July 2012 Almanac by AOPA

The American Orthotic & Prosthetic Association

JULY 2012

WWW.AOPANET.ORG

THE MAGAZINE FOR THE ORTHOTICS & PROSTHETICS INDUSTRY

THE WINNING FIT

Meet five amputee athletes and their clinicians on the road to Gold at the 2012 Paralympic Games

London 2012 Paralympic Gold Medals

Lobbyists for a Day Audits and the Entities That Conduct Them

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O&P Almanac JULY 2012, VOLUME 61, No. 7

Cover Story

COLUMNS

20 The Winning Fit

By Lia K. Dangelico As athletes of many abilities prepare to compete at the 2012 Paralympic Games in London, expect to see hundreds of recordbreaking performances. Five Paralympic athletes and their clinicians share their incredible stories and their expectations for next monthâ&#x20AC;&#x2122;s Games.

CONTENTS

Reimbursement Page Learn the review processes behind RAC audits, CERT audits, and ZPIC audits

departments

4 AOPA Contact Page How to reach staff

6 At a Glance

Statistics and O&P data

In the News Research, updates, and company announcements

38 AOPA Headlines

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

Feature

45 AOPA Membership 00 Applications

30 Capitol Hill Journal

By Adam Stone Follow this personal account of several AOPA members-turnedlobbyists who made an impact on Capitol Hill during the AOPA Policy Forum in April as they set out to influence decision-making regarding the Medicare O&P Improvements Act, the Veterans Bill of Rights, and the Insurance Fairness for Amputees Act.

46 Marketplace

Products and services for O&P

48 Jobs

Opportunities for O&P professionals

53 Calendar

Upcoming meetings and events

55 Ad Index 56 AOPA Answers

Expert answers to your FAQs

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; email: 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, email: dmather@mrvica.com. JULY 2012 O&P Almanac

AOPA IN THE Contact NEWS 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

Kelly Oâ&#x20AC;&#x2122;Neill, manager of membership and meetings, 571/431-0852, koneill@AOPAnet.org

O&p Almanac

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

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

Stephen Custer, coordinator, membership operations and meetings, 571/431-0876, scuster@AOPAnet.org

Josephine Rossi, editor, 703/914-9200 x26, jrossi@strattonpublishing.com Catherine Marinoff, art director, 786/293-1577, catherine@marinoffdesign.com

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 Dartmouth Printing Company

BOARD oF DIRECTORS Officers

AOPA Bookstore: 571/431-0865

President Thomas V. DiBello, CO, FAAOP, Dynamic O&P, a subsidiary of Hanger Inc., Houston, TX

Government affairs

President-Elect Tom Kirk, PhD, Hanger Inc., Austin, TX

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

Catherine Graf, JD, director of regulatory affairs, 571/431-0807, cgraf@AOPAnet.org

Vice President Anita Liberman-Lampear, MA, University of Michigan Orthotics and Prosthetics Center, Ann Arbor, MI

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

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

Treasurer James Weber, MBA, Prosthetic & Orthotic Care Inc., St. Louis, MO

Stephen Custer, staff writer, 571/431-0876, scuster@AOPAnet.org

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

Immediate Past President James A. Kaiser, CP, Scheck & Siress, Chicago, IL

Reimbursement/Coding: 571/431-0833, www.LCodeSearch.com a

directors

Christine Umbrell, editorial/production associate, 703/914-9200 x33, cumbrell@strattonpublishing.com

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

Kel M. Bergmann, CPO, SCOPe Orthotics and Prosthetics Inc., San Diego, CA Michael Hamontree, OrPro Inc, Irvine, CA

e k a M own r u o Y

y r o t His at the

2012 AOPA National Assembly and Combined New England Chapter Meeting www.AOPAassembly.org 4

O&P Almanac JULY 2012

September 6-9 Historic downtown Boston

Russell J. Hornfisher, MBA, MSOD, Becker Orthopedic Appliance Co., Troy, MI Alfred E. Kritter, Jr., CPO, FAAOP, Hanger Inc., Savannah, GA Eileen Levis, Orthologix LLC, Philadelphia, PA Ron Manganiello, New England Orthotic & Prosthetic Systems LLC, Branford, CT Mahesh Mansukhani, MBA Ă&#x2013;ssur Americas, Aliso Viejo, CA Michael Oros, CPO, Scheck & Siress, Chicago, IL Frank Vero, CPO, Mid-Florida Prosthetics & Orthotics, Ocala, FL Copyright 2012 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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AT IN THE A GLANCE NEWS

The Paralympic Games: How Far They’ve Come… The number of countries and individual athletes participating in the Paralympic Games has been growing steadily over the past 20 years.

Number of Countries Participating in Paralympics Barcelona 1992

Number of Athletes Participating in Paralympics

Barcelona 1992 104

Atlanta 1996

Atlanta 1996 122

Sydney 2000 Athens 2004

Athens 2004

146

London 2012

3,259

Sydney 2000

135

Beijing 2008

3,001

160

3,808 3,951

Beijing 2008

(expected)

3,881

London 2012

4,200

(expected)

Source: www.paralympic.org.

1960

Year the first official Paralympic Games were held (in Rome).

$16 million Amount of broadcast deals made to bring the 2012 Games to about 4 billion households.

279

Number of world records broken at the 2008 Paralympics in Beijing.

1.25 million Number of tickets sold for 2012 Paralympic Games as of June 2012.

50%

Percentage of presenters and broadcasters who have disabilities and will cover the Paralympics for London’s Channel 4, the official broadcaster of the 2012 Paralympic Games.

Number of Gold Medals awarded to U.S. Paralympic athletes in Beijing. (China won the most, with 89, and Great Britain came in second, with 42.)

Source: www.paralympic.org, www.london2012.com, BBC’s Disability Sport, The Guardian, AFP-Relaxnews via Yahoo.

O&P Almanac JULY 2012

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IN THE NEWS

PAC Releases Clinical Practice Guidelines At its annual symposium in April 2012, the Pedorthic Association of Canada (PAC) launched its first-ever Clinical Practice Guidelines. The manual was written by 60 Canadian pedorthists and reviewed by 33 foot professionals from Canada, the United States, the United Kingdom, and Australia. “Our primary objective when we started this project in the fall of 2010 was to develop a publication that would help improve patient care— and we have done that,” says PAC President Ryan Robinson, C.Ped Tech (C), C.Ped (C). “I’m confident that our members will see the Clinical Practice Guidelines as an essential resource.” The publication promotes current best practice about more than 60

CMS Delays the Recovery Audit Prepayment Review Demonstration The CMS has again delayed the Recovery Audit Prepayment Review demonstration to a start date of “the summer of 2012.” According to CMS, the program is designed to help lower the error rate by preventing improper payments rather than collecting improper payments after they occur. It was originally slated to begin January 1 and then changed to June 1. CMS now says it will provide 30 days’ notice prior to the program’s start.

O&P Almanac JULY 2012

conditions. It also serves as a tool pedorthists can use to build relationships with physicians, podiatrists, and other health-care providers, as well as policy makers. A sample SAMPLE CHAPTER chapter from the Rheumatoid Arthritis Clinical Practice Guidelines can be found by searching on the PAC website at pedorthic.ca/ about-clinicalpractice-guidelines. For more information about the manual, contact PAC Executive Director Jonathan Strauss at info@pedorthic.ca or 888/268-4404. Pedorthic Association of Canada Clinical Practice Guidelines

Lisa Irish, BSc, C. Ped (C)

Keywords: chronic, progressive, autoimmune, joint inflammation, synovial joints, articular, pannus, nodules, polyarthritis

Key Messages

■ Early diagnosis and treatment is vital to reducing disabling effects of rheumatoid arthritis.

■ Recognition of signs and symptoms of possible rheumatic disease may speed appropriate diagnostic tests in previously undiagnosed individuals.

■ There is strong evidence that foot orthoses and specific footwear reduce foot pain and improve functional ability.

■ Orthotic efficacy may be as much a result of changes in muscle activation, proprioception, and motion facilitation as skeletal alignment and kinematic changes. ■ Semi-rigid and rigid orthotics in combination with rocker toe footwear were the most effective in relieving forefoot pain where soft orthoses (plastazote, poron) were less effective.

■ Footwear modifications are an effective treatment option for the rheumatoid foot.

Introduction

A 75-year-old female with rheumatoid arthritis. Note dorsal subluxation of metatarsophalangeal joints. Photo by Shannon Bunnett, HBSc (Kin), MSc, CK, C. Ped Tech (C), C. Ped (C).

An X-ray showing rheumatoid arthritis. Photo courtesy Apostolos A. Tountas, MD, FRCS (C).

This is an excerpt from “Clinical Practice Guidelines: A reference manual of best practice in pedorthic care.” – © The Pedorthic Association of Canada, 2012

Rheumatoid arthritis (RA) is a chronic, progressive, autoimmune disease of unknown cause in which the body’s immune system attacks the joints and surrounding tissues leading to joint inflammation, pain, joint damage, and disability. It is a systemic disease that targets synovial joints but can have extra-articular ramifications in other organs. RA affects approximately 1% of Canadians (Health Canada, 2003) and is more than twice as likely to affect women as men. Rheumatoid arthritis can occur at any age but tends to begin between the ages of 25 and 60. Children can be affected by a distinct but closely related inflammatory arthritic condition called juvenile idiopathic arthritis, or juvenile rheumatoid arthritis. Rheumatoid arthritis affects all ethnic groups and is found worldwide (Thould & Thould, 1983). Symptoms of initial onset of RA most commonly include insidious fatigue, morning stiffness lasting 30-60 minutes or more, joint pain and swelling involving the small distal joints including the wrist, metacarpophalangeal joints, proximal interphalangeal joints, metatarsophalangeal joints (Rheumatoid Arthritis, 2011; Tehlirian & Bathon, 2008). Inflammation of the small joints of the hands and feet in a symmetrical pattern is specifically characteristic of RA (Robinson, 2008) and occurs early in the onset of the disease (Otter et al., 2010). Other joints that may be affected include elbows, shoulders, hips, knees, ankles, jaw, and neck. In addition to articular symptoms the early symptoms of RA can also include low grade fever, fatigue, loss of appetite, weight loss, swollen glands, weakness, malaise, myalgias, and anemia. Muscle weakness and atrophy is a common complaint and may be a result of pain from articular and/or periarticular inflammation. A reference manual of best practice in pedorthic care

‘No Amputee Alone’ Program Targets Veterans The Amputee Coalition has partnered with the Department of Veterans Affairs (VA) to improve and enhance the recovery and readjustment of the more than 41,000 veterans living with limb loss across the country. “Losing a limb can be emotionally devastating,” says Cindy Poorman, rehabilitation planning specialist at the VA and the VA lead on this initiative. “New amputees often feel overwhelmed and isolated and wonder what the future holds.” The No Amputee Alone program offers amputees and their families support, information, and education to empower them to move forward, regain hope, and live well with limb loss. The program has been integrated into the Department of Defense’s support for wounded warriors, and the Amputee Coalition has provided its program to the Wounded Warrior Project. In 2010, the VA and the Amputee Coalition began integrating the Amputee Resilience Program into the VA’s Amputation System of Care. The program also offers training for the families of veterans living with limb loss. For more information, visit the Amputee Coalition website at amputee-coalition.org.

IN THE NEWS

NAAOP Releases Webcast on Injured and Amputee Veterans Bill of Rights The National Association for the Advancement of Orthotics & Prosthetics (NAAOP) has released a new video webcast in which NAAOP General Counsel Peter W. Thomas, JD, provides an update on House Resolution 805 (H.R. 805), the Injured and Amputee Veterans Bill of Rights, and comments on a recent report issued by the Office of Inspector General (OIG), Audit of Prosthetics Supply Inventory Management. Thomas says that support for H.R. 805 is growing, especially in the House of Representatives where it was introduced, and that NAAOP is moving forward to try and build bipartisan support. NAAOP would like to find a sponsor to introduce the bill to the Senate.

NAAOP is urging people to visit its website, click on the legislative action center link, and send a message to their representative or senator and encourage him or her to cosponsor this legislation. Thomas went on to say that NAAOP has talked to the Veterans Affairs committee that asked for the report and NAAOP has been invited to submit questions and provide information to the committee prior to a hearing to review the report. The hearing will be held in the near future. The webcast is posted on the NAAOP website at naaop. org or can be accessed via email or the NAAOP Facebook page.

COPL Acknowledges Research Gift

BOC Introduces Emeritus Status for Former Certificants

The Board of the Center for Outcomes and Evidence-Based Practice in Orthotics and Prosthetics, representing eight different independent nonprofit organizations in the O&P field, wishes to thank the Board of Certification/Accreditation, International (BOC) for its recent gift of $5,000 in support of the Center’s efforts in the areas of evidence-based practice and outcomes research. The Center recently designated grant recipients for $60,000 in pilot clinical research grants in O&P as a further step in advancing this mission. Funding for the four Pilot Grants at $15,000 each is provided by the American Orthotic and Prosthetic Association.

O&P Almanac JULY 2012

A new category, Emeritus status, has been introduced by the Board of Certification/Accreditation, International (BOC) to recognize former certificants’ years of service in orthotics and prosthetics. The designation of Emeritus status acknowledges the service, dedication, and hard work of now-inactive BOC-certified practitioners in good standing following 15 or more years of continuous BOC certification. Any BOC-certified practitioner leaving O&P practice with 15 years or more of continuous BOC certification is eligible for self-nomination or nomination by

another BOC-certified practitioner. Nominations for Emeritus status are currently being accepted by BOC Director of Certification Jan Paul Miller, MA, MEd. Once a nominee’s qualifications are verified by the BOC staff, the Emeritus-elect will be able to use his or her former credential, followed by the word “Emeritus” (e.g., Philip P. Watson, BOCP Emeritus). An Emeritus certificant who wishes to return to active status must follow the normal procedures for reinstatement in BOC’s recertification policy. For more information, visit bocusa.org/emeritus.

