May 2022 O&P Almanac by AOPA

The Magazine for the Orthotics & Prosthetics Profession

MAY 2022

Tips for Appealing Claim Denials

This Just In: Highlights From the 2022 AOPA Policy Forum P.20

P.16

Preview the 2022 AOPA National Assembly P.30

Influencing O&P Policy in New York and Beyond P.34

Quiz Me!

EARN 2 B U SIN ESS CE CREDITS

A THERAPEUTIC TOUCH FOR UPPER LIMB COLLABORATING WITH OCCUPATIONAL THERAPISTS FOR IMPROVED OUTCOMES P.22

P.18

The AOPA National Assembly is already the most talked about event for 2022— it is the premier destination for the world-wide orthotic, prosthetic, and pedorthic community.

Earn up to 40+ CE Credits FOR MORE INFO AND TO REGISTER, VISIT

WWW.AOPANET.ORG

www.AOPAassembly.org

YOUR CONNECTION TO

EVERYTHING O&P

THE PREMIER MEETING FOR ORTHOTIC, PROSTHETIC, AND PEDORTHIC PROFESSIONALS.

RATION R E G I ST O O N ! OPEN S ’T WAIT WE CAN OU! Y TO SEE

Earn up to 40+ CE Credits

Registration Opens Early June Orthotic, Prosthetic, & Pedorthic Education • NEW! Two-day education track on O&P Digital Care • NEW! Two-day education track on Post Mastectomy Care Changes in Healthcare Business Management Exhibits • NEW! A fun interactive event in the Exhibit Hall featuring patient success stories and their caregiver Cool fundraising event at Top Golf San Antonio Brand new convention center space near hotels Education available virtually post Assembly And much more.

Join us September 28-October 1, 2022, for an ideal combination of top-notch education and entertainment at the 105th AOPA National Assembly in San Antonio, TX.

San Antonio

For more info and to register, visit:

www.AOPAassembly.org

PUTTING YOUR BEST FOOT FORWARD

CUSTOM: FOOT ORTHOTICS • AFO’S • RICHIES

One size does not fit all. At Hersco, our team of professionals works to fabricate orthotics from your scans and casts to match your patients’ specific needs. Customer service is at the heart of everything we do and we work endlessly to help you be as effective and efficient as possible. When you want the job done quickly and accurately, Hersco is here to help.

BUILT ON TRUST.

MAY 2022 | VOL. 71, NO. 5

contents

FEATURES

DEPARTMENTS | COLUMNS

COVER STORY

22 | A Therapeutic

Touch for Upper Limb Partnering with occupational therapists (OTs) is a priority for many upper-limb prosthetists, who believe collaboration is key to successful outcomes. OTs can assist in training patients in using their new components, help determine which tasks are critical for patients to return to their daily life, and assess whether pain management strategies may be warranted. By Christine Umbrell

Views From AOPA Leadership......... 4 Celebrating O&P wins

AOPA Contacts............................................6 How to reach staff

Numbers........................................................ 8

At-a-glance statistics and data

Happenings............................................... 10

Research, updates, and industry news

People & Places........................................ 14

Transitions in the profession

P.11

20 | THIS JUST IN

Reunited in Advocacy AOPA members and O&P stakeholders convened in the nation’s capital to take part in the 30th AOPA Policy Forum this month. See pictures and highlights from the highly anticipated in-person event, where O&P professionals shared strategies on advocacy before meeting with members of Congress.

Reimbursement Page.......................... 16

Managing Reimbursement Pain Points

Maneuvering same or similar denials, RAC audits, and more

Opportunity to earn up to two CE credits by taking the online quiz.

Member Spotlight................................. 36 n

30 |

Some Things New in Texas

The 105th AOPA National Assembly is fast approaching. With registration set to open in June, find out which educational tracks will debut in San Antonio, learn more about expected speakers, preview the conference’s special events, and make plans to visit nearby attractions.

O&P ADVOCATE

Impulse Technology Prosthetic & Orthotic Institute

AOPA News................................................ 39

AOPA advocacy, announcements, member benefits, and more

Welcome New Members................... 39 Marketplace............................................. 40 Careers........................................................ 44

Professional opportunities

Matthew Johnson, MPT, CEEAA............. 34 Meet a physical therapist and O&P professional who shares his expertise in working with aging patients to advocate for improving patient access and addressing reimbursement inequities.

MAY 2022 | O&P ALMANAC

Calendar......................................................46

Upcoming meetings and events

Ad Index....................................................... 47 State By State.......................................... 48

California, Iowa, and New York

Naked Prosthetics now oﬀers four finger prostheses: PIPDriver, MCPDriver, ThumbDriver, and GripLock Finger. ™

™

THE CONDUCTIVE TIP IS NOW AVAILABLE ON ALL DEVICES. FEATURED: GRIPLOCK FINGER FOR AMPUTATIONS PROXIMAL TO THE MCP JOINT.

npdevices.com

Koa wears one MCPDriver and three GripLock Fingers.

VIEWS FROM AOPA LEADERSHIP

Contact Has Been Made, Communication Is Occurring

IVEN THE EVER-MORE CHALLENGING regulatory, legislative, and economic environments the O&P profession faces, wins sometimes feel few and far between. When they do happen, it’s important to acknowledge and celebrate them. I want to call out an important victory that AOPA helped achieve that will positively affect O&P facilities, manufacturers, and the patients we serve. The win involves the final standards for Medicare prior authorization of orthoses that patients require on an urgent basis. In January, CMS announced the expansion of the Medicare prior authorization program to include five codes describing certain knee orthoses and spinal orthoses— L0648, L0650, L1832, L1833, and L1851. AOPA’s conversations with members revealed significant concerns about how to adequately treat patients who cannot wait for authorization before receiving their orthosis due to an emergent clinical need. AOPA therefore initiated outreach to the durable medical equipment Medicare administrative contractors (DME MACs) and high-level CMS officials, described the issue to them, and suggested potential solutions that would grant Medicare beneficiaries appropriate device access while also ensuring adequate protection of Medicare funds. This outreach paid off when, on April 12, CMS issued guidance consistent with AOPA’s recommendations. The final regulation stated that if the existing two-day expedited review process would delay care and risk the health or life of the beneficiary, the Medicare prior authorization requirement will be suspended. This protects patients by permitting immediate delivery of emergent-need orthoses without a prior authorization determination. And it protects the Medicare trust fund by making those claims subject to 100% prepayment review. This was just the latest in a regular series of interactions between AOPA Director of Coding and Reimbursement Services, Education, and Programming Joe McTernan and CMS/the DME MACs. McTernan’s focus on regular, proactive engagement with CMS and its contractors validates AOPA’s 2022 Strategic Plan, which includes as key priorities 1) increasing access to clinically appropriate, evidence-based care and 2) driving collaboration by creating strategic relationships. This work can be thankless—it involves a real investment of time and effort, often without discernable results. But thanks to the positive relationships AOPA has fostered with these entities and their willingness, in turn, to collaborate with us, we were able to create a solution far better than the original version. We will continue to invest in our strategic priorities, especially our relationships with influencers of O&P policy. Our goal is to be able to consistently serve as a stakeholder in these discussions—either because CMS reaches out to us affirmatively, or because our outreach to them yields a call-back because they see us as having a valuable perspective worthy of consideration. Ideally, we hope to shape and influence policy before it is finalized. The “urgent need” prior authorization issue for certain orthoses is an example of how this approach can pay off. And this is just the first of what we hope will be many positive results of AOPA’s investment of time, energy, and resources into relationships with the influencers of O&P policy. Let us also reassure you that while we celebrate our wins, that doesn’t mean that we stop pushing and advocating on your behalf regarding those issues. We are always looking for the next opportunity, the next win, because more is always needed. We will continue to relentlessly advocate for this profession moving forward. We’re excited about the outcome regarding this issue. And we’re committed to delivering even more value to you throughout the remainder of 2022 and beyond.

Dave McGill is president of AOPA. 4

MAY 2022 | O&P ALMANAC

Specialists in delivering superior treatments and outcomes to patients with limb loss and limb difference.

Board of Directors OFFICERS President Dave McGill Össur Americas, Foothill Ranch, CA President-Elect Teri Kuffel, JD Arise Orthotics & Prosthetics, Spring Lake Park, MN Vice President Mitchell Dobson, CPO Hanger, Austin, TX Immediate Past President Traci Dralle, CFm Fillauer Companies, Chattanooga, TN Treasurer Rick Riley O&P Boost, Bakersfield, CA Executive Director/Secretary Eve Lee, MBA, CAE AOPA, Alexandria, VA DIRECTORS Jeffrey M. Brandt, CPO Ottobock, Exton, PA Elizabeth Ginzel, MHA, CPO Össur, Fort Worth, TX Kimberly Hanson, CPRH Ottobock, Austin, TX John “Mo” Kenney, CPO, FAAOP Kenney Orthopedics, Lexington, KY Jim Kingsley Hanger Clinic, Oakbrook Terrace, IL Linda Wise WillowWood, Mount Sterling, OH Shane Wurdeman, MSPO, PhD, CP, FAAOP(D) Research Chair, Hanger Clinic, Houston Medical Center, Houston, TX James O. Young Jr., CP, LP, FAAOP Amputee Prosthetic Clinic, Tifton, GA

NIGHT MODE

OUR FULL LINE O F VA LV ES . NOW AVAILABLE IN MIDNIGHT BLACK.

wearesp.com

AOPA CONTACTS

Our Mission Statement A trusted partner, advocating for and serving the orthotic and prosthetic community by: • Fostering relationships with decision makers to ensure equitable access • Providing education that promotes professional excellence • Supporting research that informs innovative care • Advancing equality to strengthen the orthotic and prosthetic profession and improve the lives of patients.

A world where orthotic and prosthetic care transforms lives.

Joy Burwell, director of communications and membership, 571/431-0817, jburwell@AOPAnet.org Betty Leppin, senior manager of member services, 571/431-0810, bleppin@AOPAnet.org Nicole Ver Kuilen, manager of public engagement, 571/431-0836, nverkuilen@AOPAnet.org

Eve Lee, MBA, CAE, executive director, 571/431-0807, elee@AOPAnet.org

Timishia Bannister, membership coordinator, 571/431-0835, tbannisterAOPAnet.org

Akilah Williams, MBA, SHRM-CP, senior manager for finance, operations, and HR, 571/431-0819, awilliams@AOPAnet.org

AOPA Bookstore: 571/431-0876 REIMBURSEMENT SERVICES

HEALTH POLICY & STRATEGIC ALLIANCES

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

Ashlie White, MA, director of health policy and strategic alliances, 571/431-0812, awhite@AOPAnet.org

Devon Bernard, assistant director of coding and reimbursement services, education, and programming, 571/431-0854, dbernard@AOPAnet.org

Sam Miller, manager, state and federal advocacy, 571/431-0814, smiller@AOPAnet.org MEETINGS & EDUCATION Tina Carlson, CMP, senior director, education and meetings, 571/431-0808, tcarlson@AOPAnet.org Kelly O’Neill, CEM, senior manager of meetings and exhibition, 571/431-0852, kelly.oneill@AOPAnet.org Kristen Bean, digital meetings specialist, 571/431-0876, kbean@AOPAnet.org

MEMBERSHIP & COMMUNICATIONS

EXECUTIVE OFFICES

Susannah Engdahl, PhD, manager, health policy and research, 571/431-0843, sengdahl@AOPAnet.org

MAY 2022 | O&P ALMANAC

Editorial Management Content Communicators LLC Advertising Sales RH Media LLC Design & Production Marinoff Design LLC Printing Sheridan

Our Vision

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

Publisher Eve Lee, MBA, CAE

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

O&P ALMANAC Eve Lee, MBA, CAE, executive director/ publisher, 571/431-0807, elee@AOPAnet.org Josephine Rossi, editor, 703/662-5828, jrossi@contentcommunicators.com Catherine Marinoff, art director, 786/252-1667, catherine@marinoffdesign.com Bob Heiman, director of sales, 856/520-9632 , bob.rhmedia@comcast.net Christine Umbrell, editorial/production associate and contributing writer, 703/6625828, cumbrell@contentcommunicators.com

SUBSCRIBE O&P Almanac (ISSN: 1061-4621) is published monthly, except for combined issues in June/July and November/December, by the American Orthotic & Prosthetic Association, 330 John Carlyle St., Ste. 200, Alexandria, VA 22314. To subscribe, contact 571/431-0876, fax 571/431-0899, or email info@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. ADDRESS CHANGES POSTMASTER: Send address changes to: O&P Almanac, 330 John Carlyle St., Ste. 200, Alexandria, VA 22314. Copyright © 2022 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 O&P Almanac. The O&P Almanac is not responsible for returning any unsolicited materials. All letters, press releases, announcements, and articles submitted to the O&P 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.

