changes Focus on compliance for breach notifications and business associate agreements

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n Feb. 17, 2009, President Obama signed into law the American Recovery and Reinvestment Act (ARRA), also known as the stimulus bill. ARRA contained a provision that mandated the Secretary of the Department of Health and Human Services (HHS) to make updates to HIPAA. These updates are in Title XIII, the Health Information Technology for Economic and Clinical Health (HITECH) Act. The purpose of HITECH was to further advance the use of electronic communications in the health-care arena; it also expanded the reach of HIPAA, and will affect those who also continue to use paper documents. These updates were required to go into effect no later than 12 months after ARRA was signed.

HHS released its regulations affecting both the privacy and security portions of HIPAA on Aug. 23,

2009, which then became effective on September 23; however, HHS will not begin active enforcement of these new regulations until Feb. 22, 2010. This extra time is to allow you to become compliant with the new regulations.

To help you understand the changes, it is a good idea to review some key terms associated with HIPAA: • Breach: The unauthorized use or disclosure of protected health information (PHI) that violates the HIPAA rules, and compromises the security and/or privacy of the PHI. • Business Associate: A person or entity which provides services to covered entities, and requires the use and disclosure of PHI; these could be third-party billers, accounts, or clearinghouses.

• Covered Entity: An organization that must comply with all HIPAA rules and regulations when using/ creating PHI. As a health-care provider, you are considered a covered entity.

• Disclosure: The means by which a covered entity communicates PHI to an outside entity, and is normally allowed under HIPAA. • Protected Health Information (PHI): Information created by a health-care provider that is used to identify an individual for the purpose of treatment and billing.

PHI is also referred to as individually identifiable health information, and could be such information as Medicare ID or Social Security numbers.

• Secured: Any PHI that has been rendered unusable, unreadable, or indecipherable by accepted methods. These methods include encryption for electronic records or shredding for paper information.

• Unsecured: Any PHI that has not been destroyed, made unreadable, or unusable by acceptable methods.

• Use: Refers to acceptable, under HIPAA, disclosures of PHI in the daily operations of a business; for example, PHI used for treatment or billing.

With a background on the updates, and definitions for the key terms, we can focus on those changes that relate to breach notifications and business associates.

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O&P ALMANAC JANUARY 2010

Reimbursement Page

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Breach Notifications Under the old HIPAA statute, a covered entity was not required to notify anyone when an unsecured breach occurred, unless state laws required it to do so. The only obligation was to account for the breach, and notify patients if they requested such information.

A covered entity is now required to notify the patient, in a timely manner, when an unsecured breach of PHI has been discovered. A breach is considered discovered on the date the covered entity learns of the breach, and not on the date the breach occurred. A timely manner is considered to be no later than 60 days after the discovery.

The notification must be in writing or by e-mail if the patient prefers.

If you don’t have an address, or the contact information is not current for patients, you may call them. If the breach contains PHI for 10 or more people, for whom you don’t have contact information, you may post a notice on your Web site, but the notice

must be posted for 90 days and include a toll-free contact number, or you may contact the media.

What should be included in your written notification?

• First, you must include a brief description of the breach. This should include any information that you have, including when the breach occurred, and when you learned of the breach.

• Second, provide a description of what information was breached.

• Third, provide patients with some steps they may take in order to protect themselves.

• Fourth, inform them of what you are doing to correct the breach.

• Fifth, provide patients with a way to contact you with any more questions.

If a breach involves more than 500 people, you must notify HHS immediately, and the information will be posted on the HHS Web site. You also must notify the media, and notify patients in writing.

You also must keep a record of all breaches that occur during the year.

This record will then be submitted to HHS on an annual basis, no later than 60 days after the end of the year. HHS provides an online form for submitting information about your breaches. Find the form on the Office of Civil Rights (OCR) Web site at www.hhs.gov/ocr.

How do you determine if a breach occurred and notification is required?

Ask, and document your answers to, the following four questions: 1) Was the disclosure of the PHI approved under HIPAA? That is, was the PHI used in accordance with your business activities, such as releasing PHI for treatment purposes or billing purposes.

2) Was the PHI disclosed in a secured manner? This means that the PHI was encrypted, or shredded.

3) Will the PHI not have an adverse effect on the patient? In other words, the PHI will not result in a chance of identify theft, or harm to the patient in any other way.

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Reimbursement Page

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This is referred to as a “Risk Assessment.”

4) Was the breach allowed under one of the exemptions set forth in HITECH? The three exemptions under HITECH are: • Unintentional: The acquisition, access, or use of PHI by any workforce member or person acting under the authority of a covered entity or business associate, if such acquisition, access, or use was made in good faith and within the scope of authority, and does not result in further use or disclosure in a manner not permitted by the privacy rule.

was covered under one of the exceptions, you may want to consult an attorney, as the burden of proving the breach is an exception now falls on you, as the covered entity. Besides making the notifications required under HITECH, you also must still comply with your states laws regarding reporting breaches.

Your HIPAA policy and procedures should be updated to reflect that your employees have been trained in how to identify a breach, and how to handle said breach. Not only will you have to update your policy and procedures, but also so must any of your business associates (BA). The fact that BAs will have to update their policies and procedures is a big part of the changes under HITECH.

Your HIPAA policy and procedures should be updated to reflect that your employees have been trained in how to identify a breach.

• Inadvertent: The disclosure of PHI by an individual otherwise authorized to access PHI at a facility operated by a covered entity or business associate to another person at the same covered entity or business associate, or at a organized health-care arrangement in which the covered entity participates, and the information received as a result of such disclosure is not further used or disclosed in a manner not permitted under the privacy rule.

• Unauthorized: This is a disclosure where a covered entity or business associate has a good faith belief that an unauthorized person to whom PHI is disclosed would not reasonably have been able to retain the information.

If you answered ‘no’ to any of the questions above, you probably have a breach that requires you to notify patients. If you are not sure the breach

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O&P ALMANAC JANUARY 2010

Focus on BA Agreements Why do BAs have to update or create their own policy and procedures? Because under HITECH, BAs are now required to directly comply with all HIPAA standards, which include both the privacy and security statutes. Prior to HITECH, BAs were only loosely required to follow HIPAA guidelines based on the provisions you provided in your BA agreements. Now that your BAs must comply with the same rules as you, including the new breach notification guidelines, it would be wise to review and amend your business associate agreements, if needed.

If you don’t have agreements with your BAs, now is the time to create one.

A sample business associate agreement may be found on the OCR Web site.

Here are some key items that you may want to include in your amended or new agreements:

1) Include a section that allows you to verify that the BA is in compliance with the HIPAA security and privacy regulations. This means that they should have administrative, physical, and technical safeguards in place.

2) Ensure that the BA will report all breaches to you in a timely manner, and that these notifications are done in a standard format. You may want them to provide you with the contact information for those affected; a detailed account of the breach, including what was breached; and any steps they are taking to ensure the breach doesn’t occur again. Think of any information that you may require when you have to report the breach, because it is your responsibility, not the BAs, to make the notifications.

3) Include a section which will allow you to protect yourself from any financial losses or liability that may occur because of the breach.

These are just a few suggestions, but with any legal document, it is always wise to have an attorney review the document prior to your signing.

This article covers only two of the changes to HIPAA that are currently in effect, and will immediately affect your business. More changes will be occurring over the next few months and years. AOPA will keep you informed of these changes as they happen, but if you have any questions about the changes listed in this article, please visit the AOPA Web site at www.

AOPAnet.org; go to the Benefits Products & Services tab for HIPAA-related Web sites. You also may contact your OCR regional office and speak to the education officer dedicated to this issue who can answer your HIPAA questions. a Devon Bernard is reimbursement services coordinator for AOPA. Reach him at dbernard @AOPANet.org.

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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.

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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 Previous telephone conferences are available on CD. Please visit the AOPA Bookstore for details.

Register Today!

Visit us online at

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

JANUARY 2010 O&P ALMANAC

17

Progress AND

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O&P ALMANAC JANUARY 2010

Change

BY SCOTT BRISCOE

H

ealth-care reform was a leading topic in 2009 and is certain to dominate the news in 2010.

Whatever the outcome of legislative mandates, however, many social and economic trends are already changing health care in fundamental ways, and creating new challenges and opportunities for the orthotics and prosthetics industry.

“It’s a lot more about health-care ‘transformation’ than it is about health-care ‘reform,’” says Deloitte LLP’s Life Sciences Leader Terry Hisey. “Long before the current economic situation and long before there was a new administration in Washington, we’ve been seeing changes that will affect the life sciences broadly including the medical device sector. It has to do with advances in technology. It has to do with changing demographics on a global basis.”