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IN THE NEWS

Record Track and Field Allocations for London 2012 The International Paralympic Committee (IPC) Athletics announced that a record 101 National Paralympic Committees (NPC) will have athletes taking part in track and field events at the 2012 London Games. A total of 1,100 athletes (740 male and 360 female) will compete in 170 medal events, beginning on August 30 and finishing on September 9 with the marathon, which ends in front of Buckingham Palace. Of the 170 track medal events in London, 103 are for male athletes and 67 are

TRANSITIONS

people in the news

John Brinkmann, CPO/L, MA, has joined the faculty at Northwestern University Prosthetics-Orthotics Center. Brinkmann will serve as a core faculty member for the inaugural Master’s in Prosthetics & Orthotics program slated to begin in July 2013. He is instructing classroom and laboratory courses in P&O for the remaining NUPOC postgraduate Certificate programs. International Paralympic Committee President Sir Philip Craven, MBE, has received the Lifetime Achievement Award at the 2012 Sport Industry Awards at a ceremony in Central London, United Kingdom. The Lifetime Achievement Award recognizes people whose work and dedication has changed the face of the sport industry forever. Michael Estrada has been elected to serve a three-year term on the Amputee Coalition’s board of directors. Estrada, a below-knee amputee, is the executive vice president, new business initiatives, of THOR-LO.

O&P Almanac JULY 2012

for female athletes. China, which topped the medals table at last year’s IPC Athletics World Championships, will have the biggest delegation with 80 slots, the maximum number an NPC could be awarded. This is followed by the United States with 54 slots, Russia with 53 slots, and Great Britain with 52 slots. The first 239 slots (146 male and 93 female) for London were allocated to National Paralympic Committees whose athletes had placed first or second in any of the individual medal events on the London 2012 Paralympic Games program at the 2011 IPC Athletics World Championships.

Hanger Inc., headquartered in Austin, has announced the following new hires: Sean Hembree, CP, has joined Hanger Inc.’s Santa Rosa, California, patient-care center. Thomas McNeese Jr., C.Ped, BOC COF, has joined Hanger Inc.’s Nashville patientcare center. Daniel White, BOCO, has joined Hanger Inc.’s patient-care center in Nashua, New Hampshire. Jerry Wilch, CPO, has joined Hanger Inc.’s West Palm Beach, Florida, patient-care center. Anthony Williams, CO, has joined Hanger Inc.’s San Antonio, Texas, patient-care center. Össur, Reykjavik, Iceland, has appointed Thorvaldur Ingvarsson, MD, PhD, to the position of executive vice president of research and development. He also will become a member of the Össur executive committee.

Thomas F. Kirk, PhD, CEO of Hanger Inc., has announced his plans to retire at the end of 2012. President and COO Vinit K. Asar has been appointed to succeed Kirk as CEO and will assume the position of vice chairman until Kirk officially retires on Dec. 31, 2012. Nydia Marzán-Harding, CPO/L, has joined the faculty at Northwestern University Prosthetics-Orthotics Center. Jim Moore, C.Ped, has been elected president of the Pedorthic Foundation. Moore is founder and CEO of The PSNE Group, Taftville, Connecticut, and has been a member of the Foundation’s board of directors since 2008. OPAF recently elected James O. Young Jr., LP, CP, FAAOP, to its board of directors. Young is the owner of the Amputee Prosthetic Clinic with locations in central and southern Georgia. He is also a transfemoral amputee as a result of a motorcycle accident in 1988.

IN THE NEWS

BOC Outlines Details of Orthotist and Prosthetist Eligibility Requirement Changes The Board of Certification/ Accreditation, International (BOC) released details regarding upcoming changes to the educational and experiential prerequisites for its orthotist and prosthetist certifications. The new requirements will take effect Jan. 1, 2013. The new prerequisites include an education from a Commission on Accreditation of Allied Health

TRANSITIONS

Educational Programs accredited educational program, followed by a residency approved by the National Commission on Orthotic and Prosthetic Education (NCOPE). As of Jan. 1, 2013, BOC-accredited facilities will be

eligible to serve as NCOPE-accredited residency sites, provided they meet all of the other requirements established by NCOPE. Applicants for orthotist and prosthetist certifications who want to apply under the current requirements must meet current prerequisites and apply by Dec. 31, 2012. For more information, visit bocusa.org/ boco-eligibility-prerequisites.

BUSINESSES in the news

3D Systems, headquartered in Rock Hill, South Carolina, has acquired prosthetic-fairings manufacturer Bespoke Innovations, San Francisco. Ability Prosthetics and Orthotics of Nevada has opened in Reno. The family-owned and operated patient- care facility is led by Travis Humphreys, CPO. The American Board for Certification in Orthotics, Prosthetics & Pedorthics Inc. (ABC) took part in the Commission on Accreditation of Allied Health Education Programs Annual Meeting April 29-30 in San Diego. ABC Executive Director Catherine Carter led the delegation. Bioventus LLC, a new company providing active orthopaedic healing, held its official launch following the finalization of the strategic venture between the company’s owners, an Essex Woodlands-led investor syndicate group and Smith & Nephew, the global medical technology business. Mountain Orthotic &Prosthetic Services, headquartered in Lake Placid, New York, has announced the transition of its part-time satellite office in Plattsburgh, New York, to a full-time patient-care facility.

The O&P Center at the University of Michigan Health System celebrated its 100-year anniversary in June. The celebration was accompanied by an open house showcasing $1.2 million in renovations that have nearly doubled the facility’s patient care space, among other improvements. OPIE Software of Gainesville, Florida, has partnered with Quality Outcomes LLC, Fredericksburg, Virginia. Through this partnership, Quality Outcomes’ patient outcome and patient satisfaction measurement tools will be integrated directly into the OPIE workflow process. Össur Americas has added a new product to its offerings: a portable compression device used to prevent deep vein thrombosis. Össur purchased the product from Michigan Medical Innovations (MMI). Robert Kraal, MMI’s former CEO, has joined Össur and will direct its vascular therapies.

The Prosthetics and Orthotics Manufacturing Initiative at Columbia, South Carolina-based SCRA’s Applied R&D sector was awarded a Przirembel Prize for Collaboration in Technology and Product Development at the InnoVenture Conference in Greenville, South Carolina. The winning project resulted in a long-life-cycle prosthetic socket that is reportedly light, comfortable, and durable. Special Opportunities in Advanced Rehabilitation hosted a First Dance clinic at the Elegance in Motion Dance Studio, Lake Orion, Michigan. The three-hour clinic saw individuals with amputations, wheelchair users, and stroke survivors all working together. St. Croix Orthopaedics, headquartered in Stillwater, Minnesota, has announced the rebranding of one of its integrated service lines from Brace Place to St. Croix Orthopaedics Orthotics Center. The facility’s rebranding is part of an overall initiative to provide streamlined experiences for patients and promote practice transparency.

JULY 2012 O&P Almanac

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Reimbursement Page By Devon Bernard, AOPA government affairs department

Don’t Fear the Audit How a little self-preparation can solve problems before they happen

ost of you have probably been the subject of a Medicare audit/review in one form or another, but do you know who is auditing you and why? The intent of an audit is to check the validity of a claim by reviewing all available information and ensuring that Medicare policies have been met and the service/item provided was medically necessary. Several different triggers can cause your claims to be the target of an audit, and those triggers depend on who is conducting the audit. Audits can be random—as with Comprehensive Error Rate Testing (CERT) audits—or they can be claim specific—as with Recovery Audit Contractors (RAC) audits. Audits also can be based on a specific geographical region, or they can be provider specific based on complaints or utilization numbers—as is the case with Zone Program Integrity Contractors (ZPICs). Let’s examine three of the entities or organizations, excluding the Durable Medical Equipment Medicare Contractors (DME MACs),that conduct audits on behalf of Medicare.

O&P Almanac JULY 2012

RAC Audits CMS selected four insurance companies to serve as the RACs and tasked them with conducting reviews to find Medicare over/under payments and recoup the money for the Medicare program. Each of those four companies operates in jurisdictions, which mirror the current DME MACs. The RAC contractor chosen for each jurisdiction is as follows: Jurisdiction A: Diversified Collection Services (DCS); Jurisdiction B: CGI; Jurisdiction C: Connolly Inc.; and Jurisdiction D: HealthDataInsights Inc. The RACs will conduct either an automated or complex post-payment review. Automated reviews involve clearly defined Medicare rules and regulations. An example of an automated RAC review involves the specific HCPCS codes that policy clearly states may not be billed with initial or preparatory prosthetic base codes. An automated review targets the low-hanging fruit, or the areas easiest to identify as improper payments, and will usually result in an automatic recoupment request. Complex reviews

typically target the medical necessity of an item/service. Requiring the review of additional medical records submitted by the provider, complex reviews determine if the claim was paid improperly, and a recoupment decision is not made until the records submitted have been reviewed. When you receive the recoupment or overpayment letter, you also will receive a detailed explanation of why the RAC believes the code(s) in question were paid improperly. Once you receive that letter, the clock starts ticking, so review their rationale and determine if you agree or disagree with the recoupment in a timely manner. If there is no response to the demand letter within 41 days, the overpayment will be automatically recouped from your future claims. If you agree with the RAC’s decision, you will want to refund the money immediately. If you disagree with the RAC’s decision, you have options in how you argue the recoupment. First, you may take advantage of the discussion period, a unique feature to the RAC audit process. The discussion period

is when you may discuss the specifics of the audit with the contractor and provide him or her with additional information as to why you believe the recoupment should not take place. If you are unsuccessful in overturning the recoupment during the discussion period, you then must follow the standard appeals process (redetermination, reconsideration, ALJ, etc.). For more information on the appeals process, see the Reimbursement Page article in the April 2012 O&P Almanac. CMS has placed limits on the RACs. For example the RACs have to adhere to a three-year â&#x20AC;&#x153;look backâ&#x20AC;? period from when the claim was paid. So, if a claim was paid on July 1, 2012, the RAC may audit that claim from the date it was paid until July 1, 2015. In addition to the time restrictions, the RACs also have frequency restrictions: They may only review a maximum of 1 percent

of the average monthly Medicare claim lines (maximum of 200) per National Provider Identifier number per 45 days. In other words, the RAC may review a maximum of 200 individual HCPCS codes billed for each of your locations. Lastly, the RAC audits are limited to only those issues that CMS has identified as problem areas, and the RACs must publish the problem areas they intend to audit and what they are looking for on their websites.

CERT Audits The CERT Program was created as part of the Improper Payments Information Act of 2002 and was designed to help Medicare identify, reduce, and recover improper payments and ensure that Medicare contractors are processing and paying claims correctly by producing a national Medicare fee-for-service

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error rate. Just like the RACs, CERT contractors are only looking at claims that have been processed and adjudicated. But their audits target the accuracy of the claims processed by the DME MAC, so they are auditing the DME MACs and not you directly. However, if they do find overpayment errors, you will receive an overpayment request. The DME MACs use the results of CERT audits to identify program vulnerabilities and create appropriate action plans to correct those vulnerabilities. That could mean the creation of new medical policies or updates to current polices. It also could lead the DME MACs to conduct their own pre- and post-payment reviews to catch potential errors. So, how does a CERT audit work? Two companies perform the audit functions of the CERT for all of

JULY 2012 O&P Almanac

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Medicare: Livanta and AdvanceMed. Random samples of processed claims, approximately 200 claims per Medicare contractor per month, are selected. If your claim is selected, you will receive a letter from Livanta informing you that your claim is under review and requesting that you send in all information regarding that claim. You have 75 days to respond. Livanta gathers all the information and provides it to AdvanceMed. AdvanceMed uses Medicare regulations, DME MAC billing instructions, supplier manuals, and the Local Coverage Determinations (LCDs) to conduct a review of the information gathered by Livanta. It determines if the DME MAC processed and paid the claim in error, and if a recoupment is required. Some of the more common errors and recoupment requests are the result of missing documentation (i.e., prescriptions, delivery slips, etc.), no documentation (either supporting medical necessity or not submitted in a timely manner) and illegible or missing signatures on medical records. An overpayment request as the result of a CERT audit will be sent from your DME MAC and not the CERT contractor directly. If you disagree with the overpayment request, your normal appeals rights are available to you. If you want to learn more about the CERT process, each of the DME MAC websites have pages dedicated to CERT audits and include such information as sample CERT letters, letters you can use to obtain documentation, CERT checklists, and contact information.

ZPIC Audits ZPICs will conduct post- and pre-payment reviews/audits and may also conduct probe audits with the main goal of ferreting out, combating, and deterring fraud in the Medicare program and identifying any improper payments made by the DME MACs and recouping that money. Five contractors perform the functions of the ZPICs in seven different zones, and those zones encompass the whole United States and don’t mirror

O&P Almanac JULY 2012

Seattle Coding & Billing Seminar If you want to learn more about appeals, audits, and Medicare policies, please be sure to register for AOPA’s Coding & Billing Seminar being held in Seattle, Washington, on August 6-7. To register, visit the AOPA website: www.AOPAnet.org.

the DME MAC jurisdictions. The companies, including AdvanceMed, are under a flat rate contract, and they are not incentivized to find errors (like the RACs). How does a ZPIC audit work? The ZPICs use a series of different tools to determine which provider they want to audit and the type of claims they intend to audit. Those audits will be targeted and specific; in other words, they will know what they are looking for. ZPIC tools include, but are not limited to, data mining/comparative billing records (comparing your claims relative to other providers in your area), or a ZPIC audit can be the result of a complaint of fraud. Once the ZPIC initiates an audit, you will receive a letter requesting additional information, and you may receive more than one letter because they may audit more than one claim at a time. (ZPICs don’t have frequency limits as the RACs do.) Once you receive the request letter for additional information, you have 30 days to submit the material. Once the ZPIC receives the additional information, it will thoroughly review the material and provide you with the results. It is key to note that the ZPICs don’t have a time frame in which they must respond, so they can take as long as they wish when reviewing your documentation. Another big difference between the ZPICs and the RACs or CERTs is that they may come to your facility to request documentation, and they may even interview your patients, employees, and referral sources.