Advertise With Us! Reach out to AOPA’s membership and more than 11,400 subscribers. Engage the profession today. Contact Bob Heiman at 856/520-9632 or email bob.rhmedia@comcast.net. Visit bit.ly/AOPAMedia2022 for advertising options!

superior suspension sleeve Black fabric offers horizontal stretch with highly reduced vertical stretch to allow the user excellent freedom of knee flexion Achieves secure suspension by sealing with the skin without restricting circulation or causing shear forces Choice of gel type based on clinical conditions and lifestyle HD GEL

GRIPGEL

2mm uniform thickness Recommended for all activity levels

#makinglivesbetter T: 727.528.8566 | 800.574.5426 | F: 727.528.8862 www.easyliner.com | info@easyliner.com

NUMBERS

National Health Expenditure Outlook CMS report explores impact of pandemic on current and future healthcare costs, utilization

PHYSICIAN & CLINICAL SERVICES SPENDING

Following a decline in 2020 due to the COVID-19 pandemic, healthcare utilization in the United States is expected to rebound and normalize through 2022, according to newly published data from CMS. Here’s a closer look at predicted healthcare and insurance coverage trends over the next decade.

6.2%

6.1%

Expected spending growth in 2022, as more individuals with private insurance resume typical patterns of use

PRIVATE HEALTH INSURANCE

MEDICARE/MEDICAID

207.9 Million

76.0 Million

Number of individuals expected to be enrolled in private health insurance in 2030, compared to 200.3 million in 2020

Number of individuals expected to be enrolled in Medicare in 2030, compared to 61.5 million in 2020

4.8%

MEDICARE ENROLLMENT TRENDS |

8.0% 6.0% 4.0%

4.2%

2.0%

1.7% 9.4%

6.9% 2.6%

0.0%

Number of individuals expected to be enrolled in Medicaid in 2030, compared to 76.0 million in 2020

Average Annual Growth in Enrollment, Per Enrollee Spending and Total Spending

Medicare Enrollment Growth

11.3%

12.0% 10.0%

83.3 Million

Expected annual rate of growth in private health insurance spending in 2025-2030

— “National Health Expenditure (NHE) Projections 2021-2030,” CMS

2019

MAY 2022 | O&P ALMANAC

7.5% 2.3%

3.5%

5.1%

2.1% 1.4%

2020

6.4% 2.5% 3.9%

2021

5.5%

Expected spending growth in 2025-2030, reflecting decelerating spending from private health insurance enrollees

2022

6.8% 2.1% 4.7%

2023-2024 2025-2030

Medicare Spending Per Beneficiary Growth Medicare Spending Growth Average annual growth rates are from previous year shown

SOURCE: “National Health Expenditure (NHE) Projections 2021-2030: Growth To Moderate as COVID-19 Impacts Wane,” CMS, March 28, 2022; https://www.cms.gov/files/document/national-health-expenditure-projections-2021-30-growth-moderate-covid-19-impacts-wane.pdf.

“By 2024, the government share of health spending is expected to fall to 46% as COVID-19 supplemental funding is expected to wane, down from an all-time high of 51% in 2020.”

Expected spending growth in 2023-2024, as lingering effects of the pandemic diminish

Make everyday tasks a piece of cake. The TASKA HandGen2 with it’s flexible, precise fingers and lockable grips is perfect for holding delicate items reliably and safely, allowing users to get on with their day. For more information, contact your Fillauer representative or visit taskaprosthetics.com

801.326.3434 Distributor for U.S. & Canada

Happenings FUTURE O&P TECHNICIANS

O&P Technician Students

RESEARCH ROUNDUP

Amputation Etiologies May Impact Rate of Mobility Decline

Among O&P technician students during the 2020-2021 school year, 55% were male, 43% were female, and 2% identified as “other” gender. Other 2%

Female 43%

55% Male

SOURCE: Data provided by NCOPE.

DIABETES DOWNLOAD

More Teens Have Prediabetes The number of U.S. children ages 12 to 19 who meet the criteria for prediabetes is now estimated at 28%, more than double since 1999. Prediabetes is more teens who live in poverty. SOURCE: “Trends in Prediabetes Among Youths in the U.S. From 1999 Through 2018,” JAMA Pediatrics, March 2022.

MAY 2022 | O&P ALMANAC

amputation levels for cancer, congenital, and trauma compared to diabetes/ dysvascular,” reported the authors. James Campbell, PhD, a study author and Hanger chief clinical officer, said that MAAT 7 “helped us develop a more meaningful comparison for individual patients, allowing for more personalized goal setting, and ultimately helping clinicians better meet patients where they are in their journey.” Understanding the differences among individuals with different causes of amputation may assist in the allocation of targeted interventions and could help clinicians with goal-setting when working collaboratively with patients, according to the researchers. The data they collected also may help benchmark intervention performance in reducing the rate of decline in mobility associated with age, they noted. “Together with our research partners, we have advanced outcomes-based care and revolutionized the way O&P leverages clinical research to discover best practices for patients,” said Campbell. “The MAAT series will serve as a springboard that continues to drive advances in evidence-based practice within orthotic and prosthetic care.”

PHOTO: Getty Images

prevalent in males and in

Researchers analyzed data from nearly 12,000 lower-limb prosthesis users to establish normative values for various etiologies in the seventh study in the Mobility Analysis of Amputees (MAAT) Series. MAAT 7 was conducted by the Hanger Institute for Clinical Research and Education and published in American Journal of Physical Medicine & Rehabilitation. The Hanger research team examined data from individuals with limb loss grouped by age, amputation etiology, and transfemoral vs. transtibial amputation. They established normative values for each group, ultimately expanding known benchmarks from two etiologies across four age groups, to four etiologies (cancer, congenital, trauma, and diabetes/ dysvascular) across seven age groups. The researchers found that older individuals with lower-limb loss reported reduced mobility across all four etiologies, with the oldest age group reporting the lowest mobility. Individuals with diabetes/dysvascular-related amputations had the lowest median mobility scores. “The findings of this study are valuable and insightful because mobility seems to decline at different rates across

HAPPENINGS

Patient Participation in Prosthesis Design Improves Satisfaction Engaging patients in the cosmetic design of their prosthesis may lead to more satisfied prosthesis users, according to a new study from researchers in the Department of Physical Therapy at the University of Nevada, Las Vegas (UNLV). The research team, led by Szu-Ping Lee, PT, PhD, associate professor at UNLV, surveyed prosthetists and prosthesis users regarding prosthetic prescription and fabrication, users’ perceived level of engagement, and self-reported outcomes. They found that 75% of prosthesis users were offered at least one cosmetic design option for their device. Patients who were offered at least one design option reported significantly greater satisfaction than those offered no options. Lee’s team also found that patients’ level of satisfaction regarding the look of their prosthesis correlated with

their perception that their prosthesis “empowers them in their daily activities.” Prosthesis users who are more satisfied with the look of their prosthesis perceived “higher levels of empowerment,” according to the researchers. “Offering cosmetic options and supporting patients’ autonomy involve little to no risk in clinical prosthetic practice while showing tangible benefits.” The study was published in March in Prosthetics and Orthotics International.

Researchers Investigate Ultrasound-Controlled Prosthesis

PHOTO: Getty Images

A research team from George Mason University’s (GMU’s) Bioengineering Department has published the first demonstration of real-time functional task performance by an individual with upper-limb loss using an ultrasound-controlled prosthesis. The team, led by Susannah M. Engdahl, PhD, a GMU postdoctoral research fellow and AOPA’s manager of health policy and research, studied the use of sonomyography (SMG) for prosthesis control—an alternative approach that relies on ultrasound imaging to sense muscle deformation within the residual limb during voluntary movement. The researchers worked with a participant to examine real-time performance of tasks that required the user to select different grasps over a broad range of arm positions using a TASKA hand via SMG. The participant completed the

Box and Blocks Test, Targeted Box and Blocks Test, and Rainbow Test. The research team also studied the repeatability of the tasks by the user over three hours of continuous use and with simulated doffing and donning of the socket. The participant successfully repeated tasks in a variety of positions across the reachable workspace without retraining the classifier. The findings “demonstrated that SMG could enable repeated completion of functional tests over a short-term testing period and over a three-hour testing period,” the team concluded. The study supports the feasibility of using ultrasound to control upper-limb prostheses in realworld applications, according to the researchers, which may enable more intuitive control of prosthetic hands. The study was published May 4 in Frontiers in Bioengineering and Biotechnology.

Psychosocial Measurement Tool Targets Upper-Limb Loss Seeking to improve measurement tools for individuals with upper-limb loss, researchers at Providence VA Medical Center and Brown University developed a measure of psychosocial adjustment for both prosthesis users and non-prosthesis users. The research team, led by Linda Resnik, PT, PhD, FAPTA, modified items from an existing Trinity Amputation and Prosthesis Experience Survey (TAPES) and generated new items pertinent to persons who did not use a prosthesis. “A substantial proportion of persons with upper-limb amputation experience clinical depression, post-traumatic stress disorder, general anxiety, and/ or long-term post-traumatic psychological distress after amputation,” the researchers explained in an article in Canadian Prosthetics & Orthotics Journal. “Levels of depression and anxiety have been reported to be greater, and psychosocial adjustment poorer, in persons with upper-limb amputation as compared to those with lower-limb amputation.” Because previous measures of psychosocial adjustment were designed specifically for prosthesis users, Resnik’s team developed the new measure that can be completed by individuals regardless of prosthesis use. During pilot testing, Resnik’s team used the new test items to conduct a telephone survey of 727 individuals with major upper-limb amputation, then examined the responses. Factor analyses led the researchers to identify two subscales: a seven-item Adjustment to Limitation Subscale and a nine-item Work and Independence Subscale. “Our analyses supported validity and reliability of both subscales,” reported the researchers. “Both scales can be used for persons with upper-limb amputation regardless of whether they use a prosthesis.”

O&P ALMANAC | MAY 2022

HAPPENINGS

PAIN MANAGEMENT

Pain Common Among Veterans With Upper-Limb Loss

O&P ATHLETICS

OPAF Partners With USRowing To Train Adaptive Athletes

In a study of veterans with unilateral upperlimb amputation, 72% experienced contralateral limb pain, and 60% experienced persistent pain. Black veterans and those with back pain experienced greater pain intensity. SOURCE: “Contralateral Limb Pain Is Prevalent, Persistent, and Impacts Qualify of Live of Veterans With Unliateral Upper Limb Amputation,” Journal of Prosthetics and Orthotics, April 2022.

HEALTHCARE DEI

Patients of Color Find Less Representation in Their Providers Among healthcare patients

SOURCE: Urban Institute’s Health Reform Monitoring Survey, Urban Institute.

MAY 2022 | O&P ALMANAC

by Shriners Children’s Florida. “I want to thank Dawna Callahan with All in Sport Consulting in helping to cultivate this new partnership with Debbie Arenberg, adaptive programs associate coordinator for USRowing,” said Young. “OPAF’s participants overwhelmingly present with qualifying diagnoses to participate with the U.S. Para Rowing Team, and we hope that future Paralympians will have been introduced to rowing through this new partnership.”

Invictus Games Make Triumphant Return The Invictus Games—an international sporting event for wounded, injured, and sick service members and veterans—were held in April in The Hague after a two-year pause due to the COVID-19 pandemic. Founded in 2014 by Prince Harry, Duke of Sussex, the Games provide a forum for disabled service members to compete while on the road to recovery. More than 500 competitors participated in 10 sports during the Games, including athletics, powerlifting, archery, indoor rowing, wheelchair basketball, wheelchair rugby, cycling, sitting volleyball, and swimming. Results are available at invictusgames2020.com. Almost 100,000 spectators convened at Zuiderpark in the Netherlands to view the Games. This year a “yellow bench” was introduced during the Opening Ceremony; the intention is to have yellow benches all over the world where people can listen to each other’s stories. The next Invictus Games are planned for September 2023 in Dusseldorf, Germany.

PHOTOS: OPAF

in general, 74% of white patients have a healthcare provider of the same race or who speaks the same language. Only 22% of Black adults and 23% of Hispanic and Latino adults consider their usual healthcare providers to share their race or ethnicity.

The Orthotic and Prosthetic Activities Foundation (OPAF & The First Clinics) and USRowing are partnering to offer First Row, an introductory-level adaptive rowing clinic. First Row is designed to help introduce those with disabilities to the sport of para rowing, and to help cultivate the future of the U.S. Para Rowing Team, according to Travis Young, CPO, president of OPAF. The first joint event will be held July 30 in Tampa, Florida, and will be co-sponsored

Think outside the shoe® A game changer solution for foot drop The XTERN is the only dynamic AFO for foot drop totally affixed outside the shoe to maximize comfort, prevent skin breakdown and rubbing injuries to the foot. Its flexibility helps keep maximal ankle range of motion and calf muscle strength.