Consumers also are a powerful force for change, Hisey notes. “It has to do with consumer attitudes, particularly with an aging population that wants to see medical technology and devices that will help them maintain a certain quality of life, manage chronic conditions with smaller, less invasive solutions, and to do so at a price point they find affordable.

So, there’s a lot there that goes well beyond the pay-for-it legislation currently in the works.”

“We have a toxic health-care system,” says Clement Bezold, founder and chairman of the Institute for Alternative Futures (IAF), a nonprofit research and educational organization based in Alexandria, Virginia. “In a lot of cases, it’s toxic for those receiving care, and it’s obviously toxic for the economy. We’ve evolved a system that just isn’t sustainable; either we’re going to collapse, or health care will be reinvented.”

Certainly, the so-called pay-for-it legislation would be a significant step toward altering the health-care system, but there are already many powerful forces at work. Here’s a closer look at those catalysts that will not only change health care, but also lead the O&P profession into an exciting—and perhaps unsettling—new reality.

Forces of Change Three key components are driving health-care change: rapid technological advancements in every aspect of medical care; greater personal management of health by individual consumers; and closer reexamination of health-care delivery systems.

These trends, termed “disruptive innovations,” are interconnected and create an environment that affects O&P in both direct and indirect ways, Bezold explained during his presentation at the 2009 AOPA Annual Meeting in Seattle.

CONSUMER INFLUENCE AND EMERGING TECHNOLOGIES

PAVE THE ROAD AHEAD FOR O&P JANUARY 2010 O&P ALMANAC

19

Technological advancements.

Bezold points to exciting and significant technological innovations that are revolutionizing health care: • New biomonitoring capabilities generate more and better information using devices that are noninvasive. One example is a biosensor no larger than a Band-Aid that wirelessly transmits a range of information from heart rates and temperature to amino acid levels.

• Use of genomics and massive storehouses of accessible, electronic medical records will enable treatments to be tailored to the individual based on history, symptoms, side effects, and other factors.

The Mayo Clinic’s Health Manager System is one example of how a data repository is being used to personalize health-care delivery.

Another is the AOPA and Jefferson School of Population Health at Thomas Jefferson University pilot study, which researchers hope will provide valuable insights for physicians, payers, and patients about the safety and effectiveness of O&P devices in diverse populations and situations.

Photo: ©Dirk van der Merwe. www.wildphotographs.com

Materials science, engineering, and collaboration across medical specialties also are making amazing prosthetic advances, such as osseointegration, polymers with the look and feel of actual skin, and the neurologically controlled prosthetic “Luke Arm,” whose functionality and control are nearly identical to an actual arm and limb. But innovation isn’t just in hightech robotics, Bezold says. “There’s a low-tech side to this where we’re learning to mass produce artificial

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O&P ALMANAC JANUARY 2010

limbs that are stronger and more suitable to varying conditions, and we’re able to do it with amazing efficiency,” he explains.

The key to all innovation—hightech or low-tech—is effectiveness, says Hisey. “I think we’ll focus on comparative effectiveness, meaning true innovation will generate clinically superior outcomes or better safety profiles or more cost-effective treatments. Affordability will be important, particularly in the adoption of medical technology around the world. Why use titanium if there is no medical advantage over stainless steel in a particular setting?”

Personal management of health.

Connectivity and access to information are enabling individuals to become more involved with their care.

According to Deloitte’s Connected Care: Technology-Enabled Care at Home report, “increased use of in-home technologies improves medication adherence, reduces avoidable post-acute complications, and enhances self-care management of chronic conditions.”

Access to information and monitoring devices “will make managing conditions on a day-in, day-out basis much less compromising than it used to be.

And it will be more in line with the

lifestyle that people will want to live,” says Hisey.

Of course, information access can be a double-edged sword. The Industry Compass 2.0 Report, developed by Deloitte and IAF, notes that healthcare consumers may use their personal health profile, selective information from large medical data warehouses, and other sources to question their care and self-diagnose in ways that will increase the time burden on care providers who are already strapped for time. Bezold points to the development of online digital coaching, a personalized digital medical assistant, to help consumers make informed decisions based on massive amounts of available information.

Medical tourism is another personal health management trend that Bezold highlights, pointing to a 2008 BusinessWeek report that lists the costs of various procedures in different countries. One of the largest discrepancies, for example, is a valve replacement procedure that costs $160,000 in the United States versus just $10,000 in Thailand.

But medical tourism isn’t just targeting surgical procedures.

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from the O&P profession. “Healthcare providers must expand their current focus on episodic, acute care to encompass the enhanced management of chronic diseases and the lifelong prediction and prevention of illness,” he said. “O&P provides that chronic management and we must align ourselves with those episodic, acute providers to fill this niche.”

Health-care delivery. Emerging technology and personal health management trends also are intertwined in ways that are changing how health care is delivered. Consider such innovations as retail clinics in WalMart and other national chains that treat hundreds of common conditions efficiently and with high customer satisfaction; use of medical records to transform treatments; and employers who promote wellness programs and education to ensure a more healthy and productive workforce.

Bezold describes health-care delivery in a “medical home/health home” context: “The medical home/ health home is really stepping back from some of the stupidity of the health-care system,” he says, “which is that no one really cares for you in an ongoing way. If you get past clinician to clinician and specialist to specialist, nobody really knows anything about you. A medical home would know.

They would follow you, coordinate your care, be able to anticipate your needs, and make sure you get the screenings and tests you need. A lot of this work is below the pay grade of a physician. You need a team of collaborative providers. Some of the community health centers are doing wonderful work in this area, creating a health home for individuals.”

AOPA Immediate Past President Brian L. Gustin, CP, told attendees of the 2008 AOPA Annual Meeting that this is an opportunity where the rest of the health-care field can learn

Knowledge and Accountability As episodic care evolves into the medical home/health home concept, electronic medical records will help health professionals make informed, joint decisions for patients based not only on the specific patient’s situation and history, but also on thousands of other similar records. Diagnoses and treatments will improve as the database grows, and the information available to patients so they can make better decisions for themselves. In turn, these informed health-care consumers will expect their health-care providers to be up to speed on the latest ideas and practices.

These trends are important to O&P providers, who will need to be prepared for a public that is better informed about options and opportunities, as well as more aware of the cost of prosthetic and orthotic

devices. “There will be a transparency of products and services that will enable health-care consumers to make the best decisions for their care,” says Bezold. “O&P providers will need to be prepared to add value in this new, better-informed marketplace.”

Overall, this should lead to improved health, and, in particular, improved management of chronic diseases such as Type II diabetes and hypertension. “No one is predicting a rapid end to the chronic conditions that have grown rapidly as a result of the lifestyles we live and other factors,” says Bezold. “But the hope and belief is that the rate of growth will be drastically different, and we’ll be able to better manage them.”

Working with the American Board for Certification in Orthotics, Prosthetics & Pedorthics, Bezold examined possible future scenarios and the likely impact on the number of amputations in the years ahead (see chart on the next page). The variable factors involved in making the estimates include effectiveness of health advances and lifestyle changes in controlling chronic illnesses such as Type II diabetes;, presence of war and conflict; economic conditions; safety conditions; and technological advancement, among other things.

Who Pays Paid for Who for Health HealthCare Careinin2009?

2009?

The government paid for much of it.

The government pays for much of it Billions of Dollars

Medicare Part A Annual Surplus or Deficit 2000

2010

2020

2030

2040

Based on 2007 Annual Report of the Board of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds and 2005 GAO report

Source: Clement Bezold, Institute for Alternative Futures

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O&P ALMANAC JANUARY 2010

• Scenario 1 carries forward current trends, meaning we see technological advancement, a sound economy (peaks and valleys averaging to slow, steady growth), but we are unable to alter lifestyles that contribute to chronic disease. The result is an increase of 12,000 amputations in the United Sates by 2020.

• Scenario 2 is the doomsday scenario: The rate of chronic conditions escalates even faster than it had the past 10 years, war and conflict intensify, and economic conditions lead to a riskier infrastructure and slower technological advancement. The result is an increase of 55,000 amputations by 2020.

• Scenario 3 is the same as Scenario 1 except we’re able to make progress in both lifestyle changes and technological advancement, and the number of amputations due to chronic conditions stays the same, despite a growing population.

• Scenario 4 assumes significant improvement in all variables, leading to a drop in amputations of 20,000 by 2020.

New Business Processes The sweeping changes to health care are forcing all service and product providers to change how they do business. Gustin and Bezold both say that O&P providers will certainly be affected.

For Gustin, it’s a fundamental shift in how O&P providers think of themselves. “We’ve traditionally been a hands-on profession, but it’s quickly transitioning to being a neck-up profession,” he says. “The value comes in with the service you provide, not necessarily what you produce and manufacture. There is a general reluctance to let go of the creation side, which is where the O&P industry has gotten its identity from, but that needs to change, and it needs to change rapidly.”