What are some possible results of a ZPIC audit? A ZPIC audit can result in the finding of an overpayment, and, if that is the case, the ZPIC will notify the DME MAC and your DME MAC will send out a letter requesting the recoupment of any overpayments. You will still have all the usual appeal rights available to you. But, because ZPIC audits are designed to detect and deter fraud, the audits could also result in more severe punishments, especially if it is determined that you are acting fraudulently. Some of those punishments could include a referral to the Office of Inspector General for prosecution, revocation of your supplier number, or placement on a corrective action plan, which could include pre-payment reviews of all your claims until your error rate is considered low enough. Lastly, the ZPICs can conduct projected refund requests or extrapolate the amount of money they can recoup based on the total dollar amount of all claims submitted for review and the error rate established during the review.

Avoiding Audits While impossible to avoid an audit altogether because some of them are random (e.g., CERT audits), you can increase your chances of a successful audit. First, review the Medicare medical policies and DME MAC supplier manuals to know what the auditors are looking for, especially to acquaint yourself with documentation requirements. Second, conduct your own audits to find and fix problems before someone else finds them. Review your documentation to ensure it is complete and not missing any signatures or doesn’t have signatures that are illegible. Make sure your files are organized, consistent, and all the documentation is on hand and ready to submit. a Devon Bernard is AOPA’s manager of reimbursement services. Reach him at dbernard@AOPAnet.org.

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The

Winning Fit

With their set on Gold, five all eyes change amputee athletes and their clinicians reveal what it takes to compete— and win—at the Paralympic Games

By Lia K. Dangelico

ormer Major League Baseball player and manager Tommy Lasorda once said, “The difference between the impossible and the possible lies in a man’s determination.” And if determination has anything to do with it, five extraordinary individuals—Jessica Long, Katy Sullivan, Jeremy Campbell, Jerome Singleton, and Heinrich Popow— are poised to show the world what’s possible next month at the 2012 Paralympic Games in London. Their drive to win was always there, but it wasn’t until these athletes teamed up with some of the most respected names in lower-limb prosthetics that they acquired the taste for Gold and the support system needed to take them there. Despite the fact that each athlete was born without legs at all or with a medical condition that lead to amputation, most of them say their parents struggled to keep up with them as small children. They developed a passion for pushing the limits, competing, and winning, and it never went away. “I used to do somersaults and flips all over the house,” says Paralympic swimmer Jessica Long. “They couldn’t control me.”

O&P Almanac JULY 2012

COVER STORY

Name: Jeremy

Campbell

Photo: Hanger Inc.

Hometown: Perryton, Texas Classification: F44, P44 athlete (unilateral, transtibial amputee) Clinician: Chad Simpson, CP, of Hanger Inc. EventS: Athletics, Menâ&#x20AC;&#x2122;s Discus Throw, Menâ&#x20AC;&#x2122;s Pentathalon Sports Hero: Campbell has always looked up to his little brother Caleb Campbell, an Army Lieutenant and linebacker for the Kansas City Chiefs, for his moral integrity and strong leadership qualities.

JULY 2012 O&P Almanac

Name: Katy

Sullivan

Hometown: Tuscaloosa, Alabama

Photos: Hanger Inc.

Classification: T42 athlete (bilateral, transfemoral amputee) Clinician: Will Yule, CP, of Hanger Inc. Event: Athletics, Women’s 100m Fun Fact: While fast as lightning, Sullivan also is a talented singer and actress, and has appeared on popular television shows “Nip/Tuck” and “My Name is Earl,” and in several short films.

A bilateral, transtibial amputee, Long was adopted from a Russian orphanage as a young child and was brought to the United States. Growing up in Baltimore, Long began participating in gymnastics at age 4 and later got involved with swimming. She made her first appearance at the 2004 Paralympic Games in Athens, at the tender age of 12, and brought home three Gold medals in swimming. Sprinter Katy Sullivan, a bilateral, transfemoral amputee, had more of a gradual start in the world of sports. When early attempts at athleticism yielded frustration, she explored other talents like singing and acting, at which she excelled. But it wasn’t until age 25, after receiving her first pair of running legs from Hanger Inc., that she got to experience the act of running. Since then, the Tuscaloosa, Alabama, native has never looked back or slowed down, which serves well her for her 100-meter event. As the only bilateral competing in the London Games, Sullivan must run against unilateral amputees. It’s exciting though, she says, “to witness more women without legs seeing what’s possible and seeing that they can do this—that it is an option [and] to know that in some way I have helped inspire people to try sports.”

O&P Almanac JULY 2012

The Perfect Fit Many say that Paralympic sport is about marrying the right amount of athletic effort with the most capable team of care providers. While that sounds like a simple strategy, the reality can be quite different. “It’s challenging to fit a Paralympic athlete that…will depend on that prosthesis to be reliable and fine-tuned, so they have complete confidence that it will perform at the highest level,” says Chad Simpson, CP, for Hanger Inc. Simpson works with Jeremy Campbell, a unilateral, transtibial amputee from Perryton, Texas, who has excelled at discus and the paratriathalon.

Name: Jessica

Long

Hometown: Baltimore

Classification: S8 athlete (bilateral, transtibial amputee) Clinician: Erik Schaffer, CP, of A Step Ahead Prosthetics EventS: Swimming, Women’s 100 freestyle, 100 backstroke, 100 breaststroke, 100 butterfly, 200 IM, 50 freestyle, and 400 freestyle Fun Fact: Long made her first appearance at the Paralympics at the age of 12 in Athens, where she won three Gold medals. Of her time spent in Athens, she remarked she basically survived on ice cream alone.

“When I first met Jeremy, he was using a very basic prosthesis,” says Simpson. “He was using a socket with a sock fit and a very simple walking foot…for running, playing basketball, and other sports.” Campbell, who currently uses a custom-fit socket and several different carbon-fiber energy-storing feet, has benefited from Simpson’s expertise. He is both a world-record holder and a Gold medalist in the 2008 Paralympic Games in Beijing. “As I become stronger and more of an elite athlete, my prosthesis is stronger,” says Campbell. “It provides the feedback that I need that a normal leg would as much as it can.”

Where Are They Now? O&P Almanac caught up with three former Paralympic athletes turned orthotists/prosthetists to catch up on life, work, and sports post-Games.

Fillauer Jim Lagerstrom, CP, may be a former Paralympic athlete but he is still very much an athlete, regularly participating in ice hockey, golf, skiing, and mountain biking. A five-time Paralympic alpine skier, he earned two Silver and two Bronze medals between 1992 and 2006. Lagerstrom works as the Midwest sales manager for Fillauer, and is based out of Michigan. He brings years of experience developing his own adaptive sports prostheses to the table as he works closely with the top CPs and COs in the country. “I’ve spent a lot of time modifying my own prostheses, and taking the technology into different activities,” he says. It seems Lagerstrom’s athletic talents take center stage, as teammates and opponents rarely notice he has a disability until after competition. Never one to be held back, Lagerstrom is obviously very proud of that. “I’m not a crusader; I just try to lead by example.”

Melissa Stockwell, CP, Scheck & Siress Former U.S. Army officer and the reigning two-time Paratriathlon World Champion in the Tri 2 classification, Melissa Stockwell, CP, was the first Iraq War veteran chosen for the Paralympics. Currently, she works for Scheck & Siress in Chicago, and remains active in the amputee community as a Wounded Warrior board member and motivational speaker. She was named the 2010 and 2011 female Paratriathlete of the year.

Jason Wening, CPO, FAAOP, Scheck & Siress A five-time Paralympic Gold medalist in swimming, Jason Wening, CPO, FAAOP, works for Scheck & Siress in Chicago. With a background in bio-mechanical engineering, Wening says what drew him to the profession is the day-to-day problem solving, and the realization that every individual is unique and different. He also likes getting to see how all of the hands-on work pays off. “You’re not sitting at the back of a shop engineering something and it goes out and you never really find out what happens,” he says. “You have direct interaction with the end user, what they’re doing with it, and what their objective is.”

O&P Almanac JULY 2012

Jeremy Campbell competes in the discus event.

Sullivan has been using vacuum suspension for approximately one year. When direct-skin suction sockets gave her problems during competition, she worked with clinician Will Yule, CP, for Hanger Inc, to develop the socket technology. Her new, specialized elevated vacuum sockets “provide her the security and stability…necessary at that high level of sport,” says Yule. “She has the confidence now that her limbs are going to stay on the entire time she warms up and competes.” When Long met Erik Schaffer, CP, and founder of A Step Ahead Prosthetics, she had been suffering for years with severe pain and fitting problems of her own. Schaffer and the staff at A Step Ahead immediately got to the core of Long’s major hyperextension and laxity issues in her joints on both legs. “That lead us into a series of socket designs that were able to accommodate and make her a lot more stable, and just be able to stand up straight again so she could start her rehab,” says Schaffer. These advances in practice and technology extend beyond the Paralympics, and even the world of sports, Simpson points out. “Socket fit is critical for every prosthetic user,” he says. “And the things we learn from athletes like Jeremy help us to develop better and more comfortable designs for our nonathletic patients.”

Photo: Hanger Inc.

Jim Lagerstrom, CP,

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Name: Heinrich

Popow

Hometown: Leverkusen, Germany

Photos: Hanger Inc. Photo: Ottobock

Classification: T42, F42 athlete (unilateral, transfemoral amputee) CARE Provider: Team of Clinicians at Ottobock EventS: Athletics, Men’s 100m, 200m, 4x100 relay and Men’s Long Jump Fun Fact: Never wanting to be hindered by his so-called weakness, Popow’s philosophy of life is: “Seize the challenge!”

Gearing Up A perfectly fitted prosthesis, however, means nothing when you have an out-of-shape athlete. That’s why each of these competitors has entered into the final weeks and months of intense cardio and strength training to ready their bodies and minds for London. Unilateral, transfemoral amputee and sprinter Heinrich Popow, of Leverkusen, Germany, hasn’t modified his typical training routine at all. “You never know which results the slightest change might have,” he says. “I started to prepare myself for the Paralympics from the beginning of

O&P Almanac JULY 2012

my career. The only thing I change is how much I concentrate on the single training sessions.” A mentor for new and young amputees in Germany and elsewhere, Popow earned a Silver medal in the 100-meter sprint at the 2008 Paralympic Games. Long, who is currently living at the Olympic Training Center in Colorado Springs, Colorado, says she and her team are doing weight training three days a week and incorporating power workouts into their everyday swimming routines. “It’s all about training, pushing the envelope,” says Schaffer, adding that sometimes making the legs is the

easiest part. “The teaching and the understanding of how these things work with their bodies is where the success comes in.” Running, lifting, and/or swimming six days a week, Sullivan noted that a big part of the training process is learning to listen to her body, and being mindful of when something’s not feeling right. “You have to be reasonable and real with yourself,” she says. Of course, avoiding injury is a priority for all, and it requires close monitoring of all the prosthetic components involved, says Francois Van Der Watt, CPO, for Össur Americas Inc., and clinician for sprinter and unilateral, transtibial amputee Jerome Singleton, an Irmo, South Carolina, native. “The foot reacts to how much pressure is applied,” says Van Der Watt, “so as the athlete gets stronger that amount of pressure can increase…[if not closely monitored] that’s when injury or a component failure happens.” Equally important is the unique bond between clinician and athlete. All have expressed an unspoken connection in which their clinicians seem to know what they’re thinking or feeling just by the looks on their faces. “I’ve learned to trust the people in my corner, to trust my team,” says Singleton.

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Singleton Carolina Classification: T44 athlete (unilateral, transtibial amputee) Clinician: Francois Van Der Watt, CPO, of Össur Americas Inc. Event: Athletics, Men’s 100m, 200m, 4x100 relay Sports hero: Singleon admires Paralympic wheel-chair racing Gold medalist and Rhodes Scholar finalist, Cherie Blauwet. In addition to excelling athletically, Blauwet attended medical school at Stanford University and is currently in residency.

Name: Jerome

Photo: Össur Americas Inc.

Hometown: Irmo, South

Staying Motivated For these athletes, working out involves so much more than just deciding to get out of bed in the morning, but it seems that fact fuels them to go even farther, to push that much harder. When asked what keeps her motivated, Long answers honestly: It doesn’t always come naturally, she says, but “it helps to know that it won’t hurt later. ...All you’re ever going to remember is that Gold medal, standing up there representing your country.” Many Paralympians have a staggering level of motivation, and even breaking a world record won’t quench their thirst for competition. After recently breaking the world record for throwing a discus 60 meters as a Paralympic athlete, Campbell

O&P Almanac JULY 2012

quickly moved on to his next goal: being the first disabled athlete to throw the heavier, Olympic-regulation 2K disc 60 meters. “I’ve always had an innate competitive nature, he says. “I want to be the best at what I do. And so whatever that takes, I go after it.” For Singleton, motivation is a gradual process, a one-day-at-a-time sort of thing. “Every year, I want to be a little bit better than I was last year,” he says. A Gold medalist at the 2008 Games, Singleton also excels in the classroom, earning a double major in Mathematics and Applied Physics from Moorehouse College. Noting that it’s never easy being the first to do something, he says he has always looked to those who came before him for inspiration. “So I know I can do it too, because it’s not the first time that it’s happened.”