Adaptable Lightweight, sleek design Amazing energy return No skin contact

Versatile Symmetrical design

PDAC Validated (L1951) USA turbomedusa.com

PEOPLE & PLACES BUSINESSES ANNOUNCEMENTS AND TRANSITIONS

The Challenged Athletes Foundation (CAF) has distributed 3,256 grants valued at $6.2 million to athletes ranging from first-time applicants to elite-level Paralympic competitors this year. The grants provide financial support for adaptive sports equipment not typically covered by medical insurance for items such as running prostheses, handcycles and sport wheelchairs, adaptive training equipment, and expenses related to competition travel, training, and coaching. Almost 20% of the funds went to individuals with limb loss or limb difference. “We believe sports is a pathway to more in life, and that’s why we are committed to providing access to equipment, travel, and competition expenses for athletes of all abilities across a wide variety of sports and activities,” said Kristine Entwistle, CAF chief executive director. “We were proud to support nearly 700 first-time applicants, increase the number of grants to youth under 18, and provide access to some of the most innovative sports equipment available.” This year, 80 Össur prosthetic sports feet and knees were granted to athletes as part of the program. “Thousands of people have benefited from the partnership between Össur and CAF, and we are proud to continue this tradition this year, so that even more people with limb loss and limb difference have the opportunity to enjoy life without limitations,” said Sveinn Sölvason, president and CEO of Össur.

Hanger Clinic announced that the ASCENT K2 clinical study has enrolled its first 100 patients. The five-year study, called Assessing Outcomes With Microprocessor Knee (MPK) Utilization in a K2 Population (ASCENT K2), is a collaboration between the Hanger Institute for Clinical Research and Education and Ottobock to study the health benefits that MPK technologies provide for individuals ages 65 and older. ASCENT K2 began enrolling test subjects and fitting patients with MPKs in July 2021. Half of the participants are being fit with MPKs while the other half are being fit with mechanical, non-MPK knees. The study may provide findings to support new coverage policies, potentially providing expanded access to seniors with above-knee limb loss, according to Hanger.

Correction: The article “Foot Comfort and Care” in the March 2022 issue misstated the location where the UCBL foot orthosis was originally designed. It was developed at the University of California Biomechanics Laboratory, not the University of California-Berkeley Lab.

www.bocusa.org

TOP QUALITY ORTHOTIC, PROSTHETIC AND PEDORTHIC EDUCATION AND CE CREDITS FROM THE ORGANIZATION THAT KNOWS O&P.

Start earning your credits today! 14

MAY 2022 | O&P ALMANAC

A more

FLEXIBLE SOLUTION With the same unique features as KiddieGAIT® & KiddieROCKER®! KiddieGAIT®

KiddieROCKER®

Support for Better Life!

KiddieFLOW™

REIMBURSEMENT PAGE

By JOE MCTERNAN

Managing Reimbursement Pain Points

DENIED

Tips for maneuvering same or similar denials, RAC audits, and more

DENIED

E! QU IZ M EARN

BUSINESS CE

CREDITS P.18

Editor’s Note—Readers of Reimbursement Page are eligible to earn two CE credits. After reading this column, simply scan the QR code or use the link on page 18 to take the Reimbursement Page quiz. Receive a score of at least 80%, and AOPA will transmit the information to the certifying boards.

“T

HESE ARE THE TIMES that

try men’s souls.” This quote, attributed to Thomas Paine in his 1776 publication, “The American Crisis,” was written during a time when General George Washington’s Continental Army was suffering through several demoralizing defeats and the bitter Valley Forge winter. While a comparison of the daily struggles that O&P businesses face due to reimbursement challenges to those of the Continental Army during the early stages of the American Revolution might seem a bit dramatic, the struggle is real. In today’s O&P climate, reimbursement challenges continue to grow, and they are becoming more difficult to manage. This month’s Reimbursement Page examines some of the more common situations that frustrate O&P providers and offers strategies to help manage the pain points and improve the success of O&P businesses.

MAY 2022 | O&P ALMANAC

Same or Similar Denials

When it comes to O&P pain points, same or similar denials are consistently at the top of the list of AOPA member frustrations. Medicare policy does not allow for the provision of replacement items within the items’ defined “reasonable useful lifetime.” In addition to not covering replacement of identical items, Medicare also will not cover items that are considered “same or similar” to items that were previously provided to the patient. Unfortunately, Medicare’s definition of same or similar is rather broad and often creates significant coverage challenges involving treatment methodologies that are considered clinically appropriate. A common example of a frustrating same or similar denial occurs when a Medicare beneficiary is treated with a prefabricated walking boot to stabilize an acute injury and, after a more comprehensive evaluation, it is determined that the patient requires additional treatment with a custom-fitted or custom-fabricated ankle-foot orthosis. Another common example occurs when a patient receives an orthosis to treat an orthopedic condition and several years later is prescribed another orthosis that Medicare considers “same or similar” to treat a new and different condition. In both of these scenarios, the Medicare claim for the second orthosis will almost certainly be denied as a same or similar item.

While same or similar denials cause tremendous frustration, the Medicare appeals process can be used effectively if there is proper documentation in the patient’s medical record that discusses either the need for advanced treatment beyond acute stabilization or the independent nature of the orthopedic conditions that warrant coverage of a second orthosis within reasonable useful lifetime timeframes. AOPA continues to address concerns regarding the overbroad interpretation of same or similar classifications with the durable medical equipment Medicare administrative contractors (DME MACs) and CMS to ensure that Medicare beneficiaries continue to have access to medically necessary, clinically appropriate care.

Reasonable Useful Lifetime Denials

Reasonable useful lifetime restrictions are another source of frustration for O&P providers. While often part of the process that results in a same or similar denial, Medicare claim denials caused solely by useful lifetime restrictions are often a result of unreasonable requirements that an O&P item or component last for at least five years. The Social Security Act states that in absence of guidance from the Secretary of Health and Human Services, the reasonable useful lifetime of an item designated as durable medical equipment, prosthetics, orthotics, and supplies is no less than five years.

Meet Zeus The strongest bionic hand in the world! Robust Design with patent pending impact resistance mechanism. Only hand that can be 100% locally repaired by a clinician in under 60 minutes. 12 Grip patterns with 100% customizability of each finger. Web based software allowing clinicians to remotely configure the Zeus hand.

Book a free demo today!

www.aetherbiomedical.com

REIMBURSEMENT PAGE

The Medicare Improvements for Patients and Providers Act established that prostheses can be replaced without regard to useful lifetime restrictions. However, the Medicare Knee Orthosis Policy established a reasonable useful lifetime of one to three years for knee orthoses, and other orthoses fall under the five-year minimum useful lifetime requirements. Claims for replacement orthoses that are identical to the original orthosis will be denied if the orthosis is less than five years old regardless of the condition of the orthosis. Exceptions to these restrictions include replacements due to a change in patient condition and replacements due to loss, theft, or irreparable damage of the original orthosis. Replacement due to irreparable damage must be supported by documentation that identifies a specific incident that caused the damage and does not include damage due to wear. When appealing claim denials involving replacement orthoses, it is important that your documentation is specific as to why replacement is necessary outside of reasonable useful lifetime restrictions.

RAC Audits

The Medicare Recovery Audit Program is not a new process. It began in 2005 as a limited demonstration project that was quickly expanded into a permanent part of Medicare Program Integrity Operations. Recovery audit contractor (RAC) audits continue to be a significant pain point for O&P providers. RAC auditors are highly incentivized to identify Medicare overpayments, collecting contingency fees between 9% and 12% for every overpayment that is ultimately recovered. Since O&P claims represent relatively high costs per claim, they are an attractive target for RAC audits. The fact that RAC audits can review claims that were paid up to three years in the past often creates accounting challenges for O&P businesses when RAC audits result in significant overpayment requests. While RAC audits are an established process, certain rules may protect you when building strategy on how to 18

MAY 2022 | O&P ALMANAC

deal with them. RAC contractors are limited to performing complex audits on a maximum of 10 O&P claims per tax ID every 45 days. Complex audits are those that are based on medical necessity and include the issuance of an additional documentation request (ADR). Automated RAC reviews, which are based on coverage restrictions based in policy (e.g., no acrylic on preparatory base codes), are not subject to the 10-claim limit. O&P providers should challenge RAC auditors if they issue more than 10 ADRs within a 45-day period. In addition to ADR limits, RAC contractors must publish and maintain lists of audit issues that have been approved by CMS. RAC contractors may not perform audits on claims that do not include CMS-approved issues. Providers should verify that any RAC audits involve approved issues before responding. Finally, RAC contractors must return any contingency fees if a provider successfully appeals the RAC determination. This is not profitable for the RAC and may make you a less attractive target for future audits.

Medicare Policy Coverage Gaps AOPA members often express frustration with out-of-date Medicare medical policies or policies that have obvious gaps in coverage. While AOPA continues to work with the DME MAC contractors to ensure that Medicare Local Coverage Determinations (LCDs) and Policy Articles offer appropriate access to medically necessary, clinically

appropriate care, there are certain situations where an item or service is simply not a Medicare benefit or there is medical policy that restricts coverage regardless of its clinical effectiveness. A recent example involves Medicare coverage of knee orthoses used to treat osteoarthritis. While there is significant evidence of the benefits of treating knee osteoarthritis using unloader-style knee orthoses, the current Medicare Knee Orthosis LCD requires objective documentation of joint laxity in order for certain knee orthoses to be considered medically necessary. While an unloader brace may be effective in relieving pain associated with osteoarthritis, it may be difficult to objectively identify joint weakness or laxity—creating a coverage quandary. Make sure that you fully understand all of the medical necessity and other coverage requirements before providing a service to a Medicare beneficiary. If you believe there is insufficient documentation to support a service prescribed by a physician, you may want to consider obtaining an advance beneficiary notice from the patient.

Relieving the Pain

The pain points discussed above represent a sample of the challenges that O&P providers face on a daily basis. AOPA’s reimbursement staff will continue to work with our contacts at CMS and the DME MACs to help ease O&P administrative challenges and allow you to focus on providing Medicare beneficiaries with the best O&P care available. Joe McTernan is director of coding and reimbursement services, education, and programming at AOPA. Reach him at jmcternan@AOPAnet.org. Take advantage of the opportunity to earn two CE credits today! Take the quiz by scanning the QR code or visit bit.ly/OPalmanacQuiz. Earn CE credits accepted by certifying boards: www.bocusa.org

The Exclusively Endorsed AOPA Insurance Agency

TRUST LOYALTY PROTECT RESPECT

EASY STEPS

1. Download the O&P Program Application at bit.ly/cailorﬂemingOandP 2. Fill out the form 3. Email the form to Tom Furtaw at tfurtaw@cailorﬂeming.com Cailor Fleming Insurance will provide your program quote ready in 1-3 business days.

Call Cailor Fleming today and we’ll gladly customize a speciﬁc plan for you. We’ve been a trusted insurance company for years, let our experience and lasting service speak for itself. AOPA’S INSURANCE PROGRAM Practitioners trust us most because we know your O&P business and we know insurance unlike any other program.

800-796-8495

http://cailorﬂeming.com/OandP.asp

PROFESSIONAL LIABILITY

GENERAL LIABILITY

PROPERTY

AUTO

UMBRELLA

WORKERS COMP & MORE

This Just In

Reunited in Advocacy

AOPA President Dave McGill welcomed participants during the Opening Luncheon.

O&P stakeholders take part in AOPA’s 30th Policy Forum

ORE THAN 110 AOPA MEMBERS and O&P

students reunited in Washington, DC, May 17-18 for the annual AOPA Policy Forum—the first time the event was held in-person since 2019. O&P business owners, managers, clinicians, educators, and students joined forces to learn about advocacy strategies, game-plan for one-on-one congressional visits, and meet up with legislators and their staff. The first day of the Policy Forum, participants learned “Advocacy 101,” discussed the “why” of advocacy, discovered how outcomes help elevate the role of O&P professionals as clinical care providers, heard successful advocacy stories, learned expert tips on communicating with legislators, and participated in breakout sessions to prepare for their Capitol Hill visits. The second day, attendees split up into small groups to meet with individual senators and representatives or staff members to share their stories and deliver their “ask”: that the legislators sign on to cosponsor the Medicare O&P Patient-Centered Care Act—HR 1990 and S 2556. Participants completed more than 70 congressional visits with representatives of 30-plus states. They used the opportunity to connect with lawmakers, explain the value of O&P clinicians as care providers, and increase awareness of the Medicare O&P PatientCentered Care Act. Look for details about the event and a discussion of the importance of advocating both in Washington and in daily O&P practice in the June/July O&P Almanac.

MAY 2022 | O&P ALMANAC

AOPA Board Member Shane Wurdeman, PhD, CP, FAAOP(D), discussed the importance of outcome measures during the session on “Defining Today’s O&P Care Provider.”

Participants met in breakout sessions Tuesday afternoon to game-plan for congressional visits.

Attendees enjoyed the opportunity to discuss O&P advocacy in-person.

This Just In

Sam Miller, AOPA manager of state and federal advocacy; Nicole Ver Kuilen, AOPA manager of public engagement; Alex Gates, CPO, a clinician at Evergreen P&O; Jane Lucas, counsel at Alston & Bird; and Ashlie White, AOPA director of health policy and strategic alliances, led a discussion on “The Advocate Experience.”

Participants were encouraged to ask questions and share their viewpoints during this year’s interactive Policy Forum.

White shared why it’s important for O&P stakeholders to advocate for both their patients and the profession.

