November 2012 Almanac

OP

The American Orthotic & Prosthetic Association

NOVEMBER 2012

&

WWW.AOPANET.ORG

THE MAGAZINE FOR THE ORTHOTICS & PROSTHETICS INDUSTRY

ShoeS and orthotic

intervention the success of any foot orthosis depends on the proper choice of footware

SPECIAL: 2012 Foot-Care Buyer’S Guide In Review: 2012 AOPA national aSSemBly

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O&P Almanac CONTENTS

NOVEMBER 2012, VOLUME 61, NO. 11

COLUMNS

Cover Story

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20

the Importance of Shoes in Pedorthics

By Deborah Conn The success of any foot orthosis, from an AFO to an orthotic insert, depends on the proper choice of shoe.

Fit, construction, materials, and comfort are all important considerations in selecting appropriate footware.

Feature

26

2012 Conference Recap: Making History in Boston During AOPA’s 2012 National Assembly, a record-breaking 2,300 attendees experienced first-hand some of the latest innovations, including gait analysis equipment, in-house fabrication tools, infant cranial orthoses, and much more.

SPeCIaL

42

2012 Foot-Care Buyer’s Guide The O&P Almanac’s seventh annual Foot-Care Buyer’s Guide is a one-stop resource for O&P foot-care products and services.

Reimbursement Page Seven steps to an effective compliance program

dePaRtMeNtS

4

aOPa Contact Page How to reach staff

6

at a Glance Statistics and O&P data

08

In the News Research, updates, and company announcements

32

aOPa Headlines News about AOPA initiatives, meetings, and more

41 00

aOPa Membership applications

52

Jobs Opportunities for O&P professionals

57

Calendar

59

ad Index

60

aOPa answers Expert answers to your FAQs

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

NOVEMBER 2012 O&P AlmAnAc

3

AOPA IN THE CONTACT NEWS INFORMATION

AmERIcAn ORTHOTIc & PROSTHETIc ASSOcIATIOn (AOPA) 330 John Carlyle St., Ste. 200, Alexandria, VA 22314 AOPA Main Number: 571/431-0876 AOPA Fax: 571/431-0899 www.AOPAnet.org eXeCUtIve OFFICeS

MeMBeRSHIP aNd MeetINGS

thomas F. Fise, Jd, executive director, 571/431-0802, tfise@AOPAnet.org

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

don deBolt, chief operating officer, 571/431-0814, ddebolt@AOPAnet.org O&P aLMaNaC thomas F. Fise, Jd, publisher, 571/431-0802, tfise@AOPAnet.org Josephine Rossi, editor, 703/914-9200 x26, jrossi@strattonpublishing.com Catherine Marinoff, art director, 786/293-1577, catherine@marinoffdesign.com dean Mather, advertising sales representative, 856/768-9360, dmather@mrvica.com Stephen Custer, staff writer, 571/431-0876, scuster@AOPAnet.org Lia K. dangelico, contributing writer, 703/914-9200 x24, ldangelico@strattonpublishing.com Christine Umbrell, editorial/production associate, 703/914-9200 x33, cumbrell@strattonpublishing.com

Kelly O’Neill, manager of membership and meetings, 571/431-0852, koneill@AOPAnet.org Stephen Custer, coordinator, membership operations and meetings, 571/431-0876, scuster@AOPAnet.org Lauren anderson, coordinator, membership operations and meetings, 571/431-0843, landerson@AOPAnet.org aOPa Bookstore: 571/431-0865 COMMUNICatIONS Steffanie Housman, content strategist, 571/431-0835, shousman@AOPAnet.org Steven Rybicki, communications manager, 571/431-0835, srybicki@AOPAnet.org

OP Almanac &

PUBLISHeR Thomas F. Fise, JD edItORIaL MaNaGeMeNt Stratton Publishing & Marketing Inc. adveRtISING SaLeS M.J. Mrvica Associates Inc. deSIGN & PROdUCtION Marinoff Design LLC PRINtING Dartmouth Printing Company

BOARD OF DIREcTORS OFFIcERS President thomas v. diBello, CO, FaaOP, Dynamic O&P, a subsidiary of Hanger Inc., Houston, TX President-Elect tom Kirk, Phd, Hanger Inc., Austin, TX Vice President anita Liberman-Lampear, Ma, University of Michigan Orthotics and Prosthetics Center, Ann Arbor, MI

GOveRNMeNt aFFaIRS

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

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

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

devon Bernard, manager of reimbursement services, 571/431-0854, dbernard@AOPAnet.org Joe Mcternan, director of coding and reimbursement services, education and programming, 571/431-0811, jmcternan@AOPAnet.org Reimbursement/Coding: 571/431-0833, www.LCodeSearch.com a