The Will to Win Fueled by an inexhaustible drive to win, not one of these athletes is willing to take “no” for an answer, or settle for anything less than Gold. Some are more down-to-earth in their approach to the Games this summer: “My goal is to reach my potential…to make my family and country proud,” says Singleton, who hopes to medal in the 100 meter, 200 meter and 4x100 relay events. Others, like Popow, are less flexible on the subject. “I ended up third in Athens and second in Beijing,” he explains. “There’s only one possible goal for me, which is winning in London. This is the perfect moment to finish first.” While medaling in the Olympics is next on the horizon, these individuals get out of bed every day to prove they can to a world that suggests they can’t. “I feel like most people allow their circumstances to define their capabilities,” says Campbell, “and my circumstances are never going to define my capabilities in the world of sports.” From the perspective of a clinician, Van Der Watt says it best: It’s all about seeing the athlete succeed. It’s about watching them up on the podium and knowing that “it’s their true ability that gets them to that level,” he says. “They didn’t get a medal because of any component or some prosthetic device they’re wearing. If they have the best to wear and use, they can rely on their own abilities to achieve the highest level … that is my favorite part.” a Lia Dangelico is a contributing writer for O&P Almanac. Reach her at ldangelico@strattonpublishing.com.

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Medicare O&P Improvements Act â&#x20AC;˘ Veterans Insurance Fairness for Amputees Act

l a n r u o J Capitol Hill

A day in the life of AOPA members-turned-lobbyists

O&P Almanac JULY 2012

Bill of Rights •

By Adam Stone

he ballroom of the L’Enfant Plaza Hotel buzzed with energy April 18, 2012, as AOPA members, lobbyists, and staff prepared to make their case on Capitol Hill as part of the two-day 2012 AOPA Policy Forum. The gathered group had a busy day ahead, with more than 300 appointments scheduled with members of Congress and their staffs. In a morning drizzle, they packed into cabs to make the short drive up to the nation’s seat of power. The group had their work cut out for them. They would be advocating for three bills. First was the Medicare O&P Improvements Act, which reduces fraud and abuse by prohibiting Medicare from reimbursing unlicensed providers in licensure states; paying only qualified providers and adopts a revised payment system that links practitioner qualifications with the level of complexity of the care. “We feel we are being punished because Medicare didn’t do their homework in the first place,” says Gene Bernardoni, CO, LO, L.Ped, owner of Ballert Orthopedic in Chicago. The second bill is the Veterans Bill of Rights, which asks for nothing more than definitions spelling out exactly what veterans can expect in their O&P care, including choice of providers and other rights. These rights must be posted in VA facilities and on the VA website. The third bill, The Insurance Fairness for Amputees Act, calls on insurers to provide O&P benefits equal to other medical and surgical benefits offered in the policy without lifetime caps or other limits. While errantly perceived by some as if it were mandating O&P coverage, in fact, the legislation merely defines behaviors for insurers that choose to provide coverage. “But facts don’t always matter when politics are in play,”

suggests AOPA Executive Director Tom Fise, JD. In all approximately 100 clinicians, facility owners, and friends of the industry participated in this year’s Forum. The following is an account of the meetings between several AOPA members from Georgia and their state representatives, as observed by this reporter.

Legislation on My Mind When half the Georgia contingent found themselves outside the Members-only door of the Hart Senate Building, James Young, CP, LP, FAAOP, an amputee who lost half of his leg in a motorcycle crash and owns Amputee Prosthetic Clinic (with three clinics based in Macon), had no intention of walking all the way around the block to the public entrance. Instead, he spun his abovethe-knee prosthetic 180 degrees—an impressive sight in dress pants and loafers—and the guards let the group pass. These Georgian gentlemen came ready to play. Young was joined by Alfred Kritter, CPO, FAAOP, an AOPA board member, veteran political player, and vice president of clinical services and chief compliance officer for Hanger Inc. in Savannah. We arrived at the offices of Sen. Saxby Chambliss, a Georgia Republican. As is typically the case on the lobbying circuit, Young and Kritter did not meet with the senator, but rather with an aide designated to deal with healthcare matters. Saxby carries some clout. A second-term senator, he is “a highly visible and well-respected presence in Washington,” wrote Georgia Trend magazine. Among his many hats, Chambliss is a member of the Senate Armed Services Committee, which means he likely has an interest in the Veterans Bill of Rights legislation.

JULY 2012 O&P Almanac

Preparation, Anticipation In the days leading up to the 2012 AOPA Policy Forum, practitioners around the country were expressing enthusiasm for the venture. At Mid-Florida Prosthetics and Orthotics, Frank Vero, CPO, noted that the Medicare O&P Improvements Act already has bills pending in the House and Senate. That kind of momentum might make it easier for members to sign on. “Now that we have both a House H.R. 1958 and a Senate S. 2125 version, that should be of interest among lawmakers,” he says, adding that just showing up gives him a sense of satisfaction. “Getting involved in the political process, you do feel like you are making a difference. People are frustrated with politics because they don’t see anything happening, but if you are there ringing the bell, at least you feel like you are doing your part.” As Teri Kuffel, Esq., vice president of Arise Orthotics & Prosthetics Inc., in Blaine, Minnesota, prepared to go to Washington, she too, thought about the reality of the stakes on the table. “This is all about telling our legislators that amputees need insurance coverage, that without appropriate coverage they cannot work, they cannot return to their new normal, they cannot maintain their taxpaying citizen status,” says Kuffel. A policy forum veteran, she has been impressed by the access provided to lawmakers at the federal level. “I’ve seen how easy it is to talk to these legislators. Maybe it’s the fact that you have traveled the distance to D.C. Whether or not they could help us, they seemed all ears and willing to try and work with us,” she says. “In Minnesota at the state level, there is a lot more red tape. There are legislators who won’t even take the time to see us.” To help make their case, Kuffel and her husband, Charles Kuffel, CPO, FAAOP, brought along Christopher Dunn, an amputee and former Marine. He made an impact: Rep. Erik Paulsen, a second-term Republican from Minnesota’s 3rd Congressional District, brought Dunn’s two kids down on the House floor to cast votes on his behalf. “They wanted to hear from Christopher. They wanted to hear about his prosthetic device, and he could speak to several of the issues firsthand, especially the Veterans Bill of Rights,” Kuffel says.

O&P Almanac JULY 2012

Only his aide didn’t show, which is not unusual in the frenetic Capitol Hill environment. After half an hour enjoying the senator’s nicely appointed vestibule, Young and Kritter made their way down the hall to the office of another Republican, Sen. John Isakson. Isakson has some longevity as a lawmaker; he spent three terms in the House before moving to the Senate. Fortunately, Saxby’s aide caught up with us, giving Young and Kritter the chance to address two senatorial aides at once. Then, some lobbying happened. Kritter presented the Medicare O&P Improvements Act. Knowing Chambliss sits on the Special Committee on Aging, Kritter pushed the money-saving aspects of the bill. Young talked about the basic good sense in giving veterans some latitude in where they receive care, because many don’t have a VA center close to home. Young also was able to put a human face on the equation, reminding the aides that he spoke not just as a practitioner, but also as a consumer. “I can quit being a prosthetist tomorrow, but I can’t quit being an amputee,” he said. Out in the hall, Young gave the meeting positive marks: “They recognized us; they seemed familiar with the issues,” he said. “That’s always a positive sign.” Young and Kritter’s next visit with Rep. Jack Kingston fairly glowed with goodwill. Kingston, a Republican, serves on the House Appropriations Committee and the Defense Subcommittee, so it was clear going in that the Georgia team would find if not a sympathetic ear, at least an interested one. The representative’s meeting room had a down-home feel: decorations included a gaping alligator head, souvenir footballs from the Georgia Tech Yellow Jackets, and the Camden County Wildcats, and bowls filled with free peanut samples, which you’ll find in the office of every Georgia lawmaker.

I t ’s all about finding common ground.” Kritter launched into the details of the Medicare O&P Improvements Act. He explained that, for industry, it comes down to wanting Congress to help CMS reduce fraud and abuse by defining qualifications for who can practice in the field and bill Medicare. “Now, how often does someone walk in here and say, ‘Please regulate us?’” Kritter’s comment drew an appreciative laugh. By the time they got around to talking about waste, fraud, and abuse, Kritter and Kingston’s aide were finishing each other’s sentences. The aide declared she was “very interested” and promised to pass the information on to the representative.

Meet in the Middle Next stop for the gentlemen from Georgia: an impromptu drop-in at the office of Rep. Sanford D. Bishop, a 10-term Democrat from Georgia’s 2nd Congressional District. Because Bishop serves on a subcommittee that deals with veterans’ affairs, Young and Kritter felt he’d be interested in what they had to say. Moreover, Bishop’s 10 terms provides a certain amount of influence. The aide indicated some support to the lobbyists, especially on the topic of certifying providers and laying out a bill of rights for veterans. The aide politely accepted the AOPA information packet, promising to give it a read. In the course of the day, packets also landed in the hands of aides to two other Georgia congressmen, Republican Rep. Tom Price and Democratic Rep. David Scott. At some point, Young led the way to one of the congressional cafeterias. There’s something exciting about waiting in line at the congressional salad bar. The place was so chock-full of conservative suits, it was impossible to discern who the powerbrokers were, who the elected representatives were,

O&P Almanac JULY 2012

and who was wearing out shoe leather pushing the next farm bill. Over institutional eggplant parmesan, Young reflected on the nature of the day’s enterprise. He noted it helps that the O&P bills already have some grounding. Medicare O&P Improvements Act is before both the House and Senate, as is the Insurance Fairness for Amputees Act. Having a bill in play in both bodies makes it a lot easier to draw cosponsors, which is a part of the objective.

—James Young, CP, LP, FAAOP

Capitol Hill Comfort The biggest meeting of the day was not a visit not with an aide but with an elected congressman, Rep. Austin Scott, a first-term Republican from Georgia’s 8th Congressional District and former small business owner. Although we weren’t on Rep. Scott’s schedule, he and Young have history. Scott represents Young’s district and his dad is an orthopedic surgeon. In short, they understand each other. Scott and Young talked about real estate deals back home, while the representative sipped iced tea. Scott talked about complications from his shoulder surgery, and Young described blowing his shoulder at the Paralympics trials and his wife’s rotator cuff. The lobbying that went on here was mostly unspoken. That’s a benefit of establishing a relationship with your elected officials. While the Medicare, insurance, and veterans’ rights bills were barely mentioned, Young once again put a human face on the equation, reminding Scott that he spoke not just as a practitioner but as a consumer. Not much more needed to be said. Each man knew where the other stood, where they agreed, and where they didn’t. Although Young didn’t get Scott’s full backing, he reaffirmed their

relationship. “It’s always valuable to make those connections, and, hopefully, that spreads out back to the issues,” Young said. “It’s all about finding common ground.” The work these gentlemen did on Capitol Hill on April 18 isn’t going to resolve the debate or make the kind of difference that brings a vote to the floor. But their work does move the needle, keeping amputee concerns on the radar. “It takes forever, and it is not a one-visit thing. We are only one piece of a larger agenda,” Kritter remarked. Young agreed. We’re not just building a case, he says. We’re building relationships, the kind of connections that will have a real effect over time. Young obviously has been working on his relationships for a while. While congressional staff see dozens of lobbyists a day, when Young entered an office the aides remember him and his issues. In politics, that’s big progress. a Adam Stone is a contributing writer for O&P Almanac. Reach him at adam. stone@newsroom42.com.

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The National Assembly:

It’s So Much More

Don’t miss this year’s event co-hosted by AOPA and the New England Chapter in Boston, Sept. 6-9, 2012

he growing relevance of the National Assembly to the O&P community is amazing. The program schedule, 34 available education credits, networking opportunities, and burgeoning exhibit floor all make this event a must do and certainly the place to be September 6-9 in Boston. But how did the National Assembly become such a supersized learning and networking experience for O&P professionals? In just the past three years, the schedule has Award expanded dramatically, WINNING adding hallmark events that highlight specific areas of interest for O&P professionals. The Sam E. Hamontree, CP, Business Lecture Award series, launched in 2010 via a grant from the Hamontree family, seeks to recognize the best business paper submitted on an aspect of O&P management. In the past, the winner took center stage to present his or her award-winning paper during the National Assembly and received further recognition and a $1,000 cash award. This year, however, there’s a new twist: The National Assembly Education Committee decided to change the rules and will select two

O&P Almanac JULY 2012

finalists. Both will present their papers and then the audience will vote to decide which finalist should receive first place and the cash award. Further emphasizing AOPA’s focus on business education needs, the National Assembly Planning Committee, chaired by Russ Hornfisher, MS, MSOD, created the

e k a M own r u o Y

y r o t His The Business Management Certificate Program addresses skills that are fundamental to the success of an O&P business.

Business Management Certificate Program in collaboration with the University of Virginia. Introduced in 2011, this comprehensive certificate How to get started: program offers a series of business and management seminars to provide business owners, managers, and practitioners of O&P patient-care facilities, O&P manufacturers, and distributors an opportunity to explore crucial PRESENTS THE NEW

AOPA Business Management Certificate Program

AOPA is proud to announce the new partnership with the University of Virginia’s School of Continuing and Professional Studies to create an improved Business Management Certificate program. The O&P Business Management Certificate is a comprehensive certificate program that will offer a series of business and management seminars to provide business owners, managers and practitioners of O&P patient care facilities, O&P manufacturers and distributors an opportunity to explore crucial business challenges— from finance, sales and marketing to business operations, reimbursement policies and management.

The improved Business Management Certificate Program will be similar to non-degree continuing education programs that universities offer in conjunction with their business colleges. These programs will be offered at the AOPA Assembly, online at AOPA’s website and targeted seminars throughout the country (such as the Mastering Medicare: Essential Coding and Billing Techniques Seminar).

Complete the online sign up form: https://aopa.wufoo.com/forms/earn-acertificate-in-op-business-management/

Select and complete four required core modules and four elective modules within three years.