Dozens of O&P professionals chose to attend the optional “Advocacy 101” session prior to the Opening Luncheon.

Attendees appreciated the opportunity to access advocacy strategies and details about the Medicare O&P Patient-Centered Care Act prior to their legislative visits.

Keynote Speaker Candace Doby motivated participants to find their “courage” when meeting with legislators.

O&P ALMANAC | MAY 2022

COVER STORY

A Therapeutic Touch for UPPER LIMB

The benefits of and strategies for collaborating with occupational therapists for improved outcomes By CHRISTINE UMBRELL

NEED TO KNOW: • For prosthetists who treat patients with upper-limb loss, working closely with occupational therapists (OTs) is key to successful patient outcomes. • Not only do OTs help train patients in using their new devices, they also help them to integrate the prosthesis into their life, and teach them to perform increasingly complex tasks that will aid them in carrying out activities of daily living. • In addition to teaching “skills drills,” OTs consider the environments in which clients will be using their devices and help them

MAY 2022 | O&P ALMANAC

translate the skills they learn in therapy into meaningful activities. • OT-prosthetist partnerships add value when treating limb loss patients who experience pain—whether residual limb pain, phantom pain, or general body pain that may have been preexisting. • More training is needed to educate more OTs on working specifically with limb loss patients, and prosthetists can help fill the void by raising awareness of the profession and offering training courses to area OT professionals.

COVER STORY

FTER YEARS OF failures in finding

Lucas learned to pick up blocks and complete other new tasks after hours of occupational therapy and prosthetic training.

PHOTOS: Handspring

O&P ALMANAC | MAY

a prosthesis that would assist their son in using his left arm, Lucas’s parents turned to the team at Handspring in Salt Lake City. Months of virtual preparation involving prosthetic evaluation and occupational therapy—Lucas lives in Hawaii—resulted in the 8-yearold finally receiving a well-fitting and functional device during a three-day visit to the Utah facility. When Lucas tried out his prosthesis, comprising a self-suspending socket, a prosthetic forearm and wrist, cable and harness, and multiple terminal devices, he was able to stack blocks, grasp a snowball, and play alongside his twin sister. “It was the first time he was able to reliably hold things with that side of his body,” explains prosthetist Chris Baschuk, MPO, CPO, FAAOP(D), a regional clinic manager at Handspring. “Lucas asked me, ‘Do I get to take this home?’ When I said ‘yes,’ I got the biggest hug!” This success would not have been possible without a team approach to care that prioritized both occupational therapy (OT) and prosthetic innovation. Baschuk worked closely with Debra Latour, OTD, MEd, OTR/L, as well as prosthetist Amy Ginsburg, CPO, to design an appropriate solution. “Debi spent a lot of time evaluating him and establishing his needs,” then preparing him for the prosthesis. “It was critical to have her input” to understand what Lucas needed in a prosthesis

Chris Baschuk, MPO, CPO, FAAOP(D), fit 8-year-old Lucas with a prosthesis after multiple sessions with an occupational therapist. to function in his natural environment. During OT evaluations, Latour “sees things I don’t necessarily see,” Baschuk says. Lucas’s positive outcome came about “because we were all working as a team.”

Early Intervention

Upper-limb prosthetists say that working closely with occupational therapists is key to successful patient outcomes. Baschuk notes that such cooperation is necessary to validate the functionality and design of the prosthesis. 2022

COVER STORY

An effective OT who is experienced passing it back and forth,” he explains. water bottle and learning to drink from in amputation teaches patients not “You’re maximizing the patient’s time it, or cutting food with a fork and knife. only how and when to use a prosthesis, and making sure that you identify “Once those skills are mastered, we but also which device is potential barriers that can shift to more complex activities— appropriate for specific could arise, and dealing preparing a meal, or looking at tasks to tasks. “The OT helps with those proactively enable return to work.” them learn to integrate so there aren’t delays in Teaching patients to perform the prosthesis into their the rehabilitation of the increasingly complex tasks can help life, and works closely patient.” prevent prosthesis abandonment, with the prosthetist to The initial evaluations according to Wagner. “You can make explain areas of deficit enable the prosthea great prosthesis, but if the patient so that the prosthetist tist and OT to assess doesn’t understand how to functioncan properly adjust the the patient’s physical ally use it, they won’t use it,” he says. Rob Wagner, CP device,” Baschuk says. limitations and capabil“When OT shows them how to carry Rob Wagner, CP, an ities and assess range of out daily activities using a prosthesis— upper-extremity specialist at Wright motion, strength, edema, scar managelike folding clothes or opening a bag of & Filippis, emphasizes the value of ment, and other factors that inform a chips—they want to use their devices.” OT intervention both prior to and successful fitting process, according to The type of upper-extremity device after a patient receives a prosthesis. Baun. Arm Dynamics OTs a patient receives affects Whether a patient is fit with a bodyalso assess the patient’s the amount and the or electric-powered upper-extremity social and psychosocial type of therapy needed, prosthesis, “we want the OT to work needs—“the mental according to Baun. with the patient before receiving the health and well-being,” Even patients with less device so they can improve their range she says. “You’re complex devices, such as of motion, to strengthen the flexors dealing with the physcustom silicone restoand extensors, so they’ll be able to use ical pieces, but you’re rations, benefit from the device” once it is delivered, says also paying attention working with an OT, but Wagner. to what’s going on for therapy will be more John Miguelez, CP, FAAOP(D) intense for individuals At Arm Dynamics centers, the them socially—do they prosthetist-OT collaboration “happens have the resources they with more advanced right at the beginning, and goes right need, and if not, can I help facilitate components. “A fully electric prosto the end—lifelong care,” says Kerstin getting those in place? The same goes thesis is going to require programming; Baun, MPH, OTR/L, national director for mental health needs.” it’s going to require learning to control of therapeutic services. the various components of the device, “It’s so important that Individualized Care learning how to preposition it, and the initial evaluation is After initial evaluahow to optimize the function of it. collaborative because tions, individualized That often requires collaborative probyou’re really getting OT sessions prepare the lem-solving and lots of practice.” at: What is important patient for successful The patient and their demeanor also to this person? What use with the prosthesis, influence the therapy plan. “We could will matter to them at according to Baun. have two patients with the same level the end?” The answers OTs usually start with of amputation, being fit with essento those questions will education—about the tially the same prosthetic device, that Kerstin Baun, MPH, OTR/L enable the team to select prosthesis, how to care need two completely different amounts and fit an optimal prosthetic solution, for it, and how to care for the residual and types of therapy,” Miguelez and develop a plan of care that facililimb—before moving on to the basics explains. “Part of the art is to undertates the patient to succeed in using the of component operation, and donning stand what will work best for each device. and doffing independently. patient’s personality and preferred John Miguelez, CP, FAAOP(D), As a next step, therapists may learning mechanism.” president and senior clinical director ask patients to perform rote, simple Many prosthetists attend some OT at Arm Dynamics, equates collaboraactions. “We start with a simple task, appointments to get a better undertive care between a prosthetist and an and as the individual shows control standing of the patient and their needs, OT with a relay race: “There are times and skill, we can grade to more says Baschuk. “I like to get involved in when we’re both holding onto the complex activities,” explains Baun. at least one or two OT appointments, baton, and there are times when we’re Early tasks may include holding a both before and after delivery, to 24

MAY 2022 | O&P ALMANAC

800-356-3668 - orders@amfit.com - AMFIT.COM

COVER STORY

validate that the design of the prosthesis is meeting the functional needs of the patient,” he says. “Sometimes the initial plan you thought would work” for a particular patient doesn’t progress as hoped. “It’s an iterative process. You use the device in training sessions with the OT, then deliver the prosthesis, then transition into the maintenance phase,” he says. “The patient may come back as they get used to the device and try to do more with their prosthesis than they originally

thought they could,” which may require device adjustments and well as more therapy. For O&P facilities that don’t have OTs on staff, prosthetists may need to travel to participate in OT sessions with patients. At Wright & Filippis, Wagner travels throughout the state of Michigan to treat patients, and he has developed relationships with OTs in different regions. “There are not a lot of upper-limb patients, so it’s good to stick with one OT [in an area] so they

can build up their experience” working with this select patient base, he says. Wagner also lends equipment to OTs to facilitate more productive therapy sessions. For example, for myoelectric devices, he loans a tester, or he sets up a hand (without a socket) with a few electrodes so the patient can practice before prosthesis delivery. Working with feedback machines allows the OT and patient to see EMG signals as the patient moves. For some myoelectric devices, he introduces

What an Experienced Occupational Therapist Wants You To Know

Debra Latour, OTD, MEd, OTR

Debra Latour, OTD, MEd, OTR, is an occupational therapist, the doctoral capstone coordinator and a professor of occupational therapy (OT) at Western New England University, and a consumer of upper-limb prosthetics. Born with right upper-limb absence in 1956, Latour became a prosthesis user at 14 months old in an innovative program at Shriners Hospitals for Children in Springfield, Massachusetts. As a trailblazer, she became a prolific prosthesis user—despite having never participated in OT herself. In high school, she learned about the OT profession and decided to pursue a career in the field. She earned a bachelor’s degree in occupational therapy, embraced clinical roles, and eventually earned master’s and doctorate degrees and university positions. In addition to serving as a clinical therapy consultant at Handspring, she also teaches upper-extremity courses for OTs and physical therapists, has authored multiple textbook chapters, and consults to Fillauer-TRS Inc.

Given her experience, Latour offers the following advice to prosthetists who treat upperlimb patients: • Embrace collaborative care. Prosthetists should work with OTs and other members of the rehab team to share knowledge and provide overlapping—rather than siloed–patient care. • Ensure that all persons with upper-extremity absence have access to OT care. Even individuals using passive and body-powered components can improve their outcomes when they take part in OT. • Encourage clients to participate in preprosthetic training. Individuals can get started using simulators and other training devices when working with OTs, even before their prostheses are ready. “They’ll start to train their minds on

MAY 2022 | O&P ALMANAC

how to use their prostheses, and will be more comfortable once they get their devices,” Latour says. • Focus on communication skills. Recognize that other members of the healthcare team—and the device users themselves—may not understand or feel comfortable with some of the terminology prosthetists use. Embrace person-first language, and avoid technical terms. • Help train OTs in prosthetic subspecialties. There are more than 80,000 OTs in the United States, but specialized training specific to limb loss is hard to access, says Latour. Prosthetists can raise awareness of the profession and the need for OTs with expertise in upper-limb loss/ absence, and offer training courses to area OT professionals.

COVER STORY

software that trains the patient via video games—directing cars through a maze, or opening and closing a hand. “Then they’re more prepared to practice ADLs after they receive their device,” Wagner says.

Taking Field Trips

PHOTO: Arm Dynamics

In addition to teaching “skills drills,” OTs consider the environments in which clients will be using their devices. “An OT will take the time to figure out specific activities—those most meaningful—they want to be able to accomplish,” says Latour. Occupational therapy plays an important role in ensuring the prosthesis design and rehabilitation plan addresses patient’s individual concerns, says Latour. “OT looks beyond limb loss to the total person, and helps people find their voice,” she explains. “We can learn what is troubling them, and in what environments they find themselves. We discuss intimate topics such as how they dress, grooming, toileting, and relationships with spouses. They are much more open to talking to OT about these topics—and we can bring back the relevant information to the prosthetist.” At Arm Dynamics, OTs work with patients at locations where they will most benefit from using their devices. “It’s one thing to be successful in the clinic, but when you add the physical uniqueness of different environments, and the social challenges of having people look at you, it really changes the demands of the task,” explains Baun. “It adds psychosocial layers, and complexity.” Home visits, for instance, can yield positive results. In addition to evaluating how the patient can use their device and how much support they have at home, the OT can recommend modifications to the patient’s home or specific external devices to accomplish different tasks, “well beyond the scope of the prosthetist,” says Baschuk. Many OTs also accompany patients as they engage in community activities, according to Miguelez—for example, visiting the grocery store to teach

John Miguelez, CP, FAAOP(D), works with a patient on activating grip patterns with his multiarticulating hand. patients how to grab items to place in their carts and pay for purchases. The OT’s role is “to be there and support them, and note the things they did really well, and the activities that were more difficult—then spend more time perfecting control through training, so the patient feels confident in any environment,” he says. In-person worksite evaluations also can be informative. Baun frequently goes with patients to their workplaces—offices, factories, and even construction sites—to understand the physical tasks involved in their jobs. “Helping them problem-solve in the ‘here and now’ is hugely beneficial. It helps them get to that next level, and helps them problem-solve through challenges.” She also accompanies patients to physical activities, such as going to the gym, paddle-boarding, or rock-climbing—where she can assess whether they have appropriate activity-specific componentry. “We can take that information back to the prosthetist,” who can make changes

and adjustments, Baun explains. All of these field visits help boost patients’ confidence—which can prevent prosthesis abandonment, according to Miguelez. “We want our patients to continue to wear their prostheses, so anything we can do to lower or eliminate the potential for abandonment is really important,” he explains. Even after patients have received their definitive devices and are satisfied with their function, collaborative follow-up is beneficial. Patients at Arm Dynamics complete a short survey every three months to ensure they are still on track in their rehabilitation journey. The data they provide helps identify lapses or reduced prosthesis use—“we can ask them to come in so we can talk about it and address any issues,” says Miguelez. “Sometimes it’s as simple as they’ve taken up a new hobby, and they were never trained with their prosthesis in that activity— so we have them come in and work with their therapist. That can mean a huge change in quality of life.” O&P ALMANAC | MAY 2022

COVER STORY

Measurement Tools Inform Upper-Limb Care Plans

Kerstin Baun, MPH, OTR/L, guides a patient through a series of basic functional tasks.