One of the critical factors driving this change is the move to bundling payments, according to Bezold.

Simply, this means that episodic costs

Amputations in 2020 (ABC Scenarios) Amputations in 2000

136,000 Amputations in 2010 estimated to be

145,000 AMPUTATIONS IN 2020: SCENARIO 1

SCENARIO 2

SCENARIO 3

SCENARIO 4

157,000

200,000

145,000

125,000

Source: Clement Bezold, Institute for Alternative Futures

will be bundled together and billed by one care provider. For example, continuing therapeutic care for stroke victims incurs various costs from many different health-care professionals, including O&P providers. Rather than individual billing for the different care, one group will manage the billing.

“Prosthetists are down the food chain a little bit,” Bezold says. “They’re unlikely to be the ones controlling the bundle, and the ones controlling the bundle—whether it’s a physician or physical therapy—are likely to want to squeeze the profitability of that bundle, and that’s going to affect how O&P providers price their products and services.”

“I agree with that wholeheartedly,” says Gustin. “Technology today can allow disparate people to provide the services that O&P has traditionally provided. Either O&P embraces that technology and survives, or it doesn’t and somebody else will. Those clinging to the status quo and the past won’t survive that kind of change. We really need to look at our business model and find ways to reduce costs. Traditionally, O&P has three areas of cost: labor, overhead, and cost of goods sold. We need to develop models that reduce all three of those areas if we want to maintain profitability.”

Finally, there’s the nexus where technology intersects with new business models and the question of how people pay for better health care.

There’s a difference between a $1,000 prosthetic and a $50,000 prosthetic: Who will decide which is the right prosthetic for which situation?

“There’s a prevailing school of thought that there’s a baseline that everybody should be able to access and some additional tiered options on top of that, where employers offer enhanced coverage or people choose to pay for advanced technology out of their pocket,” says Hiser. “And I think it’s important to realize that health care 1.0—what we’re talking about now in Washington—is about paying. But over time, there will be a health care 2.0 and 3.0 that will start to address some of these and other advanced issues.” a Scott Briscoe is a contributing writer for O&P Almanac. Reach him at sebricoe@ gmail.com.

EDITOR’S NOTE: For more information about comparative research efforts and the future of O&P service models, check out the December 2009 issue of O&P Almanac.

JANUARY 2010 O&P ALMANAC

23

Where We’re Headed Industry veterans speak out about the role of O&P in the years ahead

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Technology will continue to reduce the time we spend fabricating devices in the lab and allow us to spend more time providing accurate, efficient, and appropriate patient care. With the advancement of computerized alignment devices, programmable knees and ankles, we will need to become even more computer savvy.

Outcomes also will play a role in our future. This will necessitate us spending more time collecting data on our patients and performing evidencebased and patient-reported outcomes.

Our future job description will require us to be proficient at running various software programs and analyzing data.

The industry must continue on its path of defining quality patient care through evidenced-based and patientperceived outcomes measurement.

The more we are able to quantitatively define that what we do is appropriate and justified, the less resistance we will have from payers on reimbursement issues. It’s very disheartening to receive a denial from an insurance company stating the components requested are considered “experimental” or “there is lack of evidence to support your claim.”

Change is inevitable. Certified practitioners are currently evolving into pure clinicians. In the future, their primary role will be to provide a clinical assessment, create an orthotic or prosthetic care plan, and then utilize technology and staff to carry out that plan. The use of this model will allow clinicians to focus the implementation, execution, and completion of their care plan rather than participating in the details.

Measuring and monitoring outcomes and sharing them with our referral sources as well as the payers.

Insurance companies dictate patient care. A concerted effort on the part of O&P to provide evidence-based outcomes will help to better educate these insurers. This education will ultimately assist patients in obtaining the best devices as deemed by technology as opposed to what an insurer may feel is the most appropriate based on cost.

The job functions of a practice owner will most assuredly change over the next five to 10 years. For those who are practicing clinicians they will face increased challenges in trying to balance patient care and managing business processes. Owners will need to redefine themselves as facilitators and managers.

The industry is on the right track toward improving patient care. The advent of facility accreditation and elevating the educational requirement for practitioners to masters and doctorate level will position us to meet quality patient-care standards of the future. Of course you cannot address improved patient care without including professional licensure. Practitioners in every state should get behind their states licensure effort.

Jim Alaimo, CPO Location: Spring City, Pennsylvania

30

YEARS IN THE INDUSTRY

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YEARS IN THE INDUSTRY

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YEARS IN THE INDUSTRY

Do you foresee your job functions changing over the next five to 10 years? Why or why not?

Jim Haas, CO, President

Facility: Orthotics & Prosthetics Laboratories, Inc. Location: Springfield, Massachusetts

Eileen Levis, CEO, President Facility: Orthologix, LLC Location: Philadelphia

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O&P ALMANAC JANUARY 2010

How can the industry improve patient care today?

From health-care reform to emerging technologies, so much of the orthotics and prosthetics business is rapidly changing to meet the demands of an evolving industry. While many experts predict this decade will bring fundamental shifts in how patients receive care and businesses carve out revenues, those providing care and managing facilities have yet to be heard.

O&P Almanac recently talked to three veteran professionals about this changing landscape and what success will look like for facility owners and practitioners in the coming years. Here’s what they had to say: CPO

3

4

5

Vacuum assisted technology has been around for a few years concentrating primarily in transtibial applications. In 2009, we started seeing this application getting more of a foothold in socket technology for transfemoral patients. This year, I think we will see enhanced versions using sub-ischial designs. Look for rapid development of articles, components, and fabrication techniques surrounding elevated vacuum in sub-ischial sockets.

This is here to stay and will undoubtedly change the way we provide patient care.

With significant health-care changes ready to pass in Congress, I believe the end result will mean a reduction in reimbursement for the services we provide. As a practitioner and manager, I believe our skills will need to be focused on how we can reduce costs in every aspect of our business. We will need to look very closely at our labor and material costs necessary to deliver each orthotic and prosthetic device and make tough decisions on which devices we can provide at a profit and the labor quotient needed to deliver that product.

From the business point of view, there is no doubt that CMS is trying to reduce the number of codes we use and thus reduce our reimbursement.

They are doing this in two ways: by bundling codes and by eliminating non-custom, prefabricated, or off-theshelf codes. We’ve seen this happen over the past four or five years with knee orthoses and prosthetic knee joints—when they rolled add-on codes into base codes. They also have eliminated many soft goods codes that historically were paid for. The future lies in our profession concentrating its efforts on providing custom devices.

It will be the same as it has been for 2009: health-care reform. The uncertainty and speculation surrounding this topic will stimulate conversation and debate throughout the next year.

Although I feel that stable orthotic and prosthetic practices will be sustained during the process, they will not be without some financial challenges.

Most likely, they will experience reductions in fees schedules, the introduction of a detailed prior-authorization process, and ultimately a stronger push toward competitive bidding.

We must learn to effectively market ourselves. Certified practitioners face competition daily, and it is no longer only from to the O&P place across town. Manufacturers’ sales representatives, occupational and physical therapists, and even orthopedic physicians are routinely fitting patients with orthotic devices.

As practitioners, we will need to “wear our marketing hats” more often and continually remind our referral sources why we should be their primary outlet for orthotic and prosthetic devices.

In my practice there are two. One is our transition to Internet-based business management software. It is allowing us to create a paperless office, tremendously improving our efficiency as well as making communication with referral sources more efficient and effective. The other is the use of a scanner for certain aspects of patient care. It gives us a tool to measure outcomes and also allows us to bridge the shipping gap between us and our manufacturers.

For 2010, as in 2009, I believe the hot-button topic will be health-care reform. We are all concerned how this will play out and how our industry will be affected. Most of us are Medicare and Medicaid providers and anticipate those programs being targeted.

Our industry has and will survive, but in order for us to “thrive” we need strong leadership and advocacy at all levels. Partnerships with groups such as AOPA, Point/VGM, The American Academy, state associations, and so forth are essential. At the very least, we need to become members of these organizations, but we also should consider getting involved with their projects, boards, lobbying efforts, and more.

There are many business and technological developments that will influence O&P. I believe one of the most significant is the emergence of central fabrication as an industry unto itself. The driving force, as we look at the practice of the future, will be clinical excellence. The role of a technician in this new model might be more focused on computer skills or scanning than manufacturing. Central fabrication labs will be our strategic outsource partners. a

What will be the hot-button topic for 2010 and why?

What one skill or ability will be necessary for survival of the profession?

What business or technological development will have the most influence on O&P and why?