Complete a Module specific quiz for each program.

Participants that successfully complete the program will be awarded a certificate of completion, in addition to being recognized at the AOPA National Assembly and the O&P Almanac.

business challenges—from finance, sales, and marketing to business operations, reimbursement policies, and management. As with most certificate study pathways, the AOPA Business Management Certificate Program offers required courses along with a menu of electives. All coursework receives varying continuing education (CE) credits. Program participants will want to know that some of the mandatory courses are so central to the curriculum they are only offered at the yearly National Assembly; other courses, however, are offered through different venues and more are being added. The Business Management Certificate Program is designed to broaden the understanding and skills needed to successfully manage today’s O&P business in this time of change. Participation in the program sends a strong signal to peers Earn YOUR Certificate in and current and O&P BUSINESS MANAGEMENT future employers that your commitment to achieve better business managements skills sets you apart from others in the field. Through a joint partnership between AOPA and the University of Virginia School of Continuing and Professional Studies

This unique leadership learning experience will provide business owners, managers and practitioners an opportunity to

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AMERICAN ORTHOTIC & PROSTHETIC ASSOCIATION 330 JOHN CARLYLE STREET, SUITE 200 ALEXANDRIA, VA 22314

A NEW AOPAversity OPPORTUNITY!

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Another addition to the valuable education, products and services offered by AOPA that you need to succeed.

AOPA HEADLINES

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Innovations—such as the abstract poster competition open to students and residents—attempt not only to seek out original thinking and ideas but also expose these future practitioners to the workings of the O&P community by encouraging their presence at the National Assembly. To accomplish those goals, two separate awards were created: An award for the best orthotic poster subject was established to honor Otto and Lucille Becker by the Becker family of the Becker Orthopedic Appliance Company; the second award, for the best prosthetic abstract poster, honors Edwin and Kathryn Arbogast and is made possible by the Arbogast family of WillowWood. To further involve young people in the culture and educational realm of O&P, the Assembly Technical Workgroup has organized an inaugural two-day summit and contest to build a swim prosthesis. The competition is sponsored by AOPA, OPTA, Ottobock,

Cascade, and ABC and is open to students, residents, and practicing professionals, with a first prize of $500. New to the National Assembly in 2012: roundtables. This popular form of peer group idea sharing offers the distinct advantage of relaxed, informal presentations with each roundtable dedicated to a specific discussion topic. The discussion leader will kick off the subject area and encourage the group to share ideas, opinions, and strategies or to brainstorm on a specific topic. No extra fees are involved, but those attending a roundtable are asked to sign up in advance for their preferred topic (eight are offered), so adequate seating can be ensured for everyone’s topic preferences. Four years ago, AOPA’s National Assembly Planning Committee introduced another new feature to the annual meeting by scheduling early morning, large, general sessions and booking one or more nationally known keynote speakers. This year’s opening speaker will be Max H. Bazerman, PhD, and Straus Professor of Business Administration at the Harvard Business School. His message

will include how to negotiate from a position of weakness, which the O&P community may find invaluable as it seeks to find a place in the coming accountable care organization structures. Remember: In terms of reimbursement, O&P ranks pretty far down on the provider totem pole. You’ll need all the tips you can get if you try to negotiate a presence in one, and Bazerman will give you more negotiating arrows for your quiver. The preliminary program was sent to the O&P community with the June issue of the O&P Almanac and is available online. Visit www. AOPAassembly.org for an opportunity to view, print, and download the preliminary program. More details about the 2012 National Assembly are soon to be announced. With its array of spectacular programming, special events, and the most exhibitors participating in AOPA history, this year’s National Assembly will truly knock your socks off. You can register online, but do so today. Make an early-bird registration prior to July 20, 2012, and save $100 (AOPA members only). Hotel reservations must also be made before July 20 because room availability at the Boston Sheraton cannot be guaranteed at the special convention rate of $230 per night. And finally, the city of Boston is just a wonderful place to be. In fact, when you can combine this historic venue and walking city with all the outstanding National Assembly offerings, you’ll find yourself re-energized, re-educated, and revived about what we do and for whom we do it. Boston is the place to be. a

JULY 2012 O&P Almanac

AOPA HEADLINES

Learn the Ins and Outs of ABNs— Join the Audio Conference August 15 One of the most important and often misused Medicare forms is the Advanced Beneficiary Notices (ABN) form. Join AOPA August 15 at 1 p.m. EDT for an AOPAversity Mastering Medicare audio conference that will focus on and cover the basics of when to use an ABN form. Learn strategies and techniques from an AOPA expert who will address the following topics: • which modifiers to use with the ABN form • additional uses for the ABN form • how to use the ABN to protect your bottom line • tips on how to properly fill out the ABN form.

Master Medicare in Seattle:

Essential Coding & Billing Techniques Seminar Join your colleagues August 6-7 at the Hyatt at Olive 8 in Seattle for AOPA’s “Mastering Medicare: Essential Coding & Billing Techniques” 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 and much more. Meant for practitioners and office staff, this advanced two-day event will feature break-out sessions for these two groups to ensure concentration on material appropriate to each. Basic material that was covered in AOPA’s previous Coding & Billing seminars has been converted into nine one-hour webcasts. Register for the webcasts on AOPA’s homepage. Register online for the “Essential Coding & Billing Techniques” seminar in Seattle at https://aopa.wufoo.com/ forms/2012-mastering-medicare-seattle or contact Devon Bernard at dbernard@AOPAnet.org or 571/431-0854 with questions.

O&P Almanac JULY 2012

The cost of participating is $99 for AOPA members ($199 for nonmembers), and any number of employees may listen on a given line. Participants can earn 1.5 continuing education credits by returning the provided quiz within 30 days and scoring at least 80 percent. Contact Devon Bernard at dbernard@AOPAnet.org or 571/431-0854 with content questions. Register online at https://aopa.wufoo.com/forms/2012telephone-audio-conferences/. Contact Steve Custer at scuster@ AOPAnet.org or 571/431-0876 with registration questions.

2012 AOPA Coding Clinic You and your staff are invited to Baltimore, Maryland, BWI Airport Marriott to participate in a workshop on July 24 designed specifically for AOPA’s supplier members. Representatives from the Centers for Medicare and Medicaid Services (CMS), AOPA leadership, and staff will discuss current coding issues and the ins and outs of coding applications, as well as hints on improving your chances of success on applications. • How does coding affect product sales? • When in the product lifecycle should you consider coding? • Does the name of a device affect payment? • Who makes the final decision on what devices receive codes? • Can you get a brand name code? • Do Medicare codes affect private payors? • What do I do if my code application is rejected? • If a new code is issued, how does that interact with the Medicare allowable for that device? Don’t miss this opportunity to advance your company’s goals—get the answers you need to these questions and more! Register online for the 2012 AOPA Coding Clinic in Baltimore at https://aopa.wufoo.com/forms/2012-aopa-codingclinic-baltimore/ or contact Steve Custer at scuster@AOPAnet.org with questions or information.

AOPA HEADLINES

Get Paid for Orthopedic & Diabetic Shoes—Join the Audio Conference September 12 Explore the difference between orthopedic shoes and diabetic shoes. Join AOPA on September 12 at 1 p.m. EDT for an AOPAversity Mastering Medicare audio conference that will focus on and cover the basics of orthopedic and diabetic shoe policies. Learn strategies and techniques from an AOPA expert who will address the following topics: • the importance of modifiers on shoe claims • how to bill for diabetic shoes for amputees • requirements of the Certifying Statement and physician documentation • when to ask patients to sign an Advanced Beneficiary Notice for shoes.

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Discover Employment Opportunities at AOPA’s Online Career Center

Register Today! Don’t Miss the AOPA National Assembly Early Bird Deadline July 20 marks the Early Bird Deadline to receive discounted rates for the AOPA 2012 National Assembly and Northeast Chapter Combined Meeting in historic downtown Boston. Experience the country’s largest, oldest, and most essential meeting for orthotic, prosthetic, and pedorthic professionals. Online registration is open at www.AOPAnet.org. July 20 also is the cutoff for hotel reservations at the Sheraton Boston for the block of rooms reserved by AOPA. This block of rooms is being held exclusively for Assembly attendees; those booking rooms are required to register for the Assembly by July 20 or they will not be eligible for the group rate and may be subject to cancellation.

The AOPA National Assembly features extensive scientific programs on topics such as scoliosis, microprocessor knees, balance, and wound care. Also featured will be unprecedented business education from experts in the O&P industry covering health-care reform, documentation, business management, accountable care organizations, the Food and Drug Administration, reimbursement challenges, and more. Dedicated education tracks are offered for pedorthists, postmastectomy fitters, and technicians. Register online at https://www. expotracshows.com/aopa/2012/. Look for program updates and registration information at www.AOPAnet.org. Contact AOPA headquarters at 571/431-0876 with questions.

As an O&P professional, you can make a difference every day. Job opportunities abound throughout the country, and the need for O&P professionals is increasing rapidly. Currently, 100 percent of O&P program graduates find employment, and most choose to make it a lifelong profession. If you’re seeking employment, access the most recent jobs available. If you’re recruiting, reach the most qualified candidates by posting your job on AOPA’s Online Career Center. Visit http://jobs.AOPAnet.org, or email Steven Rybicki at srybicki@ AOPAnet.org with questions.

JULY 2012 O&P Almanac

AOPA HEADLINES

AOPA Travels to Germany for ORTHOPÄDIE + REHA-TECHNIK International Trade Show and World Congress One of the most important international events concerned with rehabilitation technology and the care of patients who have prostheses and orthoses took place in Leipzig, Germany, on May 10-15. ORTHOPÄDIE + REHA-TECHNIK is the largest event in the world for the orthotic and prosthetic rehabilitation community. This event is significant to bring leaders, suppliers, and practitioners together from around the world. AOPA had the distinguished satisfaction of attending the event for orthopaedic and rehabilitation products while exchanging ideas and opinions for serious public debate concerning policy on disability. AOPA President Tom Dibello had the pleasure of introducing the U.S. Consul General, Mark Powell, to several AOPA members. A career Foreign Service officer, Powell has served in a variety of capacities, both domestically and abroad, covering issues relating to Europe, Iraq, Central and South America, and the Caribbean.

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Powell and Dibello at Fillauer booth during the ORTHOPÄDIE + REHA-TECHNIK.

O&P Almanac JULY 2012

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AOPA HEADLINES

Master Medicare in Las Vegas: Essential Coding & Billing Techniques Seminar Join your colleagues October 18-19 at the Mirage Hotel and Casino in Las Vegas for AOPA’s “Mastering Medicare: Essential Coding & Billing Techniques” 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 and much more.

Meant for practitioners and office staff, this advanced two-day event will feature break-out sessions for these two groups to ensure concentration on material appropriate to each. Basic material that was covered in AOPA’s previous Coding & Billing seminars has been converted into nine one-hour webcasts. Register for the webcasts on AOPA’s homepage. Register online for the “Mastering Medicare: Essential Coding & Billing Techniques” seminar in Las Vegas at https:// aopa.wufoo.com/forms/2012-mastering-medicare-las-vegas/ or contact Devon Bernard at dbernard@aopanet.org, 571/431-0854.

Sponsored by

Enter the First-Annual AOPA OPTA

OPTA, OttoBocK, Cascade-USA, and AOPA

Technical Fabrication Contest

Compete to fabricate a swim prosthesis, and your device may be selected as a cash prize winner! This contest is sponsored by OPTA, OttoBock, Cascade-USA, ABC, and AOPA. The first-place prize is $500; second-place prize is $300; and third-place prize is $150. First-, second-, and third-place winners will be selected in both Professional and Student categories.

Contest Details Contest Task: Fabricate a finished belowknee (BK) swim prosthesis. Entry Classifications: Student or Professional. Student: A Student is anyone currently enrolled an orthotic and prosthetic technician training program or who has graduated from such a program in the spring/summer of 2012. Professional: All nonstudent entries will be entered in the Professional classification. Overview: Entrants will be provided a digital positive mold and specification sheet. To make the contest accessible to all, a negative cast mold will be sent to those without access to a carver, and a limited number of SACH feet are available for loan.

Request from Clinicians: Fabricate a swim prosthesis. The technician is given free rein in terms of the final shape and cosmetic finishing. Entry Procedures: To enter, simply complete the online registration form located at https://aopa.wufoo.com/ forms/2012-aopa-opta-technician-fabricationcontest/. There is a $25 entry fee. Entry Deadline: July 30, 2012. Questions? Contact Steve Custer at scuster@AOPAnet.org or 571/431-0876.

NEW

Where to Send Contest CONTEST Submission: Send your submission to AOPA headquarters no later than Tuesday, August 10. You may also bring your device to the AOPA National Assembly in Boston, but your device must be delivered to onsite registration no later than 1 p.m. on Thursday, September 6, as judging will commence that afternoon. Devices will be displayed during the Assembly, and the winner will be announced at the Opening Session on Friday, September 7. Shipments to AOPA headquarters and inquiries should be directed to: AOPA OPTA Technical Fabrication Contest Steve Custer 330 John Carlyle Street, Suite 200 Alexandria, VA 22314

JULY 2012 O&P Almanac

STAND UP for your

PROFESSION! It was said that Caesar fiddled while Rome It was said that Caesar fiddled while Rome burned. Our profession is on fire and at threat burned. Our profession is on fire and at threat of being diminished to a state that will make it of being diminished to a state that will make it impossible for us to accomplish our mission. impossible for us to accomplish our mission. The stakes are high and the risks of our ability The stakes are high and the risks of our ability to provide quality care are becoming more to provide quality care are becoming more and more difficult. Yet, we still have those who and more difficult. Yet, we still have those who say it is not my business or I can not make a say it is not my business or I can not make a difference. What will it take to get those who difference. What will it take to get those who stand on the sideline involved so they will help stand on the sideline involved so they will help those who carry the ball? those who carry the ball?