MAY 2022 | O&P ALMANAC

PHOTO: Arm Dynamics

Outcome measures can be just as important for upper-limb patients as they are for lowerlimb patients. At Arm Dynamics, occupational therapists and prosthetists work closely to capture and analyze patient data. For example, the team leverages the Wellness Inventory during patients’ initial evaluations, explains Kerstin Baun, MPH, OTR/L, national director of therapeutic services. The Wellness Inventory is a patient screening tool that helps identify psychosocial changes that could have a negative impact on rehabilitation or success with the prosthesis, and screens for issues such as substance use, pain, PTSD, depression, and other quality-of-life issues. “A lot of these patients sustain their amputations as a result of an accident, so many have post-traumatic

anxiety or depression,” says Baun. In fact, Arm Dynamics’ research in studying Wellness Inventory responses has found that 58% of patients screen positive for depression and/or post-traumatic anxiety. Baun says it’s also common for patients to screen positive for substance use, which can be a coping mechanism postamputation. “We want to make sure they’re shifting to positive coping mechanisms” by helping to find and put in place the support and resources they need, Baun says. “The Wellness Inventory informs our whole approach” and is given to patients more than once, Baun says. After patients become comfortable with their prostheses, “we touch base with them again, using that exact same inventory, to learn what’s changed, what’s been resolved, and what may still need attention.” Clinicians at Arm Dynamics also leverage other measurement tools, such as a performance measure called the Capacity Assessment of Prosthetic Performance for the Upper Limb (CAPPFULTM) and Comprehensive Arm Prosthesis and Rehabilitation Outcomes Questionnaire (CAPROQTM), a patient-reported outcome measure. “We use these at multiple time points to tap into both objective and subjective data; how well they are able to use their prosthesis, as well as their perceived function and satisfaction with their device, along with various elements of pain,” says Baun. “It’s so critical to look at it long-term, to ensure they’re successful not only in the clinic, but in real life settings—that is the essence of lifelong care and the goal of occupational therapy.”

COVER STORY

Treating Pain

PHOTO: Wright & Filippis

Collaborating with OTs adds value when working with limb loss patients who experience pain, according to Baschuk. “If they say their shoulder, or arm, or other side of their body hurts, the OT can usually watch and figure out why” the pain is occurring, then assist in devising a plan to prevent or reduce that pain. Latour says OTs also may uncover information that patients did not realize was relevant to share with their prosthetists—such as previous sound-side injuries that still bother them. Sometimes OTs can help explain problems patients encounter with new devices: “Prosthetists take pride in their end product,” she explains, “so some people are afraid to speak up if there is a problem.” But they may feel comfortable sharing that information during therapy—and OTs can serve as a bridge to the prosthetist. “We teach our clients self-advocacy.” At Arm Dynamics, clinicians screen patients for pain at initial evaluations and periodically thereafter, says Baun. Pain can run the gamut from residual limb pain, to phantom pain, to general body pain that may have been preexisting or was caused by the accident that resulted in the amputation. How the care team proceeds with patients who screen positive depends on the etiology. “For someone who has phantom limb pain, we would want to work collaboratively with their physician to make sure they have the medication they need, and may connect them with a counselor to help deal with trauma,” Baun explains. OTs also may implement pain management strategies, such as graded motor imagery—therapy using specific imagery to train the brain away from pain—and mirror therapy, or other pain management techniques, according to Baun. “It depends on the individual therapist and their training,” she says. “Arm Dynamics therapists are trained in using modalities, which usually focus on residual limb pain, and pain that’s more peripheral. Regardless

of etiology, they may be helping the patient consider a lifestyle approach to pain management,” which could involve nutrition, exercise, meditation, and even sleep hygiene. “Sometimes, as people become more functional with their prosthesis, and as the rehabilitation process continues, pain diminishes over time as life normalizes for them,” adds Baun. But for others, consultation with a surgeon may be advised. “If pain persists, we can speak to patients about the potential of surgery—for example, targeted muscle reinnervation for treatment of neuromas. OTs can facilitate a team approach to find solutions to persistent pain problems.”

also with other members of a rehabilitation team, which may include a surgeon, physiatrist, case worker, psychologist, physical therapist, and massage therapist, says Baschuk. “For upper-limb care, it’s a multifaceted challenge,” he explains. “Everyone on the team needs to know the goal and consider the ramifications across those specialties.” Ultimately, collaborative care will help ensure patients’ needs are met. With a team approach, “the patient feels they have people in their corner who will go to bat for them,” Baschuk adds. “Each of us on the rehab team can help empower them from a different angle. It’s a really rewarding experience when we all work together.”

Expanding Partnerships

Christine Umbrell is a contributing writer to O&P Almanac. Reach her at cumbrell@contentcommunicators.com.

To provide optimal patient care, prosthetists work not only with OTs but

Rob Wagner, CP, visits OT facilities to work with the therapist and patient together, and sometimes lends equipment to OTs to facilitate more productive therapy sessions.

O&P ALMANAC | MAY 2022

Some Things New in

Texas

Mark your calendar for the AOPA National Assembly in September

&P PROFESSIONALS ACROSS the

RATION R E G I ST O O N ! OPEN S ’T WAIT WE CAN OU! Y TO SEE

country are already gearing up for the 105th AOPA National Assembly, which will feature brand-new content and top-class speakers. This year’s conference will explore the “Intersection of Technology + Humanity” and will take place September 28 through October 1 at the Henry B. Gonzalez Convention Center in San Antonio.

Future-Focused Education

MAY 2022 | O&P ALMANAC

PHOTO: Getty Images

The in-person Assembly, co-sponsored by the Texas Society of Orthotic and Prosthetic Professionals, will launch several “new” features—including a Postmastectomy Care Track and an O&P Digital Care Track. The Postmastectomy Care Track

was added due to overwhelming feedback from the community on the need for information, as well as the need to maintain the CFm credential, according to Joanna Kenton, MHA, CPO, LPO, FAAOP, co-chair of the AOPA 2022 National Assembly Planning Committee. This track also aligns with AOPA’s focus on diversity, equity, and inclusion, and supports the drive to ensure equitable access to diverse patients. Over the past few years, the number of sessions addressing digital technology have increased. “Digital fabrication has traditionally been a part of the Technology Track,” Kenton explains, but “we felt that the digital world has evolved into its own category.”

CHOOSE FROM

EDUCATIONAL TRACKS IN SAN ANTONIO • Prosthetic • Orthotic • Pedorthic • Technical • Business • NEW: Postmastectomy Care • NEW: O&P Digital Care

PHOTO: visitsanantonio.com

The O&P Digital Care Track will include a new interactive experience during a breakout session, where companies can consider two case studies—one in prosthetics or one in orthotics—and share with participants how they would handle the cases leveraging their technologies, according to J. Chad Duncan, PhD, CRC, CPO, who co-chairs the O&P Digital Care Committee with Jeff Erenstone, CPO. “This will be a more immersive experience and informative for Assembly-goers,” he says. Duncan also encourages attendees to consider the content on additive manufacturing within the Digital Care track, which will touch on the many ways 3D-printing technologies can be integrated into O&P facilities. The Technical Education Track will debut a new “Fabrication Tricks & Tips” session, which will showcase tips from members throughout the country, who previously submitted three- to five-minute videos explaining their O&P “trick or tip” to be considered for inclusion. During the Assembly, participants in this session will vote for their favorite tip—and winners will be awarded cash prizes. The range of sessions to be offered in San Antonio are intended to target the interests and needs of today’s clinicians and business owners. “The Assembly Planning Committee has

done a wonderful job identifying great presentations,” says Duncan. “I’ve been impressed with the quality of the submitted presentations. All the committees involved are dedicated to a great learning experience for the attendees. There is something for everyone who comes—that being front office, technician, clinician, to the owners.”

Fresh Experiences

Inspiring keynote speakers and new trade show experiences headline this year’s event. Mona Patel, a licensed clinical social worker who founded and leads the San Antonio Amputee Foundation (SAAF), will deliver one of the keynote presentations. At the age of 17, Patel was struck by a drunk driver and underwent more than 20 limb salvage surgeries before deciding on an elective right below-knee amputation. In addition to her role as executive director of SAAF, Patel has contributed to the advancement of individuals with limb loss in many ways, including serving on the board of the Amputee Coalition of America, leading a successful grassroots legislative effort for a bill that now mandates fair insurance coverage for prosthetic limbs, and supporting individuals with new amputations. Patel is excited to share her story and the work of SAAF during the Assembly.

AOPA will launch the “O&P Experience Zone” during the Assembly on Thursday, September 29—a fun, interactive event showcasing patient success stories and their caregivers. The Experience Zone will be held in conjunction with a traditional happy hour on the exhibit hall floor. This year’s exhibit hall will feature hundreds of cuttingedge products and technologies from worldwide manufacturers and O&P innovators. Sports enthusiasts won’t want to miss a cool new fundraising event at Top Golf San Antonio—details to come.

Fostering a Sense of Community

The National Assembly will offer numerous opportunities for attendees to network and make connections with other O&P stakeholders from all realms of the O&P profession— including clinicians and business owners, suppliers and manufacturers, and educators and researchers. Taking part in the AOPA Assembly, which offers the unique blending of the business and clinical sides of O&P, is a great way to get involved in the greater O&P profession, says Duncan. “You’ll feel a greater sense of belonging within the profession,” he says. O&P ALMANAC | MAY 2022

Can’t-Miss Attractions in

San Antonio

This year, why not extend your visit, and bring the family, to take advantage of the many cultural and historical attractions in and around San Antonio? Below are just a few of the many places of interest—and don’t forget the Alamo! The River Walk: This 15-mile urban walkway is the No. 1 attraction in Texas and runs through downtown San Antonio. Lined by restaurants, shops, and bars, the River Walk is open 24/7. Visit www.thesanantonio riverwalk.com. Go Rio Electric Barges: These barges offer narrated river cruises and run along the San Antonio River Walk. Learn about the city’s culture, history, and architecture while taking in the view. Visit www.goriocruises.com.

The Pearl: This 22-acre mixed-use space is a restored and repurposed former brewery and is committed to “craft, quality, and hard work.” Attractions include restaurants, retailers, and one of three campuses of the Culinary Institute of America. Visit https://atpearl.com. Witte Museum: This famous space features the nature, science, and culture of the region. Visit www. wittemuseum.org.

MAY 2022 | O&P ALMANAC

PHOTOS: visitsanantonio.com/Al Rendon, visitsanantonio.com, AOPA

Tower of the Americas: This 750-foottall downtown landmark was built for the 1968 World’s Fair and offers a panoramic view of the Alamo City. Don’t miss the Observation Deck, a 4D theater ride, or the revolving Chart House Restaurant. Visit www.towerof theamericas.com.

“You can get involved to make a difference and to make sure the profession is relevant.” In addition, “you get to meet so many people at the Assembly,” and then bring back what you learn to share with your co-workers, colleagues, or students. And although there is a virtual option for the Assembly this year, those that make it to San Antonio will benefit from the renewed sense of community, according to Duncan. “The fact we are coming together is important. Our profession is built on relationships and engaging with others,” he says. “Virtual is nice, but it does not provide you with that side conversation or continued discussion after hearing a really good or thought-provoking presentation.” For those who are unable to travel to San Antonio this year, full conference registration grants virtual access; a virtual-only option also is available. The virtual sessions will be offered for 60 days, starting two weeks after the in-person Assembly. Duncan encourages in-person Assembly-goers to take advantage of nearby attractions in Texas. “AOPA has done a wonderful job in locating the conference in the heart of San Antonio,” he says. “This allows Assembly-goers great eating options and fun areas to investigate along the River Walk. Just walking along Texas’s No. 1 attraction is worth it. “A lot is changing in our profession, and the personal connections will keep us moving forward,” adds Duncan. “The welcoming atmosphere of San Antonio will definitely encourage and support people connecting, especially if they take a boat ride on the river.” The 2022 AOPA National Assembly will open for registration in June. Be on the lookout for registration and hotel information, as well as details on additional special events planned for San Antonio. Visit www.AOPAassembly.org for details, and contact Assembly@AOPAnet.org with questions.