JANUARY 2010 O&P ALMANAC

25

Technician’s Corner

n

By Jim Coleman

Step-by-Step Lamination Follow this process for the Proprio Foot battery dummy and Coyote pin system

T

1

2

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O&P ALMANAC JANUARY 2010

he following will outline the proper placement of the Proprio dummy plate used to laminate a socket resulting in a definite impression for the Proprio Foot battery pack placement on the posterior of a below knee, (BK) socket. You may use your shops standard layup for this lamination, although this article will suggest certain materials as well as precautions at particular steps in order to position and laminate the dummy plate unit in its proper position on the posterior of the BK socket.

Photo 1 shows a BK socket made with an inner one-fourth inch Proflex liner formed on the socket with a Coyote unit attached to the distal end of the cast. This is now ready for the lamination layup.

To start the lamination, pull a PVA bag over the cast. Depending on the patient’s weight and activity level, you should start your layup with a doublelayered carbon braid pulled over the cast. Follow with 4 inches of nyglass, then tie distally to hold all material in place. Instructions from the Coyote lamination kit should be followed to cut holes to expose the four screws on the bottom of the Coyote unit. At this time, place the Proprio dummy plate on the posterior section of the cast. The bottom of the dummy unit should be approximately three-quarters to 1 inch up from the posterior seat of the cast with the cast sitting upright in a vise with the pipe securing it in place.

As you hold the dummy unit in position, pull another 4 inches of nyglass over the unit and tie the nyglass distally to hold the unit in its proper place for lamination (see photo 2). Recheck the position, as this is very important for a definitive lamination position.

Continue layup with a reflected

3

4

carbon braid as the outer layer. Then, cut the material over the four screw inserts on the Coyote laminating plate and insert the four screws supplied in the Coyote kit. Also, when placing the dummy in position, make sure the far left stem of the dummy is laying over the edge of the posterior seat on the left side. This will aid in the trimming process, after lamination.

After the lamination cures and the socket is removed from the mold, use a sander to sand the surface of the Proprio dummy to expose the entire surface of the unit (see photo 3).

Remove the dummy unit from the socket. You may need to use a small flat instrument to lightly pry the dummy from the socket. After you remove the dummy unit, notice the two black or dark holes in the center of the dummy.

Ossur makes these holes on the unit to help the lamination become saturated with resin through the dummy plate.

Technician’s Corner

n

5

6

7 You will now notice the discreet outline made by the dummy unit on the posterior section of your socket.

Notice in photo 4 that the right side of the dummy stem is over the edge of the posterior seat. This will create the necessary clearance to insert the charging cable into the battery.

As shown in photo 5, grind out the indent on the left side of the dummy socket area to accommodate the power connection cable to the foot from the battery. The best tool for grinding out the indent is a small hand grinder.

After you check for enough space to accommodate the battery, place a Velcro hook and loop on both the

socket and back of the battery. Make sure the upper (right side) battery charger connection and the lower (left side) power connection have enough relief to accommodate both cords after installation of battery pack. Photo 6 shows this section of battery installation against the finished socket.

The battery pack will fit snuggly against the relief area to prevent lateral displacement. Photo 7 shows the finished socket in place with the battery and with the Proprio Foot attached.

Finally, there are different lamination layups and socket attachments for various patient conditions and needs, but the dummy unit placement will remain with the same finishing proce-

dures regardless of what the BK socket prescription may require.

Photo 8 shows two very satisfied people: Ken Doe, CPO, and his patient, Stan Zucker. a Ralston (Jim) Coleman has been a prosthetic technician for more than 34 years at Boas Surgical, Inc. in Allentown, Pennsylvania. Reach him at 610/432-6736.

Jeffrey Fussner, CPO, CEO of Boas Surgical Inc.; Matt Perkins, CEO of Coyote Designs; and Kurt Gruben, CPO, regional clinical manager of Ossur Americas contributed to this article.

Photos: Jim Coleman

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O&P ALMANAC JANUARY 2010

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AOPA Headlines AOPA WORKING FOR YOU

THE IDEAL

OFFICE CONCEPT Debuts at AOPA National Assembly

C

are-extenders, paperless offices, laser modeling—these ideas and more were highlighted during the Ideal Office of the Future presentation at the September 2009 AOPA National Assembly.

The new concepts were also brought to life in the exhibit hall with a detailed scale model of the ideal office featuring futuristic equipment donated by several AOPA exhibitors.

The Ideal Office of the Future strategic initiative brings together the technology, architecture, and re-mapping of the O&P practice of today to meet the needs of tomorrow.

Like all other AOPA strategic initiatives, the Ideal Office of the Future emerged from the analysis of the December 2007 member survey in which 29 percent of the membership shared their thoughts on the needs of O&P in the future.

To fully outline the concept and explain how the careextender business model works, a 15-minute DVD was produced by the initiative’s workgroup and distributed free to audience members. The recent staff report sent to AOPA members also includes an order form that enables them to receive free copies, as well.

The Ideal Office of the Future strategic initiative brings together the technology, architecture, and re-mapping of the O&P practice of today to meet the needs of tomorrow.

Kel Bergmann, CPO, the member of the AOPA Board of Directors who is championing this initiative, stars in the video. Bergmann and his workgroup drafted the script outline, hired the production company, and directed every step of the DVD’s development. To add O&P real-world impact, the video was filmed on location at the Fresno, California, facility of Hanger Orthopedic Group, thanks to the 30

O&P ALMANAC JANUARY 2010

AOPA Immediate Past President Brian L. Gustin, CP

assistance of Lars Jensen, CO, and staff members who also appear in the video: Veronica Lases, Najeeb Chaudhry, and Ken Conroy.

The core premise of the initiative’s care-extender model is to maximize the top-line value of the practitioner, focusing direct patient interaction on using practitioner cognitive skills in patient diagnosis and planning the treatment program. Care-extenders handle such tasks as initial fittings and adjustments, along with any on-site manufacturing. In the ideal office of the future, most of the fabricating process would be outsourced to central fabricators.

During his National Assembly presentation, Brian Gustin, CP, a member of the workgroup and 2008-2009 AOPA president, shared the benefits of moving from the traditional clinical model to a modern, more efficient—and more profitable—patient-centric facility through proper work-flow analysis. Jonathan Naft, CPO, built the case for using technology to develop and manage this process.

An integral part of the office of the future will be an increased emphasis on proper documentation to prove the medical necessity of the treatment program. Much of the current health-care reform conversation includes a significant focus on comparative effectiveness research in curbing runaway health-care costs. Gustin spelled out the steps in creating successful documentation for the future that will respond to these trends.

Now available in sizes 25-30 cm.

800.728.7950 I www.college-park.com

AOPA WORKING FOR YOU

How practice management software combined with The ideal office workgroup members, in addition to BergAOPA’s Business Optimization Analysis Tool (B.O.A.T.) mann, Gustin, Prusakowski, and Naft: Thomas DiBello, CO, can maximize results was outlined by Paul Prusakowski, FAAOP; Jeremy Driskell, Ing. Rüdiger Gerstemeier; Thomas CP, CPO, FAAOP, O&P Digital Technologies, and Randy Kirk, PhD; Ralph Nobbe, CPO; and Brad N. Ruhl. AOPA Schmitke, MBA. Using the senior director of meetings, software to populate data in membership and operations the B.O.A.T. management An integral part of the office of the future Tina Moran, CMP, coordinated tool leads to better decivideo production, and exhibit will be an increased emphasis on proper sions, which translate into a design and installation. documentation to prove the medical more successful practice.

A special thanks to those The final segment on AOPA members who loaned necessity of the treatment program. outsourcing fabrication equipment or other elements acknowledged that the ideal to the ideal office exhibit office of the future, like hall display: Terry Long of offices today, will follow multiple models. Outsourcing Futura International; Kim Sword, Ohio Willow Wood; Fran fabrication is an important consideration but may not Jenkins, The Fillauer Companies; Robin Burton, Orthotic be the answer for all. Jeffrey M. Brandt, CPO, Clayton and Prosthetic Assistance Fund; and Chris Collier, Mica T. Barrow, CO, and Jeffrey T. Quelet, CPO, discussed Corp.; as well as Paul Prusakowski and Jeremy Driskell. outsourcing fabrication and crucial steps, including how to For your free copy of the 15-minute Ideal Office of the establish criteria and vet various fabricators based on their Future DVD, fax your request to 571/431-0899 or e-mail areas of expertise. your request to Erin Kennedy at ekennedy@AOPAnet.org.

RED FLAG RULES: Are You In Compliance?