This year’s event will be on Friday, Sept. 7, during the AOPA National Assembly in historic Boston. For more information, please contact Devon Bernard at dbernard@ aopanet.org or Catherine Graf at cgraf@aopanet.org.

Will it require that... Will it require that... A our service be constantly backed up with A our service be constantly backed up with physician notes? physician notes? A we be taxed as if we were manufacturers? A we be taxed as if we were manufacturers? A we be questioned about whether or not our A we be questioned about whether or not our service is essential? service is essential? A we be faced with encroachment from other A we be faced with encroachment from other professions? professions? A we spend more time doing the paperwork A we spend more time doing the paperwork required to provide a service than the time required to provide a service than the time it takes to do the service? it takes to do the service? A we receive reimbursement that is so poor A we receive reimbursement that is so poor it becomes more and more difficult to keep it becomes more and more difficult to keep the doors open? the doors open? A individuals change professions due to the A individuals change professions due to the complexity of operating in our present complexity of operating in our present environment? environment? I could go on but it would do no good. We all I could go on but it would do no good. We all know what the problem is and yes, we know know what the problem is and yes, we know what the answer is. You need to say I am mad what the answer is. You need to say I am mad as hell and I am not going to take this anymore. as hell and I am not going to take this anymore. How you can have a voice is thru the AOPA How you can have a voice is thru the AOPA Political Action Committee. Political Action Committee.

Being at the AOPA Wine Tasting and Auction Fundraiser Being at the AOPA Wine Tasting and Auction Fundraiser shows your support for AOPA government relations shows your support for AOPA government relations efforts. Therefore, we ask that you help in these efforts. Therefore, we ask that you help in these Healthcare battles by BIDDING HIGH AND BIDDING OFTEN!!! Healthcare battles by BIDDING HIGH AND BIDDING OFTEN!!!

Our PAC is fighting all those problems listed Our PAC is fighting all those problems listed above and many more. The only problem is above and many more. The only problem is that it is too small and does not have enough that it is too small and does not have enough funds to do the job we need done. I once made funds to do the job we need done. I once made the statement “you donate to your church, the statement “you donate to your church, your school and to other charities, but you your school and to other charities, but you do nothing to insure that you can continue to do nothing to insure that you can continue to support those causes”. By that I mean, donate support those causes”. By that I mean, donate to your PAC to insure that your profession and to your PAC to insure that your profession and livelihood will be represented and protected. livelihood will be represented and protected. But to insure these rights, it costs money to But to insure these rights, it costs money to educate our legislatures and representatives. educate our legislatures and representatives. If our elected officials do not understand who If our elected officials do not understand who we are and what we do, then that is our fault. we are and what we do, then that is our fault. It is the responsibility of everyone who is It is the responsibility of everyone who is associated with this industry to stand up and associated with this industry to stand up and be counted by their numbers and funds. Liberty be counted by their numbers and funds. Liberty is not cheap and the right to practice your is not cheap and the right to practice your profession is not either. All of us must stand profession is not either. All of us must stand up and be counted with our time, talents and up and be counted with our time, talents and funds. You can no longer stand by and watch funds. You can no longer stand by and watch our profession go up in flames. Please do this our profession go up in flames. Please do this for yourself, your family,and your future. If you for yourself, your family,and your future. If you have not signed a PAC authorization form - DO have not signed a PAC authorization form - DO IT NOW. The law says you must agree to be IT NOW. The law says you must agree to be solicited for a contribution. If you have signed solicited for a contribution. If you have signed an authorization form, then you know what to do an authorization form, then you know what to do next! But Please DO IT NOW. next! But Please DO IT NOW. Rick Fleetwood, PAC Chair Rick Fleetwood, PAC Chair

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.

OP Marketing 5205 S. Jules Verne Court Tampa, FL 33611 813/416-3419 Category: Institution/Education Andy Bottner

Smith Prosthetic Services Ltd. 2450 Lancaster Road, Unit 18 Ottawa, ON K1B 5N3, Canada 613/739-9452 Fax: 613/739-1860 Category: International Company Jo-Ann Smith

Spyder Technologies Abilities in Motion

Kogan Prosthetics

11151 Kenwood Road Cincinnati, OH 45242 513/245-0253 Fax: 513/245-0258 Category: Patient Care Facility Robyn McGrail

1547 Bittersweet Circle Jamison, PA 18929 267/614-1538 Fax: 267/897-9055 Category: Patient Care Facility Mike Kogan, CPO

FDR Center for Prosthetics and Orthotics, Inc.

O&P Designs Inc.

H YN ES C ON VENT IO N CEN TER, BOS TO N

39 Simon Street, Ste. 7 Nashua, NH 03060 603/595-9255 Fax: 603/595-9253 Category: Patient Care Facility Cindy Minich

10525 Newkirk, Ste. 260 Dallas, TX 75220 214/204-6803 Fax: 214/572-1246 Category: Patient Care Facility

527 Park Lane Waterloo, IA 50702 319/234-7942 Fax: 800/408-3595 Category: Supplier Affiliate Parent Company: O&P 1 Central Fabrication, Waterloo, IA

Summer Street Capital Partners 70 W. Chippewa Street, Ste. 500 Buffalo, NY 14202 716/566-2900 Fax: 716/566-2910 Category: Affiliate Parent Company: New England Orthotic & Prosthetic Systems LLC, Branford, CT a

MARK YOUR CALENDAR!

Attend the country’s largest, oldest, and essential meeting for orthotic, prosthetic and pedorthic professionals. SUPERIOR EDUCATION ADVANCED PROGRAMS MYRIAD OF EXHIBITS EARN CE CREDITS QUALITY NETWORKING

For information about the show, scan the QR code on the left with a code reader on your smartphone or simply visit www.AOPAnet.org.

The

Placee!

To B

JULY 2012 O&P Almanac

Marketplace FRIDDLE’S LIMBGUARD SYSTEM

WillowWood’s Carbon Copy 2® Foot

Friddle’s LimbguardTM System (patent pending) once again shows our commitment to innovation. The Limbguard is a cost-effective postoperative residuum maintenance/knee R.O.M. preservation system that is completely customized by the practitioner—on site. Volume fluctuation is accommodated via the floating pretibial section and out proprietary distal GillsTM for the perfect fit. • L5450 IPOP, rigid dressing • L5684 BK for strap • L5688 BK, waist belt, webbing. Contact Friddle’s to order your pair today at 800/3692328, fax 800/369-1149, or visit www.friddles.com.

The Carbon Copy 2® foot is a sound choice for amputees who are active or are transitioning from a lower-activity foot. • Outstanding durability and stability by incorporating a carbon/nylon keel • Dual-spring design provides energy return and smooth transition from heel to toe • Good upgrade for SACH Foot wearers • Engineered for moderate to high-activity use • Suggested L code: L5976. For more information, call 800/848-4930 or visit www.willowwoodco.com.

Mauch Knee® by Össur®. The gold standard. Setting the bar for swing-and-stance hydraulic knees, Mauch Knee is the next best thing to an MPK for multispeed ambulators. Available in two models—the standard model and the Mauch Plus for users up to 365 lbs—Mauch Knee features an extension stop on the frame for durability and a more secure motion, a spherical bearing designed to eliminate torsional and lateral loads on the cylinder, removable covers for easy access to the mechanics, and a sleek, lightweight aluminum design that is easy to fit and easy to cosmetically finish. To learn more about Mauch Knee by Össur, call 800/2336263 or visit www.ossur.com today.

Total Knee® by Össur®—Totally versatile With K2, K3, and K4, models to choose from, Total Knee enables a broad range of amputees to walk with a smooth, more natural, energy-efficient gait, enhancing their confidence and stability. Key features include geometric locking for stability, plus mid-swing shortening designed to prevent hip-hiking and reduce the chances of tripping. Each model fits a wide range of amputees and is lightweight and easy to cosmetically finish. To learn more about Total Knee by Össur, call 800/2336263 or visit www.ossur.com today.

O&P Almanac JULY 2012

Reformulated KISS® Adhesive: Amazing adhesion The reformulated KISS adhesive features increased flexibility and less time needed for bonding. The adhesive bonds porous and nonporous surfaces, and bonds flexible as well as rigid materials. It is packaged in two separate bottles for increased shelf life. For more information, call 410/663-KISS (5477) or visit www.kiss-suspension.com.

Dive In! Waterproof Prostheses from Ottobock Ottobock now offers a line of waterproof components. Designed specifically for use in the water, the Aqualine® waterproof prostheses provide waterproof protection for either below-knee or above-knee users. The Aqualine components are perfect for use as a shower leg or for other water activities. The Aqualine accommodates users who weigh up to 330 lbs and includes specially modified adapters, pylons, and a tube clamp along with the waterproof knee and foot. To learn more, call your local sales representative at 800/328-4058.

Marketplace PEL offers Edison™ Intelligent Vacuum Suspension System

NEW—Introducing Spine Line from Ottobock

Orthocare Innovations Edison™ provides a truly quiet experience for patients. Its large-bore piston eliminates vibration noises associated with other electronic vacuums. The protective, insulated casing housing the in-line pump further reduces sounds during operation. Edison™—“the most intelligent vacuum suspension system available”—automatically adjusts vacuum levels to meet a range of activities. It increases vacuum pressure when activity demands greater augmented suspension, and assures optimal comfort when higher levels of vacuum are not required, such as when a patient is sitting or walking slowly. The 18-hour battery and fob less control provide patients with true worry-free performance. Edison allows the prosthetist to customize settings, or select from one of three standard activity profiles so socket pressure remains within the desired ranges for each patient’s individual requirements. For more information, contact PEL Supply at 800/3211264, email customerservice@pelsupply.com, or visit www. pelsupply.com. US Patent: 8,007,543 Orthocare Innovations, LLC. Other US and Foreign Patents Pending. US Patents: 7,914,586; 7,947,085; 8,016,892 Under License From Ohio Willow Wood Company.

You asked for more—and we’ve delivered! Now your patients with spinal bracing needs can benefit from the renowned Ottobock quality and value. The complete lineup of products includes cervical, lumbar, thoracic, and sacral orthotics. (The Ottobock Fulcrum LSO is pictured here.) These latex-free, off-the-shelf spinal products provide superior support and stabilization for all your patients’ conditions, from relief of acute back pain to pre- and postoperative stabilization. Call 800/328-4058 to order.

A/K Brim Sheath from PEL Supply Now available from PEL Supply, the Knit-Rite A/K Brim Sheath is for above-knee patients and all socket styles. It is designed to separate and protect the soft tissue in the top brim of the socket by bridging the gap between the top edge of any roll-on liner and the groin. The A/K Brim Sheath will work on both pin suspension and seal-in liners. It uses a stretchy, slick nylon material constructed in two angled sections to allow the fabric to appropriately fit the high lateral and lower medial shape, and includes gripper elastic to secure to the outer socket. Suggested billing, L8410, Prosthetic Sheath, AK each. Patent pending. For more information about the A/K Brim Sheath—or any other products from Knit-Rite—call your friendly PEL Supply customer service representative at 800/321-1264, fax 800/2226176, or email customerservice@pelsupply.com. Registered customers may order online at www.pelsupply.com.

Aeris Performance foot system The Aeris Performance foot system improves upon the already successful foundation laid by the original Ibex foot. The foot uses compliant composite technology (CCT) that is derived by using multiple springs to increase the range of flexibility. The result is a unique advanced energy release (AER) pylon design composed of nested parallel springs that enable the foot to react in a compliant manner at heel strike and then work together to create a dynamic push-off at toe release. The AER pylon takes advantage of independent spring action to provide smooth, stable progression while increasing the axial rotation, which minimizes the forces transmitted to the residual limb. For more information, contact Fillauer LLC at 800/2516398 or visit www.fillauer.com. a

JULY 2012 O&P Almanac

JOBS

Find your region on the map to locate jobs in your area.

- Northeast - Mid-Atlantic - Southeast - North Central - Inter-Mountain - Pacific

Classified rates Classified advertising rates are calculated by counting complete words. (Telephone and fax numbers, email, and Web addresses are counted as single words.) AOPA member companies receive the member rate. Member Nonmember 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 $678 $634 $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 emailed 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. Note: AOPA reserves the right to edit Job listings for space and style considerations. 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 Member Nonmember board in the industry at Rate Rate jobs.AOPAnet.org! $80 $140

Inter-Mountain Director, Clinical Services Austin, Texas The director, clinical services, is a certified prosthetist responsible for clinical and quality management programs including: professional review of orthotic and prosthetic services (PROPS), utilization review accreditation commission (URAC) accreditation, quality management committees, and credentialing. Directly reporting to the director, clinical services, are PROPS program director, senior manager credentialing, and URAC coordinator. This individual is directly responsible for coordinating quality management program and meeting URAC accreditation requirements. Performs all duties of the chief case reviewer for PROPS. Works with direct reports to create and implement work flows to meet efficiency requirements; write standard operating procedures for all functions of responsibility; and support organizational goals. Essential Functions: • Ensures policies, practices, and procedures comply with administrative, legal, and regulatory requirements • Participates in developing and implementing Linkia’s strategic direction for clinical operations and programs • Performs all duties of chief case reviewer—PROPS program clinical lead • Consults with all constituents (internal and external) as clinical expert • Oversees credentialing and compliance functions • Coordinates quality management program and documents—QI/UM/credentialing plan, QI indicators, QI committees • Writes SOPs for all areas of responsibility as appropriate • Performs other duties as assigned. Required Skills and Abilities: • Demonstrated ability to lead and manage through influence and change • Strong interpersonal skills emphasizing flexibility and diplomacy • Exceptional presentation and public speaking skills • Strong analytical and creative problem-solving skills • Ability to prioritize and manage multitask functions • Knowledge of Microsoft Office Suite • Excellent time management, organization, prioritization, research, analytical, negotiation, communication (verbal and written), and interpersonal skills Required Credentials: • 5-10 years of clinical experience as certified prosthetist (CP) • Education: BA/BS • 3-5 years of supervisory/management experience preferred

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

O&P Almanac JULY 2012

If interested, please contact Mike Phelan in confidence.