Designed for my real life... without compromise. Ramin I Property Manager, OK Kinnex has helped me change my overall quality of life. You get the full motion, the natural motion that you miss with a fixed ankle. It takes a lot of the pressure and shock off of my actual joints. I feel less fatigue at the end of the day and my overall quality and comfort of my limb is tenfold better than it ever has been.

www.proteorusa.com www.freedomkinnex.com

Connect with us

#DesignedForRealLife #HumanFirst #PROTEOR

O&P ADVOCATE

Championing Care for Aging O&P Patients Therapist plays key role in advocating for fair O&P reimbursement in New York

New for 2022, the O&P Advocate column focuses on individuals who go above and beyond to advocate on behalf of the O&P profession. Here, you will get to know colleagues and O&P stakeholders who champion issues of importance to O&P practitioners, business owners, and patients, and who foster relationships with decision makers to ensure equitable access for individuals with limb loss and limb impairment.

WO YEARS AGO, Matthew John-

MAY 2022 | O&P ALMANAC

through the Assembly (S 7023/A 7892); it will require the state health commissioner to look further at rate adequacy for the O&P profession in New York.

Well-Rounded Advocate

Johnson, whose responsibilities at Hanger include supporting O&P professionals in evolving healthcare environments and delivering evidence-based patient care, is well-suited to his role as a champion for O&P. His background is in physical therapy, specifically addressing care needs for the senior adult population, and he is certified as an exercise expert for aging adults. “My patient-care experience was in a variety of areas, such as acute hospital, inpatient rehab, subacute rehab, home health, and outpatient over an eight-year span before working as a therapy program consultant,” he explains. Early in his career, Johnson worked for a therapy technology and clinical program consulting company that was acquired by Hanger in 2010. That move inspired his clinical interests in O&P. “Over the next 10 years, various projects further exposed me to O&P as a profession, and I eventually transitioned into an area leadership position for Hanger Clinic in 2019.”

PHOTO: Hanger Clinic

son, MPT, CEEAA, jumped into O&P advocacy after connecting with Ted Drygas, CPO, FAAOP, and others as part of the New York State Chapter of the American Academy of Orthotists and Prosthetists (NYSAAOP). “There have been decades of unchanged reimbursement rates within the New York Medicaid system that created care disparity for those on Medicaid/ managed Medicaid programs,” says Johnson, who recently became Hanger Clinic’s area director in Philadelphia after serving as regional director for the New York Metro Area for several years.

“We collected patient testimonials, data from AOPA, information from New York Academy members, and feedback from other care providers and organizations to better understand the care disparity.” Johnson’s group also interviewed lobbyists, “which was a learning experience,” to shape the team’s overall plan. “Through patient contacts, we were able to get initial Zoom meetings with New York legislative leaders and their teams to educate on this disparity and seek guidance on steps to take for improving,” Johnson explains. “The key was aligning our message with legislative leaders having interest in healthcare or taking part in related committees.” Johnson notes that partnering with those champions has been instrumental in navigating legislative processes designed to secure additional funding to increase the New York Medicaid O&P fee schedule and reduce some of the stress in creating access to care issues. The team’s efforts are reaping some benefits: For the 2023 New York fiscal year budget, approximately $4 million has been allocated to increasing O&P reimbursement and adding in missing codes from the fee schedule. Additionally, a bill has passed the New York Senate and is making its way

PHOTO: Hanger Clinic

O&P ADVOCATE

Johnson leveraged his clinical expertise in several advocacy initiatives over the past few years. “Improving access to O&P services to those with New York Medicaid is the most important advocacy initiative I’ve been involved in,” he says. “Many patients and families have to wait longer, travel further, or may not have access to the same O&P services as those covered by other insurances. Educating other care providers about these challenges, partnering with other patient advocacy organizations, and networking with legislative leaders has been a core part of my role in the NYSAAOP project.” Johnson also took part in a Washington, DC, Hill Day in 2019 as part of the National Association for the Support of Long-Term Care. Participants sought to increase legislative awareness of issues affecting the therapy industry in caring for aging adults. “The goal of the advocacy was to sustain marketbased updates to reimbursement levels within the industry, provide flexibility in delivery of care given the Patient-Driven Payment Model [a case-mix classification reimbursement model implemented for Part A skilled nursing home stays starting in October 2019], and further clarify care delivered by supervised therapy students in skilled nursing settings,” Johnson says. He and other participants helped to ensure a smooth transition of the reimbursement model in skilled nursing homes as well as continued access to valuable services for patient populations across the United States. Johnson also is eyeing future Medicaid reform. “We’re currently learning more about changes being made to the New York Medicaid O&P fee schedule, which will allow us to analyze the impact on access to care and formulate next steps,” he says. “Based on the results, we will focus on partnering with our legislative champions in the New York Assembly, Senate, and Department of Health to make further suggestions to improve the New York Medicaid structure as it relates to O&P reimbursements.” In addition, he plans to assist in establishing benchmark reimbursement

for the S1040 cranial remolding helmet codes, as well as adding codes to the fee schedule that have been previously omitted.

The Power of Partnerships

Successful advocacy stems from collaboration among different stakeholders and organizations, according to Johnson, who serves on Hanger’s Advocacy Council, a group of professionals from across the company that meet quarterly to keep apprised of industry trends and needs for national and state-level advocacy projects.

Matthew Johnson, MPT, CEEAA, presents during a recent virtual webinar at Hanger Clinic. “Since most of my professional career has been in physical therapy rehabilitation and not O&P, networking has been critical for getting others involved with advocacy initiatives,” he says. He has attended state conferences, leveraged contacts from more tenured O&P professionals, and asked for others to become involved—all of which spurred additional momentum for advocacy. Additionally, “the team at AOPA has been a great partner for helping broadcast messages for calls to action that help us reach additional O&P stakeholders on important legislative initiatives in an efficient manner.” O&P professionals should get involved in advocating on behalf of the profession, according to Johnson. “Healthcare has fully shifted to a ‘triple

aim’ of improving patient experience, achieving better outcomes, and reducing costs,” he explains. “It’s important to take an active approach with educating key stakeholders in the healthcare payment system about the value and impact of our profession. Without it, there will be continued pressures that will impact patient access to O&P services.” He calls on O&P clinicians and business owners to participate in state association meetings and join state professional organizations, and to engage with AOPA’s Co-OP. “These are places to connect with others who are facing similar challenges, share experiences, expand contacts, and plan actions leveraging the organization’s collective expertise.” Networking with allied healthcare providers and patient groups helps amplify messaging and assists clinicians in seeking guidance from their advocacy efforts. “I’ve found that hearing from different stakeholders— including patients and families—helps to add to the overall message, gain commitment at a higher level, and move actions along the path to positive change. “Staying connected with other healthcare professional groups, and reading monthly newsletters to see where overlapping topics may be of interest, is critical,” Johnson adds. “Collaborating as a profession helps amplify advocacy messages and provides a stronger platform for enacting change.” Increasing advocacy participation often involves tapping into a dedication and passion for the profession that goes above and beyond everyday responsibilities, according to Johnson. “Advocacy takes time, patience, organization, collaboration, and perseverance, and is often done after hours on top of other professional and personal responsibilities in an increasingly busy world,” he says. “I appreciate all of those involved with healthcare advocacy efforts to support specific populations or groups in need, and encourage those who are interested to take part. The O&P profession will continue to strengthen its role in the healthcare continuum through collective efforts at the state and national levels.” O&P ALMANAC | MAY 2022

MEMBER SPOTLIGHT

Impulse Technology

By DEBORAH CONN

Mimicking Human Movement Pennsylvania company offers prosthetic components aimed at restoring mobility

MPULSE TECHNOLOGY GOT ITS start in 2013 when two

MAY 2022 | O&P ALMANAC

Impulse Technology owners Kamrun Nahar, PhD, and Aman Haque, PhD, at a trade show exhibit booth not fit properly or do not allow

COMPANY: them a natural gait,” Nahar says. Impulse Technology “Over time, this can lead to addiOWNERS: Kamrun Nahar, PhD; Aman Haque, PhD; and Pennsylvania State University LOCATION: State College, Pennsylvania HISTORY: Nine years

Impulse Technology offers a passive prosthetic ankle component designed to mimic human movement.

tional pressure on their other limbs and joints, back problems, pain, and limited mobility. The more closely a prosthetic leg can mimic human movement, the better it will be for the person wearing it.” Nahar and her team proposed adding a passive prosthetic ankle component that allows a prosthetic leg to more closely mimic human movement, at a competitive price. “Our solution was granted Phase I and Phase II Small Business Innovative Research Funding to develop it further,” she explains. Today, Impulse Technology offers a 6-degree-of-freedom ankle prosthesis, Goralign PSA, that can be mounted on most commercially available prosthetic feet. While the device’s advanced functionalities can benefit all lower-limb amputees, Nahar says, it will be particularly helpful to individuals who do not have access to or cannot afford high-end robotic prostheses or are located in remote areas where access to prosthetic care is limited.

Deborah Conn is a contributing writer to O&P Almanac. Reach her at deborahconn@verizon.net.

PHOTOS: Impulse Technology

Pennsylvania State University researchers, Kamrun Nahar, PhD, and Aman Haque, PhD, founded the company to commercialize innovative ideas and products in high-impact mechanical and energy applications. “For me, it was doing something new in a different career path,” says Nahar, who was a research faculty member in the Engineering Sciences and Mechanics Department. “For Dr. Haque, a mechanical engineering professor, it was a way to apply his research to real-life applications in parallel to his academic career.” Jeffrey Brandt, CPO, founder of Ability Prosthetics & Orthotics and director of business development at Ottobock Patient Care, is the company’s business advisor. “Jeff is a Penn State graduate, and we met him through clinical research [Ability P&O] was doing in conjunction with the university,” Nahar explains. Impulse Technology has five employees, including full-time mechanical engineers, parttime mechanical engineering technicians and research assistants, and administrative and marketing support staff. The business is located in State College, Pennsylvania, at Innovation Park, a business incubator and real estate space owned by Penn State. In 2017, the company learned that the Defense Health Agency at the U.S. Department of Defense was seeking to create prosthetic legs to give users improved mobility and comfort. “People with below-knee amputations often struggle with prostheses that do

“The product is a passive structure that offers self-alignment with variable stiffness in all planes of motion,” explains Nahar. “It ‘extends’ the optimal range of the dynamic alignment performed by the prosthetist, mitigating the negative effects of misalignment. This also enhances the mobility of the user by adapting to the changes in gait or terrain” and absorbing shock during heel strike and during twisting and bending. The company is working with Ability P&O in fitting patients with the Goralign PSA. “We are expanding our partnerships with other prosthetic clinics to fit the device and offer other prosthetic products in the pipeline,” Nahar says. The company markets heavily in the United States and abroad and participates in industry trade shows and conferences, including the AOPA National Assembly. Nahar recognizes the challenges facing Impulse Technology as a startup as it tries to penetrate the market and develop trust and brand reputation. She has noted the trend of consolidation and mergers in the industry and expects a smaller number of large corporations to influence patient care and the overall industry. “We plan to partner with larger manufacturers, patient-care facilities, and other stakeholders for our innovations and products to reach the patients,” she says. “The road to success might not always be a straight one,” acknowledges Nahar, “but we are taking on these challenges and plan to offer additional innovative product options for prosthetists to serve their patients.”

CALL FOR VOLUNTEERS

Drive Transformation Build your network. Advance your career. Give back to the profession. Volunteer for a Workgroup and/or Committee.

The American Orthotic & Prosthetic Association (AOPA) has opened its annual call for volunteers and we need your talent. Employees of all AOPA member companies are invited to serve on one of AOPA’s Committees and/or Workgroups.

Don’t miss this exciting opportunity to become involved in the O&P profession by supporting AOPA and your colleagues!

AOPA VOLUNTEER

COMMITTEES | WORKGROUPS  Coding and Reimbursement Committee  Government Relations Committee  Member Services Committee  Operating Performance and Compensation Workgroup

APPLICATION DEADLINE: JUNE 30, 2022 Terms of service are two-years and begin December 1, 2022.