Executive Director/Secretary thomas F. Fise, Jd, AOPA, Alexandria, VA

DIREcTORS Kel M. Bergmann, CPO, SCOPe Orthotics and Prosthetics Inc., San Diego, CA Michael Hamontree, Hamontree Associates, Irvine, CA Russell J. Hornfisher, MBa, MSOd, Becker Orthopedic Appliance Co., Troy, MI alfred e. Kritter, Jr., CPO, FaaOP, Hanger Inc., Savannah, GA

www.LCodeSearch.com the O&P coding expertise you’ve come to rely on is now available whenever you need it.

•

Match products to L codes and manufacturers— anywhere you connect to the Internet.

•

this exclusive service is available only for aOPa members.

Contact Lauren Anderson at 571/431-0843 or landerson@AOPAnet.org.

Michael Oros, CPO, Scheck & Siress, Chicago, IL Frank vero, CPO, Mid-Florida Prosthetics & Orthotics, Ocala, FL

Log on to LCodeSearch.com and start today.

Not an aOPa member? Get CONNeCted

visit aOPa at www.aOPanet.org.

MaNUFaCtUReRS: Get your products in front of AOPA members!

Contact Joe McTernan at jmcternan@AOPAnet.org or 571/431-0811.

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O&P AlmAnAc NOVEMBER 2012

Ron Manganiello, New England Orthotic & Prosthetic Systems LLC, Branford, CT Mahesh Mansukhani, MBa Össur Americas, Aliso Viejo, CA

eXPeRt COdING advICe 24/7 •

eileen Levis, Orthologix LLC, Philadelphia, PA

Copyright 2012 American Orthotic and Prosthetic Association. All rights reserved. This publication may not be copied in part or in whole without written permission from the publisher. The opinions expressed by authors do not necessarily reflect the official views of AOPA, nor does the association necessarily endorse products shown in the Almanac. The Almanac is not responsible for returning any unsolicited materials. All letters, press releases, announcements, and articles submitted to the Almanac may be edited for space and content. The magazine is meant to provide accurate, authoritative information about the subject matter covered. It is provided and disseminated with the understanding that the publisher is not engaged in rendering legal or other professional services. If legal advice and/or expert assistance is required, a competent professional should be consulted.

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AT IN THE A GLANCE NEWS

Feet and Foot Care about one quarter of the bones in the human body are found in the feet.

Here’s a breakdown of those bones:

Number of bones in each region of the foot…

HInDFOOT (talus and calcaneus):

2

mIDFOOT (5 tarsal bones):

5

Talus

Navicular

Calcaneus

total: FOREFOOT (5 metatarsal and 14 phalanges):

19

26

Phalange Metatarsal

Cuneiform

Cuboid

Source: “Foot Bone Anatomy” by V.K. Panchbhavi, M.D., et al.

100

Approximate number of muscles, tendons, and ligaments in each foot.

24%

Percentage of the U.S. population reporting at least one foot ailment.

1958

Year the Pedorthic Footcare Association was founded.

11

Number of states that have enacted pedorthic licensure requirements (Pennsylvania is the most recent to pass legislation).

90% Percentage of patients with rheumatoid arthritis who develop symptoms in the foot or ankle over the course of the disease.

208

Number of individuals who were certified by ABC to become certified pedorthists in 2011.

Sources: Pedorthic Footcare Association; Current Opinion in Rheumatology; the American Board for Certification in Orthotics, Prosthetics & Pedorthics; American Academy of Orthopaedic Surgeons.

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O&P AlmAnAc NOVEMBER 2012

THE MOST CLINICALLY PROVEN OA BRACE WITH A NEW TWIST. The Unloader line of braces by Össur are clinically proven to reduce pain and improve function for patients who wear them.

Recent clinical research* demonstrates that the Unloader One® provides decreased pain, improved function and reduction in pain medications for patients. * Briggs KK, Matheny LM, Steadman JR. Improvement in quality of life with use of an Unloader knee brace in active patients with OA: A prospective cohort study. J Knee Surg 2012; Advance online publication.

Retrieved 23rd August 2012. DOI:10.1055/S-0032-1313748

SmartDosing™ now available.

SmartDosing, powered by Boa® Technology, provides patients with a simplif ied, single-hand dosing dial for on-the-f ly adjustability of the dual Dynamic Force Straps (DFS), helping them better manage their unicompartmental OA knee pain.

Lightweight, low-profile and easy.