Email: MPhelan@hanger.com Website: www.hanger.com/careers

JOBS

Inter-Mountain Certified Prosthetist/Orthotist All Major Cities in Texas Stay ahead with cutting-edge technology and the latest advancements in prosthetics. Highly respected company in Texas has immediate openings for self-motivated, energetic, ABC-certified practitioners with at least two years of experience. The position requires excellent communication and time-management skills, and the ability to demonstrate patient care. We offer a competitive salary, car allowance, technical support, health and vacation benefits, and relocation assistance. Come experience true living with year-round optimal weather in the great state of Texas. We offer a professional environment and a marketing team for our highly established locations in all the major cities. For more information, contact:

Certified Prosthetist/Orthotist, Certified Orthotist, or Licensed Orthotist Corpus Christi and McAllen, Texas Immediate opening for CPO, CO, or LO with experience. Positions in Corpus Christi and McAllen, Texas, with minimal travel to satellite offices. Must be ABC-certified and licensed by the state of Texas. Competitive compensation package! Please send resume and salary requirements to Barbie Baker at:

Fax: 361/888-7424 Email: Barbie@ccprosthetics.com

Schuyler Nelson Cell: 214/770-4161 Fax: 281/419-3585 Email: snelson@prostheticscience.com Website: www.prostheticscience.com

AVAILABLE POSITIONS Orthotist Springdale, AR Denver, CO Urbana, IL Jackson, MS

Spartanburg, SC Parkersburg, WV Waukesha, WI

Prosthetist Chico, CA New London, CT Brunswick, GA

Johnson City, NY Syracuse, NY

Prosthetist / Orthotist Santa Cruz, CA Stockton, CA Denver, CO Naples, FL Pensacola, FL Bowling Green, KY Waterville, ME Mooresville, NC Buffalo, NY Johnson City, NY

Syracuse, NY Mayfield Heights, OH Bartlesville, OK Portland, OR Wilkes Barre, PA Austin, TX Houston, TX San Antonio, TX Tacoma, WA

Certified Pedorthist Portland, ME

Parkersburg, WV

Soft Goods Fitter Tulsa, OK

JULY 2012 O&P Almanac

JOBS

Inter-Mountain Clinical Marketing Representative Salt Lake City, Utah Seeking a person with excellent communication skills to provide marketing and educational services for myoelectric UL and advanced LE prostheses for prosthetists and other professionals throughout North America and international markets. Successful candidate will be responsible for: • Developing and presenting educational and marketing programs; • On-site visits to evaluate candidates and assist with upper extremity and lower extremity fittings and training with company’s products. • Extensive contact with customers via a variety of media, including telephone, e-mail, Internet and multi-media materials, including trade shows, educational seminars, printed materials, etc. • Experience in myoelectric prosthetics is preferred, but not essential; training will be provided. Benefits include: • An excellent salary/benefit package is offered, and a great working environment. • Certified Prosthetist (CP, or CPO) preferred. Call us or e-mail/fax resume to:

Motion Control, Inc. 115 N. Wright Brothers Drive Salt Lake City, UT 84116 Phone: 801/326-3434 Fax: 801/978-0848 Email:HumanResources@UtahArm.com Website: www.UtahArm.com

International Volunteer Position: Certified Prosthetist/Orthotist Honduras Central American Medical Outreach, Inc. (CAMO), humanitarian aid organization providing orthotic and prosthetic services to the local population of western Honduras, is looking to fill a volunteer interim position at its fully equipped prosthetic lab in Santa Rosa. Term length of one month to upwards of a year, expected to teach a local individual; ideal candidate must be bilingual. Supporting organization will provide housing and per diem. Learn more by contacting:

Kathy Tschiegg, Executive Director CAMO 322 Westwood Ave. Orrville, Ohio 44667 Phone: 330/683-5956 Email: kathrynt@camo.org

O&P Almanac JULY 2012

North Central Certified Orthotist, Certified Orthotist/Prosthetist, or Board-Eligible Orthotist/Prosthetist Advanced OrthoPro Inc. is looking for experienced COs, CPOs, or board-eligible COs/CPOs to join our busy practice. Applicants must be highly motivated and outgoing. AOI offers a competitive salary commensurate with experience and a great benefits package. Email resume to Mohamad Mansoori.

Email: Mohamad@aoiindy.com

Northeast Certified Orthotist/Certified Fitter Long Island/New York City We are a well-established practice offering an excellent opportunity for a driven person with a positive attitude. We offer benefits including 401(k), health, and profit sharing. Send resume to:

O&P Ad 0611, C/O: The O&P Almanac 330 John Carlyle Street, Ste. 200 Alexandria, VA 22314 Fax: 571/431-0899

Certified Orthotist, Certified Orthotist and Board-Eligible Prosthetist, or Certified Prosthetist/Orthotist New York State Privately owned and growing multisite ABC-accredited P&O practice in upstate New York is seeking a certified orthotist with a minimum of two years of experience and/or a certified orthotist and board-eligible prosthetist, or certified prosthetist/orthotist. We are looking for individuals with strong orthotic backgrounds, and we may entertain an NCOPE prosthetic residency if needed. Our offices in the historic and scenic Hudson Valley and Catskill Mountains of New York are located from Saratoga to Poughkeepsie, with immediate openings in Kingston and Poughkeepsie. The ideal candidate must be self-motivated and a team player, possess good communication and technical skills, and be willing to excel for performancebased objectives. Competitive salary and benefits package offered. Submit resume to:

David Misener, CPO Clinical Prosthetics & Orthotics, LLC Fax: 518/432-0686 Email: DBM@clinicalpando.com

JOBS

Certified Prosthetist/Orthotist, Certified Prosthetist, Certified Orthotist

Southeast Certified Orthotist/Prosthetist Chattanooga, Tennessee Fillauer O&P, a Chattanooga, Tennessee-based patient care facility, is seeking a certified or board-eligible CPO practitioner. We offer competitive salary, bonus opportunity, and a comprehensive benefit package. M/F/D/V Equal Opportunity Company Tennessee Drug-Free Workplace Send resume to:

Email: humanresources@fillauer.com

For Sale or Lease: Prosthetic/Orthotic/Pedorthic Business and Building West Palm Beach, Florida ABC-accredited facility; independently run, 11 years old, low volume, 95 percent prosthetic, reputable business. Freestanding building (4,000 square feet), excess parking. Great visibility on corner location. Close to Palm Beach International Airport, hospitals, and skilled nursing facilities. Many variables, very negotiable. Contact:

Richard Jesteadt Phone: 561/644-2677 Email: poppsprosthetics@earthlink.net

Pacific Certified Prothetist or Certified Prothetist/Orthotist Bend, Oregon Growing western states O&P business seeking a certified prothetist or certified prothetist/orthotist in Bend, Oregon. Unlimited business opportunities available in an expanding local market. Competitive salary, benefits, and profit sharing as the business grows. Interested parties should email inquiries/resume to:

Orange, Riverside, and San Bernardino Counties, California A reputable, well-established, multi-office, Southern California O&P company is looking for energetic and motivated individuals who possess strong orthotic/ prosthetic clinical skills and experience to provide comprehensive patient assessments to determine orthotic/prosthetic needs, formulate and provide treatments, perform necessary protocols to ultimately deliver the best orthotic/prosthetic services, and provide follow-up patient care. Candidates must have excellent communication, patient care, and interpersonal interaction skills, and always abide by the Canons of Ethical Conduct instilled by ABC. We offer competitive salaries and benefits to full-time employees. Salary is commensurate with experience. US - Pacific Send resume to: , Inc.

CPO/CP/CO Attention: Human Resources Orange County, Riverside County, Inland ArtificialCounty, LimbCalifornia & Brace, Inc. San Bernardino Fax: 951/734-1538 A reputable, well-established, multi-office, Southern California O&P company is looking for energetic and motivated indiEmail: ialb720@hotmail.com

Send resumé, in com John 90 Tu Phone: 856 E-mai

viduals who possess strong orthotic/prosthetic clinical skills and experience to provide comprehensive patient assessments to determine orthotic/prosthetic needs, formulate and provide treatments, perform necessary protocols to ultimately delivery the best orthotic/prosthetic services, and provide follow-up patient care. Candidates must have excellent communication, patient care, and interpersonal interaction skills, and always abide by the Canons of Ethical Conduct instilled by ABC.

O&P Board Study Resources

We offer competitive salaries and benefits to full-time employees. Salary is commensurate with experience.

New Opportu

We have an immediat and a pedorthist in Ho and an excellent bene

Clinicians

If you have a successf new opportunities for and incentive plans. V

We can help you PASS your BOARDS Send resumé to: Attention: Human Resources All products updated to 2012 test standards. Director to Staff-L Inland Artificial Limb & Brace, Inc.

Manager/Territory S

Fax: 951.734.1538 E-mail: ialb720@hotmail.com

Work for the nation

Use your smart phone to see these and more job openings online.

*Do you need patie ners? Give us a call!* Jena Bax

Pho E-mail: jb

The ONLY Comprehensive Study Guides Specifically for Orthotics and Prosthetics (Many of our products are available in DVD Format also!)

Fax: 888/853-0002 Email: jwiley@pacmedical.com

US - M

Now Offering Customizable Orthotic and Prosthetic Patient Device Instruction Sheets in English AND Spanish

www.oandpstudyguide.com JULY 2012 O&P Almanac

PC or Mac

You make choices every day, based upon many factors. One of those choices is your O&P product supplier. PEL’s Power of One® service puts your practice on the worldwide web of success. Do you want everyday products, with quick shipment and low prices? But still need state-of-the-art products and exceptional values to make you the apple Rosetta Anzalone • Returns Specialist of your patient’s eye? PEL has • Temp positions for 10 years in diverse jobs gigabytes of products and an online • Joined PEL in 1996 • “I listen to the customer, then handle the ordering system that makes your return and let them know it will be OK.” • Dogs. Dogs. Dogs. And jigsaw puzzles. hard drive hum. Log on today! ALPS Extreme Locking and Cushion Liner The ALPS Extreme liner is engineered with GripGel to assist in donning and suspension • Specifically designed for transfemoral and active transtibial amputees • Limited vertical stretch reduces movement of redundant tissue

SPT Technology Composite Matrix Resin • Carbon or Fiberglass compatible • Powder promoter, easy to mix • Up to 1 year shelf life • Ships ORMD - No Hazmat fees • 1, 2 or 4 gallon kits (best value)

Trulife Matrix Spiral • Smooth, dynamic transition from heel strike to toe off • Effective energy return • Flexible heel and toe plates • Lateral design naturally spirals around the lower leg Indications: Drop foot, peroneal palsy; suitable for bilateral use

Extreme Sleeve

Easy to Fit!

• Seals against skin without restricting circulation • GripGel helps prevent sleeve from rolling down patient’s limb

it Ask for e! m a n y b

PEL Supply Co. Orthotic & Prosthetic Components

pelsupply.com

4666 Manufacturing Avenue Cleveland, OH 44135-2638 USA

Ph 800-321-1264 Fx 800-222-6176

Experience the Power of One.

CALENDAR

■■ YEAR-ROUND TESTING Multiple Choice Examinations. BOC has yearround testing for Multiple Choice Examinations; candidates can apply and test when ready. Orthotist and prosthetist candidates can take the Clinical Simulation Examination in February, May, August, and November. Applications are accepted any time, although seating is limited. For more information, visit www.bocusa.org or email cert@bocusa.org.

On-site Training Motion Control, Inc. On-site Training Course is focused on the expedited fitting of your first patient. Course Length: 3 days, CEUs: 19.5 hours (estimated). Recommended for prosthetists with a patient ready to be fit immediately. For more information, call 888/696-2767 or visit www. UtahArm.com. ■■

■■

■■ July 11 AOPAversity Audio Conference–Perfecting the Intake Process. For more information, contact Stephen Custer at 571/431-0876 or scuster@AOPAnet.org.

2012 ■■ JULY 10-12 WillowWood: OMEGA® Tracer® Training. Mt. Sterling, OH. This hands-on class covers both orthotic and prosthetic software tools, scanner applications and tasks, ‘by measurement’ shape creation, advanced tool usage, and creating custom liners. Attendees work with patient models. Must be current OMEGA Tracer facility to attend. Credits: 18.5 ABC/18.5 BOC. Visit www. willowwoodco.com.

PROMOTE Events in the O&P Almanac

CALENDAR RATES Telephone and fax numbers, email addresses, and websites are counted as single words. Refer to www.AOPAnet.org for content deadlines. Words

Member Rate

Nonmember Rate

25 or less................... $40..................................$50 26-50......................... $50..................................$60 51+................... $2.25 per word................$3.00 per word Color Ad Special: 1/4 page Ad.............. $482............................... $678 1/2 page Ad.............. $634............................... $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 email 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. Note: AOPA reserves the right to edit Calendar listings for space and style considerations. For information on continuing education credits, contact the sponsor. Questions? Email srybicki@AOPAnet.org.