 Research Committee  State Representatives  VISN Network

Learn more and submit your application at www.AOPAnet.org/volunteer. QUESTIONS? Contact Betty Leppin at bleppin@AOPAnet.org or 571-431-0810.

www.AOPAnet.org

MEMBER SPOTLIGHT

Prosthetic & Orthotic Institute

By DEBORAH CONN

Clinicians With Compassion Southern facility focuses on patient care and ventures into 3D printing

ELVIN JONES, CPO, KNEW

MAY 2022 | O&P ALMANAC

Staff at Prosthetic & Orthotic Institute has worked tirelessly in developing processes and dashboard drivers we use to gauge our business health,” says Jones. The success of those processes has led Jones to LOCATION: work with other independent O&P Rock Hill and owners to improve their systems. Jones and Sorrells adhere to Lancaster, five core values in business that South Carolina, have become the “POI way,” says and Charlotte, Jones. These values focus on conNorth Carolina tinuous improvement, responsive care, positive patient experiences, OWNERS: showing appreciation, and owning Kelvin Jones, CPO, their work, according to Jones. and Russell Sorrells POI’s services are equally diversified in orthotics and HISTORY: prosthetics. About 20% of 25 years the company’s orthotics work is pediatric, including cranial remolding helmets. “One of our priorities is continuing to enlarge our footprint in scoliosis bracing and other complex pathologies,” Jones says. “Brenda Sorrells, CO, who is Russell’s wife, has helped to solidify our position in pediatrics.” The facility has 13 employees, Russell Sorrells and including clinicians Sorrells; Kelvin Jones, CPO

FACILITY: Prosthetic & Orthotic Institute

Joshua Parker, CPO; Terry Gordon, CPO; and James “Fig” Newton, CFo, with offices in Charlotte, North Carolina, and Rock Hill and Lancaster, South Carolina. POI recently ventured into 3D printing technology, with the goal of reducing turnaround time between initial evaluations and delivery. “We have our own 3D printer,” says Jones. “We are printing our own prosthetic sockets and have recently fabricated faceguards for athletes with facial fractures, allowing them to return to their sports. Our goal is eventually to offer central fabrication services for other facilities.” POI uses OPIE outcome measures for its prosthetic K-level training and templates, as well as the Amputee Mobility Predictor before and after patients are fitted for a prosthesis. Clinicians also use the Timed Up and Go test for orthotics patients. Among Jones’s favorite patient success stories is a woman who required a below-knee amputation after a failed knee surgery. Today she hikes, teaches a cycling class at the local YMCA, and attends several athletic training classes. “She is a great example of perseverance. Her attitude and determination are driving factors in her ability to function,” he says. “I really want to stress that my staff and I don’t have to do this; we get to do it,” Jones says. “I speak for all of us when I say we enjoy caring for our patients in the community.” Deborah Conn is a contributing writer to O&P Almanac. Reach her at deborahconn@verizon.net.

PHOTOS: Prosthetic & Orthotic Institute

as a middle schooler that he wanted to own a business one day. In eighth grade, after his best friend was in a boating accident and lost his foot, Jones decided he wanted that business to be in the O&P profession. “I had the opportunity to visit my first O&P practice in 1992 with my friend, and I found prosthetics fascinating,” Jones recalls. After finishing his undergraduate internship, Jones earned a bachelor’s degree in sports medicine and worked as an O&P technician for the next two years. He graduated from Northwestern University’s O&P program and became certified in prosthetics and orthotics in 2004. Jones joined Tom Fehl, CPO, at the Prosthetic & Orthotic Institute, or POI, in 2008. Fehl, who had founded the practice in 1997, served as a mentor to Jones. “Sitting under Tom was great for me as a young practitioner learning to navigate patient care, reimbursement, and the business aspect of O&P,” he says. After working as a clinician at POI for more than nine years, Jones joined his friend and business partner, Russell Sorrells, in acquiring the business in 2017. Jones credits Sorrells for helping POI reach a high level of success and professionalism. Jones also credits POI’s success to the administrative team executing the business model that he and Sorrells implemented five years ago. “Russ has been a critical component in establishing the intentional culture we want every team member at POI to have. He

AOPA NEWS

AOPAversity Webinars

OIN AOPA EXPERTS

for the most up-todate information on specific topics during these one-hour webinars, held the second Wednesday of each month at 1 p.m. ET. One registration is all it takes to provide the most reliable business information and CE credits for your staff at a single office location. Visit www.AOPAnet.org/education/monthly-webinars for details and registration information.

UPCOMING WEBINARS

June 8 SWOs, PODs, ABNs, AOBs: Your “MustHave” Documentation

Everyone focuses on the medical necessity documentation, but what about the everyday documentation you need to have in your records? The June webinar will focus on the administrative documentation that is required to be on file. Learn when you must obtain a new standard written order, and what it must include. Review when and who can sign an ABN, and much more.

Purchase the 2022 AOPA Quick Coder The 2022 AOPA Quick Coder is now available! A speedy reference to HCPCS codes for all orthotic, shoe, and prosthetic codes and modifiers, the Quick Coder also provides references for inpatient billing and offthe-shelf versus custom-fit coding. Changes are being made to the codes on a biannual basis. If a change is made during 2022, AOPA will notify you to ensure your Quick Coder remains up to date throughout the year. To purchase the Quick Coder, access your AOPA Connection account. Email questions to info@AOPAnet.org.

July 13 Clinicians’ Corner— Orthotics: How To Get Started In Digital Workflow, From Scanning to Carving to 3D Printing

Join AOPA for the second Clinicians’ Corner of 2022, when experts will discuss digital workflow and “the next steps for O&P.” On July 13, AOPA will provide tips, tricks, and insights for orthotists looking to step up their technologies. This webinar is available for scientific credits.

August 10 Roadmap to Appeals Hear the latest information about the O&P appeals process—mark your calendar now for the August 10 webinar.

Welcome New AOPA Members

HE 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. Amparo Prosthetics Inc. 2828 E. Wander Circle Holladay, UT 84117 385/249-5196 www.amparo.world/home-en Wesley Teerlink Supplier/Startup Pelican Orthotics & Prosthetics 69156 Highway 190 Service Road Covington, LA 70433 985/276-4560 www.pelicanop.com Kenny Capritto, CO Patient-Care Facility

Ralph Nobbe Consulting 1474 Camellia Circle Carpinteria, CA 93013 805/689-2826 Ralph Nobbe Supplier/Consultant RTT Medical Billing Consultants P.O. Box 780991 San Antonio, TX 78278 210/454-2519 https://rttmedical.com/ Rita Fuentes Supplier/Consultant

O&P ALMANAC | MAY 2022

MARKETPLACE

Feature your product or service in Marketplace. Contact Bob Heiman at 856/520-9632 or email bob.rhmedia@comcast.net. Visit bit.ly/AOPAMedia2022 for advertising options.

Zeus—The Strongest Bionic Limb Aether Biomedical presents Zeus—the strongest bionic limb in the world with over 33 lbf of grip force, ensuring a firm grasp. Zeus is also extremely robust, with a patent-pending impact resistance mechanism. It can also carry loads up to 77 lbs, allowing amputees to perform tough and heavy jobs. Owing to its modular design, Zeus can be repaired locally by a clinician—100%. Additionally, it comes with a web-based software, allowing clinicians to configure the device remotely. Contact us for a free demo at 678/779-6571 or visit www.aetherbiomedical.com.

KiddieFLOW™ by Allard USA

Allard USA has extended its pediatric AFO line with KiddieFLOW™ in response to clinician requests for an orthosis with more foot plate flexibility. KiddieFLOW™ allows for better control of foot positioning in late swing, which aids in stability during stance. FLOW models offer increased range of motion in the sagittal plane and a smoother transition (flow) throughout the gait cycle. For more information, contact Customer Service at 888/678-6548 or info@allardusa.com and request your free Product Selection Guide!

MAY 2022 | O&P ALMANAC

ALPS™ Superior Suspension Sleeve ALPS™ Superior Suspension Sleeve (SFB), available in either GripGel or HD Gel, features a black fabric that allows the user excellent freedom of knee ﬂexion. It achieves secure suspension by sealing with the skin without restricting circulation or causing shear forces. Plus, its thin proﬁle makes the SFB an ideal choice for those concerned about bulk. Top features and benefits include: • Choice between High Density (HD) Gel or GripGel: o HD Gel provides a tacky and secure fit o GripGel provides active amputees a great degree of control • Available in 2-mm uniform thickness • Freedom of knee flexion • Provides a secure suspension. To learn more about ALPS’ Superior Suspension Sleeve, visit www.easyliner.com or call 727/528-8566 or 800/574-5426.

The Original Preflexed Suspension Sleeve ESP created the Flexi family of suspension sleeves as a comfortable, durable, and cost-effective alternative to traditional suspension sleeves. Preflexed at 43 degrees for maximum comfort and natural unrestricted movement. For more information, call ESP LLC at 888/932-7377 or visit www.wearesp.com.

MARKETPLACE TASKA Myoelectric Multiarticulating Hand The TASKA myoelectric multiarticulating hand is a robust, IP67 rated waterproof/dustproof terminal device for users with an active lifestyle. The encoded laterally compliant fingers and high-speed thumb rotation give the user the precision needed for fine manipulation in everyday tasks and makes securing tools in the hand simple. Breakaway knuckle clutches deliver durability and protection not found in other hands. Multiple programmable grip patterns provide confident grasp of objects, and the internal 2000-mAh battery means it’s long lasting. Fillauer is the exclusive distributor for TASKA® in the United States, Canada, and Scandinavia. For more information, visiti www.fillauer.com.

Hersco 3D Printing Hersco is delighted to offer HP’s advanced 3D-printing technology for custom orthotics. 3D printing has unique design capabilities not possible with other methods—reducing landfill waste by 90%! The accuracy of 3D is unparalleled, specs exceed direct-milled polypro, and manual plaster fabrication. Among the benefits: a 90% reduction in landfill waste, many new design possibilities for posting, and the ability to vary thickness and flexibility across the shell. The PA-11 polymer is a biobased renewable material that has been tested and proven in research and industry. Call today, 800/301-8275, for a free sample.

Comfortable, Intuitive, and Precise

Naked Prosthetics

It’s all about function. We are the manufacturers of durable prosthetic devices specifically for finger and partial-hand amputations. Our aim is to positively impact our wearers’ lives by providing high-quality finger prostheses. We offer four devices: MCPDriver (shown in rose gold), PIPDriver, ThumbDriver, and our newest device, the GripLock Finger. Our devices help to restore length, pinch, grasp, stability, and protection for sensitive residuum. Robust device engineering and their ability to withstand harsh environments help get people back to performing activities of daily living, and back to work. All available in a dozen color coatings to match our wearers’ preferences and styles. To learn more, visit www.npdevices.com.

The bebionic hand transforms the lives and abilities of amputees around the world. With 14 different grips and hand positions, this hand makes it easy to carry out dayto-day activities such as eating meals, carrying bags, opening doors, switching on lights, typing, and more. Individual motors in each finger allow users to precisely control the hand and grasp objects in a natural, coordinated way. Available in two different sizes with multiple cover options, the bebionic hand is best paired with the MyoPlus pattern recognition system for direct and intuitive control. Learn more at shop.ottobock.us. O&P ALMANAC | MAY 2022

MARKETPLACE Your Patients Trust You To Deliver the Best Care

Quattro by PROTEOR Freedom QUATTRO microprocessor knee (MPK) by PROTEOR is designed to give users the freedom to live their lives without interruption. With PROTEOR’s innovative H.A.R.T. Control Technology, Quattro is the first MPK to provide a unique customized experience that captures users’ distinctive gait patterns. Boasting 20 user modes, remote data capture, outcome measure reporting, and independent resistance for stairs/ramps and sitting, it challenges and drives the status quo for MPKs to the next level. For more information, visit www.FreedomQuattro.com.

The Xtern, a Life-Changing Solution for Foot Drop Patients by Turbomed Orthotics

You commit to their quality of life every time you trust Ottobock’s C-Leg. As the original microprocessorcontrolled knee (MPK), C-Leg redefined the standard of care for above-knee amputees. Featuring technology to keep your patients safe with real-time adaptation across terrains and speed, this knee has an unmatched, industryleading track record. After 25 years, the microprocessor technology of the C-Leg continues to raise the bar for an industry that demands innovation to achieve one primary goal: to give amputees the mobility they deserve. To learn why C-Leg is the most studied, proven, and preferred MPK, visit shop.ottobock.us.

MAY 2022 | O&P ALMANAC

Say goodbye to your painful and stiff in-shoe orthosis! This revolutionary brace, specifically designed for people suffering from foot drop, has one thing in mind: movement. The Xtern sits entirely outside the shoe (and, to add to that, to any shoe!), and is so flexible that it allows maximal range of motion and calf muscle strength. No more rubbing injuries or skin breakdowns: You’ll barely notice it’s there. Walking, running, mountain climbing, skiing? Not a problem! The Xtern will follow you as far and as long as you want. Turbomed’s innovative products are designed in Quebec, Canada, sold in more than 30 countries around the world, and distributed by Cascade in the United States. Visit turbomedusa.com, and think outside the shoe!

Photo: AdobeStock: dimdimich

Become a digital visitor of OTWorld! Discover the free of charge digital live programme: • streamed highlight sessions of the World Congress • 27 Innovation Talks of selected OTWorld exhibitors • explore more than 400 exhibitors from 32 countries in the digital Product and Exhibitor World

Join OTWorld.live at www.ot-world.com

Missed the live programme? Access the World Congress recordings with a Congress-on-Demand ticket even until 31st July. There is also a wide range of content available free of charge.

International Trade Show and World Congress

10 – 13 May 2022 Leipzig, Germany www.ot-world.com

AOPA NEWS

CAREERS

Opportunities for O&P Professionals

Southeast Certified Prosthetist/Orthotist $10,000 sign-on!

Job Location Key: - Northeast - Mid-Atlantic - Southeast - North Central - Inter-Mountain - Pacific

Hire employees and promote services by placing your classified ad in the O&P Almanac. Include your company logo with your listing free of charge. Refer to www.AOPAnet.org for content deadlines. Ads can be posted and updated any time online on the O&P Job Board at jobs.AOPAnet.org. No orders or cancellations are taken by phone. Send classified ad and payment to: O&P Almanac, Calendar, P.O. Box 34711, Alexandria, VA 22334-0711 or email jburwell@AOPAnet.org along with VISA or MasterCard number, cardholder name, 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.