The first Medicare Audio Conference of 2010, “Red Flag Rules: Are You in Compliance?” will be held Wednesday, Jan. 13, 2010, from 1-2 pm EST. During this informative lecture, you will: • learn what the Federal Trade Commission expects of you to be in compliance • walk through the template to write a compliance plan • find out the latest timetable for compliance • learn how to navigate the FTC Red Flag Web site.

The cost to participate is just $99 per line for members ($199 for non-members). Note that for one registration fee, an unlimited number of your staff can listen in—and benefit from—this audio conference. Participants also can earn 1.5 CEUs by returning the provided quiz within 30 days and scoring 80 percent or better. Sign up today at www.aopanet.org.

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O&P ALMANAC JANUARY 2010

RED FLAG RULES: ARE YOU IN COMPLIANCE? Wednesday, Jan. 13, 2010 • 1-2 pm EST

For over 50 years, PEL has offered practitioners outstanding

VALUE

on the most popular products available from the O&P industry’s most respected manufacturers.

Phone, fax or email a knowledgeable PEL CSR, like Larry, for information on the most dependable products available – representing outstanding values.

Larry Moore, Customer Service Representative • Veteran’s Administration Specialist • International Auditor with UPS • Majored in Business Management at CSU • Enjoys playing and watching sports • Devoted family man – wife, new baby son and two dogs

Hosmer Oscillator Knee

Orthomerica TLSO Stock Spinal Orthosis • Ready-to-fit prefabricated orthosis • Designed to fit 75% of adult population • You can have inventory on hand for late night/weekend fittings • Bi-valve TLSO offered with or without Anterior Thoracic Extension • Anterior and posterior shells are interchangeable in same size • Available in twelve sizes in neutral or Pendulous Abdomen fronts, in 0° or 15° lordosis.

• 5-Bar Glide-Flex polycentric knee • Rotary hydraulic control system • Independent flexion & extension adjustment • Adjustable stance flexion feature • High strength zinc-aluminum alloy • Rated for 300 lbs (136 kg)

Fillauer

Element™ Foot System • Unique 3rd Element technology • Smooth rollover and superior stability • Interchangeable heel elastomers for fine tuning heel stiffness • Modular design with superior flexibility • Low profile design requires only 3.75 in. clearance (9.5 cm) • Incredibly lightweight only 310 grams • System kit includes foot, heel bands and elastomers, Spectra® sock and instruction manual. ®

Experience the Power of One.

Over 50 years of one stop shopping for all your O&P needs.

Phone: 800-321-1264 Fax: 800-222-6176 E-mail: customerservice@pelsupply.com Web: www.pelsupply.com

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AOPA Headlines

[MORE ON MEDICARE AUDIO CONFERENCES]

Tune in for Valuable Benefits Already, hundreds of orthotics and prosthetics offices nationwide have taken advantage of AOPA’s Medicare Audio Conferences. These sessions are convenient, cost-effective, and comprehensive.

The one-hour sessions are available right in your own office on the second Wednesday of each month at 1:00 pm Eastern.

This series is an outstanding opportunity for you and your staff to: • hear the latest topics in O&P • ask questions, and get more information about more complicated Medicare issues that can be immediately put to work to help your business.

Seminars are still priced at just $99 per phone line for members ($199 for non-members). Buy the series and get two free sessions; member package price is $990; non-members: $1,990.

Practitioners can earn 1.5 CEUs per audio conference by returning the provided quiz within 30 days and scoring at least 80 percent.

If you miss an audio conference, you can still purchase the CD at the same price: $99 for members; $199 for non-members.

The list of topics for 2010 conference series is in the box. Sign up today at www.aopanet.org.

Coming to a Location Near You!

2010 Medicare Audio Conferences * All dates are the second Wednesday of the month.

January 13*

Red Flag Rules: Are You In Compliance?

February 10

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

Mastering Medicare Seminars for 2010: REGISTER NOW!

3

AOPA has scheduled three Mastering Medicare: Advanced Coding & Billing Techniques seminars ATLANTA PITTSBURGH LAS VEGAS for 2010: Atlanta, February 18-19; Pittsburgh, May 24-25; and Las Vegas, October 14-15. of the first day); discuss tough questions and complex Hundreds of AOPA colleagues have already beneconcerns with AOPA’s experts and other colleagues; and fited from this informative two-day course, with some take away valuable information about documentation attending more than once. Attendees get information and compliance. specifically designed for practitioners or coding staff Review the agenda—or access the online registration (separate sessions for each group are held on the afternoon form and sign up today—at www.aopanet.org. a 34

O&P ALMANAC JANUARY 2010

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Marketplace

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 pressure. The leather counter will reflex which allow 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 888/937-2747.

COLLEGE PARK’S NEW ONYX FOOT Integrating a dynamic pylon, the multi-axial Onyx Foot allows active users to demand more.

Highly customizable, with four degrees of plantardorsiflexion Onyx Foot Angle Control and adjustable Stride Control for fine-tuning gait, the sleek Onyx Foot delivers balanced energy with ideal comfort and enhanced terrain compliance.

Key benefits include: • Dynamic Pylon foot • Superior terrain compliance • The only Dynamic Pylon foot with four degrees of plantar-dorsiflexion Angle Control • Precision gait matched for out-of-the box performance • Adjustable Stride Control to fine-tune foot stiffness from heel strike to heel off • Three-year warranty • Onyx–Balanced Energy, Ideal Comfort.

For more information, call 800/7287950 or visit www.college-park.com.

EURO INTERNATIONAL, PEROMAX CARBON FIBER AFO

The Peromax Carbon Fiber AFO is an excellent recovery device for Peroneal Paralysis patients. Its carbon fiber design allows for high energy return and is rated up to a maximum weight of 275 pounds. The Peromax also is used for the rehabilitation of Achilles tendon injuries. For more information about the Peromax contact Euro International at 800/378-2480 or visit www.eurointl.com.

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O&P ALMANAC JANUARY 2010

FILLAUER, PARAPOD The ParaPod comes in a kit form that can be sized and assembled easily for significantly less than conventional HKAFOs. The kit provides an exoskeleton worn over clothing that consists of shoe clamps, aluminum uprights, foam knee blocks, and upper-back and chest supports.

The aluminum uprights are sized at the knee and hip and are cut to length.

Additional tubes can be cut to a longer length to accommodate growth.

Contact Fillauer at 800/251-6398 or www.fillauercompanies.com.

INTRODUCING KISS SUPERSLIDER™ 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.

OHIO WILLOW WOOD, LIMBLOGIC™ VS OFFERS RELIABILITY AND VERSATILITY

Ohio Willow Wood has expanded LimbLogic™ VS’s versatility by broadening the conditions in which it will operate. Prosthetists may advise patients that LimbLogic VS can be used in wet environments and even immersed in fresh water. This is the only waterproof elevated vacuum suspension system available in the prosthetic market. Ohio Willow Wood’s Thermoplastic Drop-In Adapter maintains an airtight seal with LimbLogic VS and permits the system to be used with thermoplastic sockets. The adapter allows for the fabrication of a distal cup that replicates the user’s correct anatomical shape. For information, contact Ohio Willow Wood at 800/848-4930 or www.owwco.com.

OSSUR, NEW ICEROSS® CUSHION LINER AND ICEROSS® SLEEVE

The Iceross Cushion Liner and Iceross Sleeve offer three of the most sought after features: durability, comfort and flexibility. Vascular patients and those with sensitive skin will appreciate Össur’s Active Skin Care ingredients, while the DermoGel® Silicone and elastic Supplex® cover offer excellent durability and security when using a vacuum system. Iceross Cushion is available with the Wave Feature for additional knee flexion. For a more intimate fit add the Cushion Liner’s counterpart: the Iceross sleeve.

Improved mobility, a more secure fit, and optimal comfort—an unrivaled liner and sleeve solution. For more information call 800/233-6263 or visit www.ossur.com.

OTTO BOCK, E-MAG ACTIVE STANCE CONTROL KAFO Take a Step in the Right Direction! Easy to fit for practitioners and even easier for patients to use, this integrated, lowprofile joint provides the best in electronic stance control and helps your patients get into a more active lifestyle. The E-MAG Active calibrates itself to capture the user’s unique gait pattern with the help of the simple onboard programming.

This unique feature adds a whole new dimension of functionality for people who previously have had limited bracing options, such as a locked knee brace or manual device. Help your patients get back into the swing of things with the E-MAG Active! For more information call 800/328-4058 or visit www.ottobockus.com.

OTTO BOCK, HARMONY® P3 Less is more: introducing the new Harmony® P3 by Otto Bock. An 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 800/328-4058 or visit www.ottobockus.com.