Unloader One‘s lightweight, low-profile design is barely noticeable to the user and fits comfortably under clothing. And, by utilizing the new SmartDosing dial, users can easily adjust the dual DFS tension right through their clothes.

Prescribe the Unloader One for any OA patient. If they are not happy with it for whatever reason, they can return it within 30 days for a full refund.

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IN THE NEWS

Neural Stem Cells May Regenerate Broken Spinal Cord Nerves Researchers have successfully regenerated axonal growth at the site of severe spinal cord injury. The research, conducted during a study at the University of California, San Diego, and the U.S. Department of Veterans Affairs San Diego Healthcare System, revealed that early stage neurons have the ability to survive and extend axons to form new, functional neuronal relays across an injury site in the central nervous system (CNS) of adult rats. The study also proved that at least some types of CNS axons can overcome a normally inhibitory growth environment to grow over long distances. Stem cells across species exhibit these properties.

The work was published in the September 14 issue of the journal Cell.

The scientists embedded neural stem cells in a matrix of fibrin (a protein key to blood clotting that is already used in human neuron procedures) mixed with growth factors to form a gel. The gel was then applied to the injury site of rats with completely severed spinal cords.

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O&P AlmAnAc NOVEMBER 2012

After six weeks, the number of axons emerging from the injury site exceeded (by 200-fold) what had ever been seen before, according to the scientists. In addition, the axons grew 10 times the length of axons in any previous study. The regeneration of these axons resulted in significant functional improvement.

In addition, adult cells above the injury site regenerated into the neural stem cells, establishing a new relay circuit that could be measured electrically. To confirm that the mechanism underlying recovery was due to formation of new relays, the spinal cords of the recovered were re-transected above the implant. The rats lost motor function—confirming formation of new relays across the injury.

According to the researchers, the study makes clear that early stage neurons can overcome inhibitors present in the adult nervous system that normally work to maintain the elaborate CNS and to keep cells in the adult CNS from growing aberrantly.

IN THE NEWS

CGS Retains DME MAC Contract

Foot Ulcers Respond To the Healing Powers of Honey A team of researchers in Greece has found that manuka honeyimpregnated dressings may speed the healing of diabetes-related neuropathic foot ulcers. Researchers attributed the enhanced healing to the antibacterial properties of the honey, which is produced in Australia and New Zealand from the nectar of the manuka tree. The study was published September 18 in the International Wound Journal.

Researchers found that patients with Type 2 diabetes who were treated with manuka honey-impregnated dressings applied to their foot ulcers saw a quicker healing process for their bacterial infections. In addition, the researchers noted that wound closure was not adversely affected by the antibacterial component of manuka honey. They concluded that future research is necessary to fully explain the healing effect of manuka honey on diabetes-related neuropathic foot ulcers.

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O&P AlmAnAc NOVEMBER 2012

The CMS has announced that CGS Administrators, headquartered in Nashville, Tennessee, has won a contract to continue as the Durable Medical Equipment Medicare Administrative Contractor (DME MAC) for Medicare’s Jurisdiction C. CGS has operated as a Medicare contractor since inception of the Medicare program in 1966.

The contract, which includes a base year starting Sept. 1, 2012,

and four option years, is valued at more than $170 million. CGS employs more than 900 people at its headquarters and more than 120 in offices in Des Moines, Iowa, and High Point, North Carolina. The new contract means current staffing levels will be maintained and there will be some new positions filled in the near future, according to a CGS press release.

For more information, visit the CMS website at www.cms.gov.

BOC Expands Year-Round Testing and Instant Scoring The Board of Certification/ Accreditation, International (BOC) has expanded year-round testing and instant test results, and now offers these options for all BOC multiple-choice and clinical simulation certification examinations.

BOC certification candidates may take their computer-based exams on

any business day throughout the year— and even some Saturdays—at locations nationwide. Once candidates complete their exams, they receive their results at the testing center.

For more information, visit the BOC website at www.bocusa.org/becomingcertified or contact BOC headquarters at 410/581-6222.

IN THE NEWS

O&P Almanac Merits Award

Study Compares Lateral Wedge Insoles and Valgus Braces for Osteoarthritis A team of researchers from the United Kingdom have conducted what they say is the first study to biomechanically compare insoles and braces in medial knee osteoarthritis (OA).

According to the research, published in Gait & Posture in August, increases in the external knee adduction moment have been associated with increased mechanical load at the knee and progression of knee OA. Valgus knee braces and lateral-wedged insoles are common approaches to reducing this loading.

Researchers compared the effectiveness of each of these modalities, concluding that there were no significant differences between the two treatments in any of the clinical outcomes; however, the lateral-wedged insoles demonstrated greater levels of acceptance by patients. Further, while both treatments reduce the potential role of knee loading in OA progression, lateral-wedge insoles appear to have a greater effect.