Birmingham, Alabama AHR is currently seeking a certified prosthetist/orthotist (CPO) to join a top academic healthcare system in Birmingham and Alabama’s largest single-site and most desirable employer! Position Requirements: Education and Experience: • Required: B.S. in orthotics/prosthetics from CAAHEPor NCOPE-accredited program, or B.S. in any major plus an orthotic and/or prosthetic certification form a CAAHEP- or NCOPE-accredited program. License, Certification, and/or Registration: • Required: Board-certified orthotist/prosthetist, licensed by the Alabama State Board of Prosthetists and Orthotists Benefits: • Significant competitive compensation structure with $10,000 sign-on. Robust benefits/amenities package.

O&P Almanac Careers Rates Color Ad Special 1/4 Page ad 1/2 Page ad

Member $482 $634

Nonmember $678 $830

Contact: Debbie Whittington Email: dwhittington@ahrstaffing.com

Listing Word Count 50 or less 51-75 76-120 121+

Member $140 $190 $260 $2.25 per word

Nonmember $280 $380 $520 $5 per word

WANTED!

ONLINE: O&P Job Board Rates Visit the only online job board in the industry at jobs.AOPAnet.org. Job Board 50 or less

Member $85

Nonmember $280

For more opportunities, visit: http://jobs.AOPAnet.org. SUBSCRIBE

A large number of O&P Almanac readers view the digital issue— If you’re missing out, visit issuu.com/americanoandp to view your trusted source of everything O&P.

MAY 2022 | O&P ALMANAC

A few good businesses for sale. Lloyds Capital Inc. has sold over 150 practices in the last 26 years. If you want to sell your business or just need to know its worth, please contact me in confidence. Barry Smith Telephone: (O) 323/722-4880 • (C) 213/379-2397 Email: loyds@ix.netcom.com

CAREERS If you have any questions, please feel free to contact Dr. Christopher Hovorka.

Inter-Mountain Director of Residency Education Position AND Teaching Faculty Position Orthotics and Prosthetics Program Midwestern University, Glendale, Arizona

The Midwestern University (MWU) Orthotics and Prosthetics Program Glendale, Arizona invites applications for two open positions, a Director of Residency Education, and a Teaching Faculty Position. Each position is a full-time, 12-month, tenure track faculty appointment beginning July 1, 2022. The Master of Science in Orthotics and Prosthetics is a 30-month curriculum that consists of a 12-month on-campus didactic-formative education phase, and an embedded 18-month off-campus residency education phase. Qualified applicants must possess an earned Master’s degree in Orthotics and Prosthetics (or a related field), clinical experience, and ABC certification in Orthotics and Prosthetics (or have the equivalent ISPO recognized Category I credential). It is preferred that the applicants hold dual-discipline certification (e.g., CPO). To learn more about each of the positions, please visit MWU’s online job board at www.midwestern.edu. • In the Quick Links section, select “Employment at MWU” • Select “Employment Opportunities” • Select “Faculty” for job category, “Arizona” for location and click “Search”.

Christopher Hovorka, PhD, CPO, FAAOP Director and Assistant Professor Orthotics and Prosthetics Program Glendale Hall, 201-33 19555 N. 59th Avenue Glendale, AZ 85308 Email: chovor@midwestern.edu Office: 623/572-3739

Finding your next job or hire just got easier with the AOPA Career Center. For Job Seekers: Job searching is easy with the pane-view job search page. Set up job alerts, upload your resume or create an anonymous career proﬁle that leads employers to you. For Employers: Reach 4,500+ O&P professionals through the Job Flash™ email. Ensure high visibility for your open positions through this highly engaging email.

For more information on recruitment options, contact Customer Service at clientserv@communitybrands.com or (727) 497-6565.

AOPA_PrintAd.indd 1

8/19/21 8:022022 PM | MAY O&P ALMANAC

CALENDAR

September 14

An Operations Presentation. 1 PM ET. Register at www.AOPAnet.org. Monthly Webinar

September 28–October 1

AOPA National Assembly. San Antonio, TX. For more information, visit www.AOPAnet.org.

October 12

Clinicians’ Corner—Prosthetics. 1 PM ET. Register at www.AOPAnet.org. Monthly Webinar

November 9

2022

The Do’s & Don’ts of Gift Giving. 1 PM ET. Register at www.AOPAnet.org. Monthly Webinar

May 1–31

November 9–11

ABC: Application Deadlines, Exams Dates, O&P Conferences, and More! Check out ABC’s Calendar of Events at ABCop.org/calendar for the latest dates and event details, so you can plan ahead and be in the know. Questions? Contact us at info@abcop.org or visit ABCop.org/contact-us.

New Jersey Chapter of American Academy of Orthotists and Prosthetists (NJAAOP) Meeting. Atlantic City, NJ. For more information, visit www.njaaop.org/annual-meeting.

June 8

SWOs, PODs, ABNs, AOBs: Your Must-Have Documentation. 1 PM ET. Register at www.AOPAnet.org. Monthly Webinar

2023 May 19–20

June 24–25

Nashville Renaissance Hotel and Conference Center In-Person Meeting. For more information, contact Cathie Pruitt at 901/359-3936, email pruittprimecare@gmail.com, or Jane Edwards at 888/388-5243, email jledwards@attnet. Visit www.primecareop.com.

Orthotic & Prosthetic Innovative Technologies Conference. Minneapolis, MN. For updates, check our website at optech.ucsf.edu. Email cme@gilletteSave Lorem Ipsum childrens.com tothe beDate! added to conference mailing list. May 19 & 20, 2023

September 6–8

AOPA National Assembly. Indianapolis, IN. For more information, visit www.AOPAnet.org.

July 13

Clinicians’ Corner—Orthotics: How To Get Monthly Webinar Started Into Digital Workflow. From Scanning, to Carving, to 3D Printing, the Next Step for O&P. 1 PM ET. Register at www.AOPAnet.org.

August 10

Roadmap to Appeals. 1 PM ET. Register at www.AOPAnet.org.

Monthly Webinar

Calendar Rates

Let us share your next event!

Phone numbers, email addresses, and websites are counted as single words. Refer to www.AOPAnet.org for content deadlines. Send announcement and payment to: O&P Almanac, Calendar, P.O. Box 34711, Alexandria, VA 22334-0711 or email jburwell@ AOPAnet.org along with VISA or MasterCard number, cardholder name, 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.

MAY 2022 | O&P ALMANAC

Words/Rate 25 or less 26-50 51+

Member $40 $50 $2.25/word

Nonmember $50 $60 $5.00/word

Color Ad Special 1/4 page Ad 1/2 page Ad

$482 $634

$678 $830

For information on continuing education credits, contact the sponsor. Questions? Email info@AOPAnet.org.

Welcome to AOPA Connection, the one-stop-shop for all things AOPA. Logging into AOPA Connection you will instantly have access to all your AOPA benefits, including: • AOPAversity • Your Membership Record • Your Individual Profile • Event Calendar • Bookstore • Co-OP But, it doesn’t stop there! We are pleased to introduce a new benefit accessible through AOPA Connection, My O&P Community. In this online community of your O&P colleagues you can get guidance, share advice, have one-on-one and group conversations, and access resources.

MyAOPAConnection.org

AD INDEX

Advertisers Index Company

Page

Phone

Website

Aether Biomedical

703/201-7343

www.aetherbiomedical.com

Allard USA Inc.

866/678-6548

www.allardusa.com

ALPS South LLC

800/574-5426

www.easyliner.com

Amfit

800/356-3668

www.amfit.com

Cailor Fleming Insurance

800/796-8495

www.cailorfleming.com

ESP LLC

888-WEAR-ESP

www.wearesp.com

Fillauer

800/251-6398

www.fillauer.com

Hersco

800/301-8275

www.hersco.com

Naked Prosthetics

888/977-6693

www.npdevices.com

Ottobock

800/328-4058

www.professionals.ottobockus.com

PROTEOR USA

855/450-7300

www.proteorusa.com

TurboMed Orthotics Inc.

888/778-8726

www.turbomedorthotics.com O&P ALMANAC | MAY 2022

STATE BY STATE Become an AOPA State Rep.

State-Level Grassroots Advocacy

If you are interested in participating in the AOPA State Reps network, email smiller@AOPAnet.org.

Updates on AOPA’s efforts in California, Iowa, and New York

Each month, State By State features news from O&P professionals about the most important state and local issues affecting their businesses and the patients they serve. This section includes information about medical policy updates, fee schedule adjustments, state association announcements, and more. These reports are accurate at press time, but constantly evolve. For up-to-date information about what is happening in your state, visit the Co-OP at www.AOPAnet.org/resources/co-op.

LONG WITH A FEDERAL ACTION CENTER at AOPAVotes.org, AOPA

has recently deployed a powerful Capitol Canary grassroots advocacy platform to address several state-level policy challenges. By engaging AOPA members and making their voices heard in statehouses across the country, we can advance the interests of the O&P field and ensure that policymakers understand the concerns of O&P professionals. Here is a glimpse into a few of AOPA’s state advocacy campaigns.

California

In collaboration with the California Orthotic and Prosthetic Association, AOPA has created a California Action Center to host an advocacy campaign focused on increasing Medi-Cal reimbursement rates for O&P. This two-pronged grassroots campaign is focused on influencing the state budget request process as well as garnering legislator support for AB 1982. Visit the California Action Center at https://p2a.co/ybh6dtq.

Iowa

AOPA has worked with the Iowa Prosthetic, Orthotic, and Pedorthic Association to support HF 2411, legislation that would require 48

MAY 2022 | O&P ALMANAC

employers to furnish medically necessary prosthetic repair and replacement for workers’ compensation patients. To gather support for the bill, AOPA has created an Iowa Action Center, adapting the grassroots campaign to target key policymakers as the bill moves first through the House and then through the Senate. Visit the Iowa Action Center at https://p2a.co/janxfeb.

New York

Last year, AOPA drafted and introduced a bill that would direct the New York Commissioner of Health to study Medicaid O&P coverage. Complementing this legislation is AOPA work supporting a group of member advocates in the state as they push for increased Medicaid reimbursement. AOPA has created a New York Action Center with grassroots campaigns supporting both of these efforts. Visit the New York Action Center at https://p2a.co/4sthmnf.

Share Experiences in Your Home State

AOPA is here to help you better serve your patients. If you’re encountering a policy challenge in your state, contact Sam Miller, AOPA’s state and federal advocacy manager, at smiller@AOPAnet.org.

Are you ready to take your career and your business expertise to new heights? The all new Certificate in O&P Business Management can help you do just that!

A comprehensive certificate program for business owners, managers, and practitioners of O&P patient care facilities, O&P manufacturers and AREAS OF LEARNING distributors to explore crucial business challenges as they relate to O&P.

This joint certificate program will provide you with: • Basic business acumen • Practical knowledge to apply immediately to your work • Techniques for developing better business practices • How to think about improving your company’s returns

Areas of Learning include:

HEALTHCARE OPERATIONS Learn techniques for planning, design, operation, control, and improvement of the processes needed to operate your business efficiently.

To complete the certificate program, you must register and complete one core course and one elective course from each of the four areas of learning within a four-year period.

Certificate in O&P Business Management AREA OF LEARNING

CORE

ELECTIVES

Healthcare Operations

Healthcare Operations for O&P Professionals

Mastering Medicare

Healthcare Management

Healthcare Management for O&P Professionals

Elective

Finance

Financial Management for O&P Professionals

Elective

Sales and Marketing

Sales and Marketing for O&P Professionals

Elective

HEALTHCARE MANAGEMENT Increase your knowledge and skills to better manage multiple, individual, and team priorities.

FINANCE

SALES AND MARKETING

Learn business financial management concepts and perspectives for Healthcare Today, Business Models, Accounting & Finance Pillars, and Strategic Decisions

Learn the functions of marketing along with a variety of tools and approaches to personal selling along with the many digital marketing tools available.

EARNING YOUR CERTIFICATE IS AS YOUR CERTIFICATE EASY AS 1-2-3

EARNING IS AS EASY AS 1-2-3 1.

Select and complete within 4 years

• 4 core courses from UHart’s Barney 1. Sign up with AOPA for the program School of Business - Online • 4 elective courses through AOPA

3. Graduation ceremony at the National 2. Select and complete within 4 years Assembly • 4 core courses from UHart’s Barney School of Business - Online • 4 elective courses through AOPA

3. Graduation ceremony at the National Assembly

Visit bit.ly/AOPACP to sign up for the certificate program. Questions? Contact info@AOPAnet.org.

Confidence in every step. Wherever your patient wants to go, the 3R80 can take them there.

professionals.ottobockus.com

May 2022 O&P Almanac

Articles inside

State By State

Marketplace

People & Places

Matthew Johnson, MPT, CEEAA

Member Spotlight

Views From AOPA Leadership

AOPA Contacts

Reimbursement Page

Calendar