JANUARY 2010 O&P ALMANAC

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Marketplace

PEL SUPPLY, SEATTLE CATALYST 9™ FOOT AVAILABLE FROM PEL SUPPLY The Seattle Catalyst 9 Foot from Trulife is a multi-axial foot-ankle system that combines a carbon composite “C” design shank and split keel. It features heel strike shock absorption, smooth rollover, controlled plantar flexion, split keel stability and a balanced transition from heel to toe. Available from PEL Supply, the Trulife foot offers increased axial torque absorption with up to 22° of rotation at 14.7ft/lb. All-in-all, its’ dynamic features, a narrow profile

and nine activity/weight categories combine to make this great value.

• Product Weight: 449g for size 25cm (#3 keel) • Minimum Clearance: 18cm (7-1/8” floor to top of pyramid dome) • Heel Wedge Height: ¼” (6.4mm), 3/8” (9.5mm), ½” (12.7mm) • Warranty: 3 years for hard components, 6 months for foot shell • Maximum Patient Weight 366lbs/166kg (Medium Activity).

For more information on the Seattle Catalyst 9 foot–– as well as the full line Trulife products––contact any helpful PEL customer service specialist at 800/321-1264, by fax 800/222-6176, or by e-mail customerservice@pelsupply.com.

DYCOR's New CFS Partial Foot

Dycor's new CFS Partial Foot incorporates an integrated custom silicone liner with an advanced carbon fiber/epoxy composite socket and urethane nylon composite upper. This combination enhances pressure dissipation and reduces bulk. The custom silicone liner is available in 4, 5 and 6 millimeter with optional zone padding, soft, medium and firm. The cosmetic cover is either a silicone or urethane/nylon composite. Function is facilitated with either passive or flexible keel feet and optional Velcro closure, depending on ADLs and ablation level. Modified model, tracing of contralateral foot and shoe are required. Allow 10 working days for fabrication. Samples available upon request.

Weight including 5mm liner and flexible keel foot is 8 oz.

(26med.). Prior to casting, please call our Technical Services dept. at 800-794-6099.

Visit our website at www.dycormfg.com.

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O&P ALMANAC JANUARY 2010

SPS LAUNCHES EXTREME CUSHION LINER SAMPLE PROGRAM

Following in the footsteps of the hugely popular Extreme Locking Liner, SPS is pleased to launch the new Extreme Cushion Liner with a sampling program. SPS Customers may choose to receive the 3mm or 6mm profile of either the AKFR24 ( 24-25cm), AKFR26 (26-27cm) or AKFR28 (28-31cm) as a FREE SAMPLE. Only one (1) sample per practitioner is available. Offer is available Jan. 1- 31, 2010.

• Applicable to TT or TF amputees allows you to reduce inventory cost and space requirements. Available in 3mm or 6mm Uniform sizing to fit circumferences ranging from 16-53 cm.

• 80 Percent Less Vertical Stretch Posteriorly as compared to other ALPS gel liners, virtually eliminating pistoning while minimizing bunching behind the knee during flexion.

• Extreme Suspension – ALPS new GripGEL is more tactile than EZGel to gently but firmly support the residual limb and sensitive tissues.

For more information, contact SPS Customer Service at 800/767-7776 ext.

3 or your SPS sales manager. a

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Jobs

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% on your order. BONUS! Online listings highlighted in yellow in the O&P Almanac.

- Northeast - Mid-Atlantic - Southeast

Mid-Atlantic

Certified Prosthetist w/Orthotic Experience Bowling Green, Kentucky Head for the National Corvette Homecoming event and assembly plant; Western Kentucky University, the third largest city in Kentucky; four seasons that support all types of outdoor sports! We are searching for a well-rounded prosthetist‌someone 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 a sign-on bonus. Ready to make a change? Join the Hanger Team! If interested, please contact, in confidence:

- 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.

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O&P ALMANAC JANUARY 2010

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

Southeast

CPO & Technician Birmingham, Alamaba UAHSF Orthotics & Prosthetics has an immediate opening for a highly motivated, ABC-certified orthotist/prosthetist as well as an orthotic & prosthetic technician located on the University of Alabama at Birmingham campus. We offer competitive compensation, moving expenses, medical/ dental/life insurance, short- and long-term disability, 403(b) retirement, incentive plan, paid vacation/sick/personal holidays, and an educational allowance. Come join our team today! Send your resume to:

Tracy Brewer, Director Fax: 205/975-6065 E-mail: tbrewer@uabmc.edu

Southeast

Southeast

Certified Prosthetists and Orthotists

Certified Prosthetist/Orthotist

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, state-of-the-art education, sign-on bonus, and much more!

If you have what it takes, the sky is the limit! Send resume, in confidence, to:

West Columbia, South Carolina Progressive ABC-certified prosthetic and orthotics facility looking for ABC-certified prosthetist and orthotist. Located two hours from mountains for ocean, Columbia, South Carolina offers southern climate and weather and is bordered by a 50,000-acre fresh water lake. We emphasize patient care and teamwork, opportunity for future ownership for the right individual. Competitive salary with benefits including 401(k), health insurance, continuing education, vacation, and great people to work with.

If you are interested in joining this progressive team, want to focus on patient needs, and have the ability o market and develop new relationships, then we would like to have your resume with education, work experience and salary requirements. All inquiries will be kept strictly confidential.

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

Lexington Prosthetics and Orthotics R. Michael Russell, CPO, FAAOP 205 Medial Circle West Columbia, SC 29169 Phone: 803/939-0097 Fax: 803/939-1103

Increase Earnings Simplify Billing

Join us and see how your career can shine.

Marshfield Clinic is one of the largest patient care, research & educational systems in the United States with over 7,000 employees in nearly 400 occupations.

Proven Turnkey Billing Services

Your Easiest and Best Billing Solution • Maximize every claim • You’re in Control • Streamline your staff • Reduce your fixed overhead • Experienced with Medicare and insurance paperwork Increase Earnings and Simplify Billing

Complete Professional Office Services

p. (810) 629-6424 - f. (810) 629-6463

www.oandpoffice.com

Live & work in one of America’s Dreamtowns* Marshfield, Wisconsin, a town that is safe, low-stress, friendly & fun: • • • • •

Low-cost of living in family-friendly neighborhoods Short commutes with low traffic volume Excellent private & public educational opportunities Cultural & recreational activities for all four seasons Access to Chicago, Madison, Milwaukee, Minneapolis

CO or CPO

ABC Certified in Orthotics & Prosthetics and 3 years of experience required.

Experience in Pediatrics would be helpful.

Apply online at www.marshfieldclinic.jobs, Reference #MC090202

1000 N. Oak Ave., Marshfield, WI 54449 Marshfield Clinic is an Affirmative Action/Equal Opportunity employer that values diversity.

Minorities, females, individuals with disabilities and veterans are encouraged to apply.

America's Dreamtowns, http://www.bizjournals.com/specials/pages/181.html JANUARY 2010 O&P ALMANAC

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Jobs Pacific

Certified Prosthetist/Orthotist

Level Four was formed in 2003 with a strong entrepreneurial spirit and an unwavering commitment to excellence. Today, we are a group of experienced practitioners building an orthotic/prosthetic and cranial remolding clinic system serving major metropolitan areas of North Carolina, South Carolina, and Georgia, including two major medical schools. We consider ourselves a group practice dedicated to maintaining independence for the orthotic/prosthetic practitioner.

Our company is seeking the following individuals to join our group: • CP or CPO - Growth in central North Carolina requires the addition of two individuals to specialize in prosthetics.

• CO – A seasoned certified orthotist with at least 15 years’ experience who is seeking the opportunity to move past patient care. Position is to manage a high volume orthotics manufacturing plant (8,000 lower extremity orthotics per year).

A high sense of quality and innovation is an overriding requirement.

We welcome both ABC and BOC practitioners.

Level Four offers a very competitive compensation program including profit sharing, paid health insurance for employee and family (excludes working spouse), and fully paid car expenses. If you have interest in working in modern offices with strong insurance, fabrication and marketing support and are considering a change, please forward your resume to:

Level Four Orthotics and Prosthetics, Inc. Fax: 336/760-8385 E-mail: rgingras@level4orthotics.com

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O&P ALMANAC JANUARY 2010

Portland, Oregon Growing western states O&P business seeking a certified CPO for an excellent opportunity in Portland, Oregon.

Unlimited business opportunities available in an expanding local market. Competitive salary, benefits and profit sharing as the business grows. Interested parties should e-mail inquiries/resume to:

E-mail: jwiley@pacmedical.com or Fax: 888/853-0002

Northeast

CPO Long Island, New York Do you feel like you are not appreciated for your talents?

Do you feel like you are building a practice that you can enjoy the benefits of? We are offering a unique opportunity for an ABC CPO with at least three years of certified clinical experience. A person who has the motivation and teambuilding philosophy to help grow the practice will have the potential for equity interest and profit sharing. Compensation package including competitive salary, health, and vacation benefits, 401(k), and paid continuing education.