■■ JULY 11 Ultraflex: Pediatric UltraSafeGait™ Continuing Education Course, via WebEx, 5–6 pm ET. Covers assessment of pediatric pathological gait and influencing shank kinematics with the new Adjustable Dynamic Response™ (ADR™) technology. Presenter: Keith Smith, CO, LO, FAAOP. Register at www.ultraflexsystems.com or call 800/220-6670. ■■ JULY 14 Ultraflex: Pediatric Spasticity Continuing Education Course, via WebEx, 9–10 am ET. Covers clinical assessment of the pediatric neuromuscular patient with spasticity and using R1 and R2 for determining orthotic design for maintaining and improving muscle length. Presenter: Keith Smith, CO, LO, FAAOP. Register at www. ultraflexsystems.com or call 800/220-6670. ■■ JULY 17 WillowWood: Discover LimbLogic® VS via WebEx, 1:30 pm ET. Critical components and operation discussed. Covers interpreting feedback from fob and basic fabrication processes for system. Credits: 2.5 ABC/2.5 BOC. To register online, visit www.willowwoodco.com. ■■ JULY 24 AOPA Coding Clinic. Baltimore. BWI Airport Marriott. To register, contact Stephen Custer at 571/4310876 or scuster@AOPAnet.org.

■■ July 26 Arizona AFO: The Custom AFO Workshop. Philadelphia. This course covers AFO selection, coding, hands-on casting, and footwear/modification tips. Fee includes lectures, handouts, and lunch. Approved for 6.5 ABC CE credits. For details, call 877/780-8382 and mention the “Workshop” or email education@arizonaafo.com. ■■ JULY 26 Ultraflex: Complex Orthopedic Rehabilitation Continuing Education Course, via WebEx, Noon–1 pm ET. Focuses on Ultraflex combination dynamic and static stretching orthosis for addressing complex orthopedic rehabilitation goals and restoring range and function. Presenter: Jim Rogers, CPO, FAAOP. Register at www.ultraflexsystems.com or call 800/220-6670. ■■ JULY 26 WillowWood: LimbLogic® VS Applications Practitioners Course. Mt. Sterling, OH. Course covers various clinical aspects of LimbLogic VS applications: static and dynamic socket fitting, vacuum pump configurations, fob operation, system evaluation, liner options, alignment, and troubleshooting. Credits: 7.0 ABC/6.75 BOC. Registration deadline is July 5. Contact 877/665-5443 or visit www.willowwoodco.com. ■■ JULY 27 WillowWood: 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, and troubleshooting. Fabricate sockets following recommended techniques for airtight socket designs. 2012 credits: 9.75 ABC/TBD BOC. Registration deadline is July 5. Contact 877/665-5443 or visit www.willowwoodco.com.

JULY 2012 O&P Almanac

CALENDAR

■■ JULY 31 Ultraflex: Adult UltraSafeStep® Continuing Education Course, via WebEx, Noon–1 pm ET. Focuses on normalizing adult pathological gait with the utilization of Adjustable Dynamic Response™ (ADR™) knee and ankle technology. Presenter: Marc Kaufman, CPO. Register at www.ultraflexsystems.com or call 800/220-6670. ■■ AUGUST 1 Ultraflex: Pediatric UltraSafeGait™ Continuing Education Course, via WebEx, 8–9 am ET. Covers assessment of pediatric pathological gait and influencing shank kinematics with the new Adjustable Dynamic Response™ (ADR™) technology. Presenter: Keith Smith, CO, LO, FAAOP. Register at www. ultraflexsystems.com or call 800/220-6670. ■■ AUGUST 3-4 Texas Chapter of the American Academy of Orthotists and Prosthetists: Annual Meeting. Sheraton Austin Hotel at the Capitol, Austin. Contact Robb Walker at 325/793-3480, email

secretary-treasurer@txaaop. org, or visit www.txaaop.org. ■■ August 6-7 AOPA: Essential Coding & Billing Seminar. Seattle. Hyatt at Olive 8 Hotel. To register, contact Stephen Custer at 571/431-0876 or scuster@ AOPAnet.org. ■■ AUGUST 13-18 ABC: Certification Exams. ABC certification exams will be administered for orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, therapeutic shoe fitters, and orthotic and prosthetic technicians. The application deadline for these exams was June 1, 2012. Contact 703/8367114, email info@abcop. org, or visit www.abcop.org/ certification.

O&P Almanac JULY 2012

■■ August 15 AOPAversity Audio Conference–The Ins and Outs of Advance Beneficiary Notices (ABNs). For more information, contact Stephen Custer at 571/431-0876 or scuster@AOPAnet.org.

sponsorship opportunities available––contact Kelly O’Neill at 571/431-0852 or koneill@AOPAnet.org. To register, please visit www. AOPAassembly.org or contact Stephen Custer at 571/4310876 or scuster@AOPAnet.org.

■■ OCTOBER 18-19 Mastering Medicare: Essential Coding and Billing Seminar. Las Vegas. Mirage Hotel & Casino. To register, contact Steve Custer at 571/431-0876 or scuster@ AOPAnet.org.

■■ AUGUST 21-23 WillowWood: OMEGA® Tracer® Training. Mt. Sterling, OH. This hands-on class covers both orthotic and prosthetic software tools, scanner applications and tasks, ‘by measurement’ shape creation, advanced tool usage, and creating custom liners. Attendees work with patient models. Must be current OMEGA Tracer facility to attend. Credits: 18.5 ABC/18.5 BOC. www.willowwoodco.com.

■■ September 12 AOPAversity Audio Conference–How to Get Paid for Orthopedic and Diabetic Shoes. For more information, contact Stephen Custer at 571/431-0876 or scuster@aopanet.org.

■■ OCTOBER 19-20 University of Michigan Orthotics and Prosthetics Center: Centennial Celebration and Education Seminar. Making a difference for 100 years, providing service, education, and research in O&P. For details and information about registration, visit www.med. umich.edu/pmr/op/index.htm.

■■ AUGUST 24-26 National Pedorthic Services. Milwaukee. A hands-on approach to footwear modifications. 19.25 CEPs. Contact Nora Holborow at 414/438-6662 or email nholborow@npsfoot.com. Visit www.npsfoot.com. ■■ SEPTEMBER 1 ABC: Application Deadline for Certification Exams and Clinical Patient Management (CPM) Exams. Applications must be received by Sept. 1, 2012, for individuals seeking to take the November 2012 ABC certification exams for orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, therapeutic shoe fitters, and orthotic and prosthetic technicians or winter CPM ABC exams for orthotists and prosthetists. Contact 703/8367114, email info@abcop.org, or visit www.abcop.org/certification. ■■ September 6-9 AOPA National Assembly & NE Chapter Combined Meeting. Boston. Hynes Convention Center. The 2012 AOPA National Assembly will be held jointly with the NE Chapter Meeting. Plan to join us for this significant event. Exhibitors and

■■ September 20 Arizona AFO: The Custom AFO Workshop. Long Beach, CA. This course covers AFO selection, coding, handson casting, and footwear/ modification tips. Fee includes lectures, handouts, and lunch. Approved for 6.5 ABC CE credits. For details call 877/780-8382 and mention the “Workshop” or email education@arizonaafo.com. ■■ SEPTEMBER 21-23 National Pedorthic Services. Milwaukee. A handson custom foot orthosis fabrication course. 18.25 CEPs. Contact Nora Holborow at 414/438-6662 or email nholborow@npsfoot.com. Visit www.npsfoot.com. ■■ October 4 Arizona AFO: The Custom AFO Workshop. Houston. This course covers AFO selection, coding, handson casting, and footwear/ modification tips. Fee includes lectures, handouts, and lunch. Approved for 6.5 ABC CE credits. For details, call 877/780-8382 and mention the “Workshop” or email education@arizonaafo.com. ■■ October 10 AOPAversity Audio Conference–What Every O&P Facility Needs to Know About the FDA. For more information, contact Stephen Custer at 571/431-0876 or scuster@AOPAnet.org.

■■ NOVEMBER 7-9 New Jersey Academy of Orthotists & Prosthetists 2012 Annual Meeting. Atlantic City. Bally’s Hotel and Casino. For details, contact Lisa Lindenberg at 973/609-2263 or visit www. njaaop.com. ■■ NOVEMBER 12-17 ABC: Certification Exams. ABC certification exams will be administered for orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, therapeutic shoe fitters, and orthotic and prosthetic technicians. The application deadline for these exams is Sept. 1. Contact 703/836-7114, email info@abcop.org, or visit www.abcop.org/certification. ■■ NOVEMBER 14 AOPAversity Audio Conference–Medicare Enrollment Procedures. For more information, contact Stephen Custer at 571/4310876 or scuster@AOPAnet.org.

CALENDAR

■■ DECEMBER 1 ABC: Certification Exam Application Deadline. Applications must be received by Dec. 1 for individuals seeking to take the winter 2013 ABC certification exams for orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, therapeutic shoe fitters, and orthotic and prosthetic technicians. Contact 703/836-7114, email info@ abcop.org, or visit www.abcop. org/certification.

■■ DECEMBER 7-8 ABC: Prosthetic Clinical Patient Management (CPM) Exam. The application deadline for this exam is Sept. 1. Contact 703/836-7114, email info@abcop.org, or visit www. abcop.org/certification.

December 12 AOPAversity Audio Conference–Are You Ready for the New Year? 2013 New Codes and Policies. For more information, contact Stephen Custer at 571/431-0876 or scuster@AOPAnet.org. ■■

2013 ■■ JANUARY 4-5 ABC: Prosthetic Clinical Patient Management (CPM) Exam. The application deadline for this exam is Sept. 1, 2012. Contact 703/836-7114, email info@abcop.org, or visit www.abcop.org/certification. ■■ February 20-23 39th Academy Annual Meeting & Scientific Symposium. Orlando. Caribe Royale Orlando. Contact Diane Ragusa at 202/380-3663 x208 or email dragusa@oandp.org.

■■ MARCH 15-16 PrimeFare West Regional Scientific Symposium 2013. Denver. Denver Marriott City Center. Contact Jane Edwards at 888/388-5243 or visit www.primecareop.com. ■■ September 18-21 O&P World Congress. Orlando. Gaylord Palms Resort. Attend the first U.S.-hosted World Congress for the orthotic, prosthetic, and pedorthic rehabilitation profession. For information, visit www.opworldcongressusa. org or contact Stephen Custer at 571/431-0876 or scuster@ AOPAnet.org. a

AD INDEX

Company

Page

Phone

Website

ALPS

800/574-5426

www.easyliner.com

American Board for Certification in Orthotics, Prosthetics & Pedorthics

703/836-7114

www.abcop.org

Becker Orthopedic

800/521-2192

www.beckerorthopedic.com

DAW Industries

800/252-2828

www.daw-usa.com

DeRoyal Industries, Inc.

888/938-7828

www.deroyal.com

Dr. Comfort

5, C3

800/556-5572

www.drcomfortdpm.com

Ferrier Coupler Inc.

800/437-8597

www.ferrier.coupler.com

Fillauer Companies Inc.

800/251-6398

www.fillauercompanies.com

Friddle’s Orthopedic Appliances

800/369-2328

www.friddles.com

KISS Technologies LLC

410/663-5477

www.kiss-suspension.com

KNIT-RITE

800/821-3094

www.knitrite.com

Motion Control

888/696-2767

www.utaharm.com

OPTEC

14-15, 36-37

888/982-8181

www.optecusa.com

Orthotic and Prosthetic Study and Review Guide

www.oandpstudyguide.com

Össur Americas Inc.

7, C4

800/233-6263

www.ossur.com

Otto Bock HealthCare

800/328-4058

www.ottobockus.com

PEL Supply Company

800/321-1264

www.pelsupply.com

Texas Assistive Devices LLC

800/532-6840

www.n-abler.org

JULY 2012 O&P Almanac

AOPA Answers

SNF 101 Answers to your questions regarding claims for O&P patients in skilled nursing facilities AOPA receives hundreds of queries from readers and members who have questions about some aspect of the O&P industry. Each month, we’ll share several of these questions and answers from AOPA’s expert staff with readers. If you would like to submit a question to AOPA for possible inclusion in the department, email Editor Josephine Rossi at jrossi@strattonpublishing.com.

When I am asked to see a Medicare patient in a skilled nursing facility (SNF), as long as that patient has been there for more than 100 days, is it accurate that I can submit my claim directly to the DME MAC?

While the Medicare Part A SNF benefit is limited to 100 days of coverage per benefit period, just because a patient has been in a skilled nursing facility for more than 100 days does not necessarily mean he or she has exhausted his or her Part A Medicare benefit. There are multiple scenarios where a patient may remain eligible for Medicare Part A SNF coverage including, but not limited to, interruptions in Part A coverage during the stay, failure to qualify for Part A benefits, and periods of hospitalization during the SNF stay. The best way to determine who is responsible for paying your claim is to confirm, in writing, the individual patient’s Medicare coverage status with the business office at the skilled nursing facility.

I have received a denial from Medicare for an L5987 delivered to a patient in a Part A SNF stay. I thought prosthetic codes were exempt from SNF consolidated billing and could be billed to Medicare?

Most prosthetic codes are exempt from the SNF PPS, or consolidated billing, and should be billed to Medicare. However, the L5987 is an outlier code and is not exempt from the SNF PPS. It must be billed to the facility if the patient is in a Part A stay.

O&P Almanac JULY 2012

Other nonexempt codes include supply items such as socks and shrinkers, but also include the parts and labor codes (L7510 and L7520), codes for postsurgical application of rigid dressings (L5400– L5460), partial foot codes (L5000–L5020), and partial hand codes (L6000–L6020). To view a full list of exempt and nonexempt codes for a prosthetic patient in a Medicare Part A SNF stay, visit the AOPA website at www.aopanet.org.

Who is responsible for payment of a custom device delivered to a patient in a skilled nursing facility when the item was ordered prior to the patient’s admission to the SNF?

Payment responsibility will depend on where the patient was residing when the device was ordered. If the patient was residing at home when the device was ordered, you may bill Medicare directly, even if the item was a custom orthosis, and your delivery date will be your start date. If the patient was in a hospital when the device was ordered, you must seek payment from the hospital. Keep in mind that these rules apply only to custom orthoses and prostheses; noncustom items and diabetic shoes follow traditional billing guidelines. a

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