We are a 23-year-old, established, innovative, ABC-accredited facility with an excellent reputation on Long Island (Port Jefferson, New York).

Send resume in confidence to:

E-mail: marty@mhmoandp.com

CO/Practitioner Assistant Manchester, New Hampshire New England Brace Co. is firmly committed to its motto: “The Patient First – Continuing a Tradition Since 1946.” We are a progressive, family-owned company with five ABCaccredited facilities in New Hampshire and Maine. We are looking for a highly motivated professional who enjoys working within a team atmosphere. The candidate should be comfortable in all facets of orthotics, and a strong pediatric background would be a plus. We offer a salary commensurate with experience, and an attractive benefits package.

Send your resume to:

Karen Acton, PT, CO New England Brace Co. 15 Nelson Street, Unit 1 Manchester, NH 03103 Phone: 603/668-8360 Fax: 603/668-0031 E-mail: karen@nebrace.com

ABC – BOC Orthotist/Prosthetist For Multiple Facility Locations

Northeast

CPO CO Board-Eligible Orthotist or Prosthetist BOCO or BOCPO C.Ped CFO 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

Yankee Medical has immediate openings available in one of our six locations. We are a “family friendly,” privately owned company with a 58-year history of providing high-quality patient care throughout Vermont and its border communities.

We are looking for an experienced practitioner who desires a long-term relationship with our progressive company. We would also consider a motivated resident with prior O&P work experience.

Yankee Medical offers a generous benefit package, including fully paid health insurance, 401K matching, profit sharing, bonuses, life insurance, short- and long-term disability insurance, as well as remuneration for your required education credits and help with relocation expenses.

Come join the family of lifelong Yankee Medical people.

Call, fax, or e-mail inquiries to:

Linda Wells, Operations Manager Yankee Medical Inc. 276 North Avenue Burlington, VT 05401 Phone: 802.863.4591  Fax: 802.658.3101 E-mail: ljw@yankeemedical.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,

AVAILABLE POSITIONS Orthotist Phoenix, AZ Rancho Mirage, CA Stockton, CA Lafayette, CO Waterbury, CT Tallahassee, FL Aurora, IL Springfield, IL

Orthotist/Prosthetist Thomasville, GA Havertown, PA

El Paso, TX

enjoy the freedom I find in my work as a local practice manager.

For more information visit www.hanger.com/careers

Evansville, IN Jackson, MI Fairfield, OH Tahlequah, OK Harrisburg, PA NW PA/NE OH Milwaukee, WI Wheeling, WV

Prosthetist Hollywood, FL Salina, KS Bowling Green KY

Hattiesburg, MS Jefferson City, MO

Prosthetist/Orthotist Beverly Hills, CA Cameron Park, CA Denver, CO Washington, DC Marietta, GA Columbia, MO Jackson, MS

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

Meridian, MS Roswell, NM Bend, OR Clackamas, OR Fort Worth, TX Alexandria, VA Bremerton, WA

Certified Pedorthist Tucson, AZ Lafayette, CO Waterbury, CT

Columbia, MO 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

JANUARY 2010 O&P ALMANAC

43

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Jobs 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

Certified Orthotist and/or Orthotist/ Prosthetist (licensed or eligible) Texas EL PASO: is the sixth largest city in Texas and stands on the Rio Grande with the Juarez Mountains as its skyline. It has 13 hospitals, multiple parks, museums and has been the filming site for 20+ movies.

DALLAS: the big D offers it all! Anchored by Downtown, the center of the city is the epicenter of urban revival along with shopping, barbecue, authentic Mexican, and Tex-Mex cuisine. Dallas has its share of football, basketball, and hockey teams. Don’t forget NASCAR, the parks and lakes, and the massive State Fair of Texas.

We offer a very competitive salary and benefit package accompanied by sign-on bonus and relocation assistance. If you are ready to make a change and desire the security of working for the oldest orthotic and prosthetic patient-care company in the world, contact, in confidence:

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

O&P Almanac Dynamic Online Version Now Available Reading the O&P Almanac has never been easier!

Access advertiser Web sites by simply clicking on the hotlinks

Access content with the click of a mouse or the touch of a smart phone Easily e-mail

your favorite articles to colleagues

Save articles as PDFs!

Go to www.AOPAnet.org, click on ‘O&P Almanac Online’ today!

For more information, contact Steven Rybicki at 571/431-0835 or srybicki@AOPAnet.org.

For advertising information, contact Dean Mather at 856/768-9360 or dmather@mrvica.com.

www.AOPAnet.org

44

O&P ALMANAC JANUARY 2010

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Calendar

2010 JANUARY 12-17: OPGA/POINT Premier Conference. Cancun, Mexico.

Dreams Resort. Premier Members and Suppliers will meet with leading speakers from the orthotic and prosthetic community for a week of education, networking, and relaxation. For more information, go to www.opga. com or contact OPGA at info@ opga.com or 800/214-6742.

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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.

46

O&P ALMANAC JANUARY 2010

JANUARY 13: Ohio Willow Wood: Clinical Tricks & Techniques with LimbLogic™ VS, via WebEx, 1:30 pm EST. Discusses clinical treatment plans for using LimbLogic VS, application of fabrication processes, in-depth review of diagnostic process, and patient education methods. Credits: 2.5 ABC/ 2.0 BOC. To register online, visit www.owwco.com/ webinar.php.

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JANUARY 13: Ultraflex: Pediatric UltraSafeGait™ Continuing Education Course, via WebEx, 2:00–3:00 pm ET. Course covers clinical assessment and compensating for pediatric gait deficits with the new Adjustable Dynamic Response (ADR) technology.

Instructor: Taffy Bowman, CPO. Register at www.ultraflexsystems. com or 800/220-6670.

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JANUARY 13: AOPA Audio Conference: “Red Flag Rules: Are You In Compliance?” To register contact Erin Kennedy at 571/431-0876 or ekennedy@ AOPAnet.org.

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JANUARY 19: Ultraflex: Adult UltraSafeStep™ Continuing Education Course, via WebEx, 2:00–3:00 pm ET. Course covers clinical assessment and compensating for adult gait deficits with the new Adjustable Dynamic Response (ADR) technology. Instructor: Taffy Bowman, CPO. Register at www.ultraflexsystems.com or 800/220-6670.

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FEBRUARY 8-12: Applied Technology Institute (ATi) Orthotic Fitter School.

Long Beach, CA. VA Hospital.

Independent comprehensive course to prepare for certification exam. Approved entry-level school by NCOPE and BOC, and for continuing education by ABC and BOC. To register, contact Lois Meier at 888/265-6077, e-mail lois@kasseledu.com, or visit www.kasseledu.com.

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FEBRUARY 9: Ultraflex: Pediatric Spasticity Continuing Education Course, via WebEx, 1:00– 2:00 pm ET. Course covers lengthening and strengthening muscles and improving range with postural support and therapeutic/stretching assist.

Instructor: Taffy Bowman, CPO. Register at www.ultraflexsystems. com or 800/220-6670.

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FEBRUARY 10: AOPA Audio Conference: “Hints on Passing Your Supplier Standards Inspection.” To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org.

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FEBRUARY 17: Ultraflex: Adult UltraSafeStep™ Continuing Education Course, via WebEx, 1:00–2:00 pm ET. Course covers clinical assessment and compensating for adult gait deficits with the new Adjustable Dynamic Response (ADR) technology.

Instructor: Taffy Bowman, CPO. Register at www.ultraflexsystems. com or 800/220-6670.

FEBRUARY 18: Ultraflex: Pediatric UltraSafeGait™ Continuing Education Course, via WebEx, 1:00–2:00 pm ET. Course covers clinical assessment and compensating for pediatric gait deficits with the new Adjustable Dynamic Response (ADR) technology.

Instructor: Taffy Bowman, CPO. Register at www.ultraflexsystems. com, 800/220-6670.

FEBRUARY 18-19: AOPA Mastering Medicare: Advance Coding and Billing Seminar. Atlanta.

Intercontinental Buckhead Hotel. To register contact Erin Kennedy at 571/431-0876 or ekennedy@AOPAnet.org.

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FEBRUARY 19-20: PrimeFare West Regional Scientific Symposium 2010.

Salt Lake City. Salt Palace Convention Center. Contact Jane Edwards at 888/388-5243 or visit www.primecareop.com.

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FEBRUARY 24-27: 36th Academy Annual Meeting & Scientific Symposium. Chicago. Hyatt Regency Chicago. Visit www. academyannualmeeting.org for the latest information. Contact Diane Ragusa at 202/380-3663, ext. 208 or dragusa@oandp.org.

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MARCH 10: Ultraflex: Pediatric Spasticity Continuing Education Course, via WebEx, Noon– 1:00 pm ET. Course covers lengthening and strengthening muscles and improving range with postural support and therapeutic/stretching assist.

Instructor: Taffy Bowman, CPO. Register at www.ultraflexsystems. com or 800/220-6670.

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MARCH 10: AOPA Audio Conference: “Billing for Refused/ Returned Devices and Deluxe Features.” To register contact Erin Kennedy at 571/431-0876 or ekennedy@ AOPAnet.org.

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MARCH 11: Ohio Willow Wood: LimbLogic VS™ Applications Practitioner Course. Mt. Sterling, OH. Course covers various clinical aspects of LimbLogic VS applications: static & dynamic socket fitting, vacuum pump configurations, fob operation, system evaluation, liner options, alignment, and troubleshooting.

Credits: 7.25 ABC/7.0 BOC. Registration deadline is 2/18/2010. To register, call 877/665-5443.

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MARCH 12-13: 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: 11.75 ABC/11.5 BOC. Registration deadline is 2/18/2010. To register, call 877/665-5443.

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MARCH 12 OPGA: Bioness Training Course. Las Vegas. One-day course covers NESS L300 system evaluation and handson training. Instructed by John Michael, MEd, CPO/L, FAAOP, FISPO. The NESS L300 is a user-friendly neuroprosthetic designed to improve gait for individuals experiencing foot drop. 7 MCEs from ABC. Register at www.opga.com or 800/214-6742.

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MARCH 16: Ultraflex: Pediatric UltraSafeGait™ Continuing Education Course, via WebEx, Noon–1:00 pm ET. Course covers clinical assessment and compensating for pediatric gait deficits with the new Adjustable Dynamic Response (ADR) technology. Instructor: Taffy Bowman, CPO. Register at www.ultraflexsystems.com or 800/220-6670.

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MARCH 25: Ultraflex: Adult UltraSafeStep™ Continuing Education Course, via WebEx, Noon–1:00 pm ET. Course covers clinical assessment and compensating for adult gait deficits with the new Adjustable Dynamic Response (ADR) technology.

Instructor: Taffy Bowman, CPO. Register at www.ultraflexsystems. com or 800/220-6670.

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APRIL 8: Ohio Willow Wood: LimbLogic™ VS Applications Practitioner Course. Mt. Sterling, OH. Course covers various clinical aspects of LimbLogic VS applications: static amd dynamic socket fitting, vacuum pump configurations, fob operation, system evaluation, liner options, alignment, and troubleshooting.

Credits: 7.25 ABC/7.0 BOC. Registration deadline is 3/18/2010. To register, call 877/665-5443.

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APRIL 9-10: 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: 11.75 ABC/11.5 BOC. Registration deadline is 3/18/2010. To register, call 877/665-5443.

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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.

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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.

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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.

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APRIL 17: Ohio AAOP Chapter Annual Spring Technical Meeting.

Columbus, OH. Hilton Columbus Hotel. Contact Richard Butchko at 614/6590197 or richardbutchko@ ohiochapteraaop.com.

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APRIL 22-24: Northwest AAOP Chapter Meeting. Seattle.

Bellevue Courtyard Marriott.

Contact Dan Abrahamson at 206/598-4026 or abrahams@u.washington.edu.

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APRIL 26-27: New York AAOP Chapter State Meeting. Albany, NY. Desmond Hotel. Contact Joann Marx, CPO, FAAOP at 518/3746011 or marx4nysaaop@aol.com.

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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.

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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.

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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 503/521-4541 or visit www.wamopa.com.

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MAY 14-15: Oklahoma AAOP Chapter State Meeting. Oklahoma City, OK. Francis Tuttle Technical Center. Contact Tom Ferguson at 405/271-3644 x 41028 or thomas-ferguson@ ouhsc.edu.

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JANUARY 2010 O&P ALMANAC

47

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Calendar

MAY 19-22: Pennsylvania AAOP Chapter Spring Conference.

Pittsburgh. Sheraton Station Square. Contact Beth or Joe at 814/455-5383.

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MAY 20-22: Louisiana Association of Othotist & 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.

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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.

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JUNE 2-5: Association of Children’s Prosthetic-Orthotic Clinics 2010 Annual Meeting.

Clearwater, Florida. Sheraton Sand Key Resort. For more information, call 847/698-1637, e-mail acpoc@aaos.org, or visit www.acpoc.org.

JUNE 10-11: Michigan Orthotics & Prosthetics Association (MOPA) Continuing Education Seminar.

Mt. Pleasant, Michigan. Soaring Eagle Casino & Resort. For details visit www.mopa.info or contact Mary Ellen Kitzman at 248/615-0600 or MOPA_ meeting@MOPA.info.

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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.

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48

O&P ALMANAC JANUARY 2010

SEPTEMBER 29OCTOBER 2 AOPA National Assembly.

Orlando, FL. Rosen Shingle Creek Resort. Exhibitors and sponsorship opportunities, contact Kelly O’Neill, 571/4310852, or koneill@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.

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2011

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JULY 14: AOPA Audio Conference: “Medicare Appeals Strategies.” To register contact Erin Kennedy at 571/431-0876 or ekennedy@ AOPAnet.org.

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JULY 15-17: Alabama Prosthetists and Orthotists Association State Meeting. Birmingham, AL. Birmingham Hilton. Contact Fred Crawford at 205/280-1666 or crawfordfc@huges.net or visit www.alabamapoa.org.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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MARCH 28 - APRIL 2: Association of Children’s Prosthetic-Orthotic Clinics 2011 Annual Meeting. Park City, Utah. The Canyons. For more information, call 847/6981637, e-mail acpoc@aaos.org or visit www.acpoc.org. a ■■

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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 state-licensed 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

50

O&P ALMANAC JANUARY 2010

Achilles Prosthetics & Orthotics LLC 503 N. Franklin Tpk., Ste. 12 Ramsey, NJ 07446 201/785-9944 Fax: 201/785-9945 Category: Patient Care Facility Peter Buffington, CPO Neu Prosthetics & Orthotics Services 325 S. Sandusky St., Ste. 213 Delaware, OH 43015 740/369-5347 Fax: 740/369-0099 Category: Patient Care Facility William Neu, CPO South Georgia Orthopedic Resources 1619 John Orr Dr. Tifton, GA 31794 229/386-9829 Fax: 229/386-9830 Category: Patient Care Facility Jeffrey D Parsons, CO, LO

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.

n

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

Affinity Insurance Services, Inc.

12

800/544-2672

www.aopa-insurance.com

Allard USA Inc.

21

888/678-6548

www.allardusa.com

ALPS

29

800/574-5426

www.easyliner.com

11

202/380-3663

www.oandp.org

Orthotics, Prosthetics & Pedorthics

27

703/836-7114

www.abcop.org

Apis Footwear

39

888/937-2747

www.bigwideshoes.com

Arizona AFO

35

877/780-8382

www.arizonaafo.com

College Park Industries Inc.

31

800/728-7950

www.college-park.com

Daw Industries

1

800/252-2828

www.daw-usa.com

Dr. Comfort

7, C3

800/556-5572

www.drcomfortdpm.com

Euro International

9

800/378-2480

www.eurointl.com

Ferrier Coupler Inc.

50

800/437-8597

www.ferrier.coupler.com

Fillauer Companies Inc.

49

800/251-6398

www.fillauercompanies.com

KISS Technologies LLC

45

410/663-5477

www.kiss-suspension.com

Med Spec

15

800/582-4040

www.medspec.com

Ohio Willow Wood

4

800/848-4930

www.owwco.com

Ossur Americas Inc.

C4

800/233-6263

www.ossur.com

PEL Supply Company

33

800/321-1264

www.pelsupply.com

OPTEC

2, 3

888/982-8181

www.optecusa.com

Otto Bock HealthCare

C2

800/328-4058

www.ottobockus.com

SPS

13

800/767-7776 Ext. 3

www.spsco.com

American Academy of Orthotists and Prosthetists American Board for Certification in

Dynamic Online Version NEW! NOW AVAILABLE

OP Almanac &

Reading the O&P Almanac has never been easier!

Access advertiser Web sites by simply clicking on the hotlinks

Access content with the click of a mouse or the touch of a smart phone Easily e-mail

your favorite articles to colleagues

Save articles as PDFs! Go to www.AOPAnet.org, click on ‘O&P Almanac Online’ today!

For more information, contact Steven Rybicki at 571/431-0835 or srybicki@AOPAnet.org.

For advertising information, contact Dean Mather at 856/768-9360 or dmather@mrvica.com.

52

O&P ALMANAC JANUARY 2010

www.AOPAnet.org

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