TRANSITIONS

peopLe in the newS

Susi Ebersbach, MT(ASCP), MBA, has joined Ability Prosthetics & Orthotics as an advanced billing and reimbursement specialist.

A.J. Gray has joined the clinical marketing team at Boston Brace.

Tom Kuelbs has joined Ottobock as market manager for orthotics.

Ottobock has promoted Adam McPherson to the position of U.S. market manager for the company’s microprocessor knee product area.

Amy Purdy, who has bilateral transtibial amputations, is competing in season 21 of The Amazing Race, which is currently airing on CBS. Purdy is a top-ranking adaptive snowboarder, motivational speaker, and co-founder of Adaptive Action Sports.

Scotti Sawyer has been appointed chief financial officer and controller at Ability Prosthetics & Orthotics, headquartered in Gettysburg, Pennsylvania.

The June 2011 issue of the O&P Almanac has been awarded a Certificate of Excellence by Graphic Design USA. The O&P Almanac was selected from among 8,000 entries, only 15 percent of which are recognized with Certificates of Excellence.

IN MEMORIAM Robert McKibben Miller Robert McKibben Miller passed away on September 26 in Ann Arbor, Michigan. Miller enjoyed a successful career as a businessman, where he contributed to the global growth of CAMP International until his retirement in 1989.

During his tenure at CAMP, he served a variety of roles and led expansion of the business into Europe, Latin America, and Asia Pacific before retiring as executive vice president.

Jack Schultz, CO Jack Schultz, CO, passed away on October 5. Schultz was a formidable force within the Wisconsin O&P field and within the Actra Rehabilitation organization, retiring in 2010. He was a founding member of the Wisconsin Society of Orthotists, Prosthetists, and Pedorthists, and a strong advocate for the O&P profession. Shultz was the loving husband of Carolyn; a devoted father of Kelly Schultz and Anne Marie Solomko; and the brother of Charles Schultz, CPO, CFo, and the late David Schultz, CPO (a past president of AOPA).

NOVEMBER 2012 O&P AlmAnAc

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IN THE NEWS

Be Counted By the U.S. Census Bureau Your O&P facility may be one of more than 4 million American businesses that will receive 2012 Economic Census forms this November or December. To ensure an accurate portrait of the American business climate, the Census Bureau asks that all businesses provide accurate and timely data. This information will be used in the coming years to help form public policy.

Return your form by Feb. 12, 2013.

TRANSITIONS

BUSineSSeS in the newS

AmpSurf, in conjunction with Operation Restore, hosted an adapted surfing event at Pismo Beach, California, in October.

pregnancy and became a quadruple amputee. To see a video showcasing the prosthetic work on this case, visit www. ec-op.com/east-coast-o-p-on-the-doctors/.

The Amputee Coalition has named David Dunville, Stella Sieber, and Troy Turner to serve on its Scientific and Medical Advisory Committee.

The International Paralympic Committee and Ottobock, Duderstadt, Germany, extended their worldwide partnership to include the Rio de Janeiro, Brazil, 2016 Paralympic Games.

The Amputee Coalition has been awarded certification through the National Health Council Standards of Excellence Certification Program. The three-year certification extends from Jan. 1, 2013, through Dec. 31, 2015.

Arimed Orthotics and Prosthetics recently opened its relocated Manhattan office, a newly designed and renovated 2,000-square-foot facility.

Cascade and Össur Americas have announced a new distribution agreement: Cascade will add Össur’s line of advanced mechanical feet, mechanical knees, liners, componentry, and prosthetic accessories to its distribution lines.

Ten athletes won national titles during the Disabled Water Ski National Championships, which were held in August at Shortline Lake, Elk Grove, California.

East Coast Orthotic and Prosthetic Corp. was featured in an episode of the television show, The Doctors.

The facility, led by Clinical Director Christopher Berger, CPO, created four prostheses for Shannon Smith, the mother who became septic during a

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O&P AlmAnAc NOVEMBER 2012

Knit-Rite Inc. has received ISO 13485:2003 certification for both of the company’s manufacturing facilities, located in Kansas City, Kansas, and Ellerbe, North Carolina.

Nobbe Orthopedics and President Ralph Nobbe, CPO, were honored during Santa Barbara’s Annual Mayor’s Awards. Nobbe received the Employment/Accommodation Award, recognizing an employer that reflects the spirit of the Americans With Disabilities Act in employment practices.

Athletes from Team Össur and Össur Ambassadors captured a total of 21 medals and set six world records during the 2012 Paralympic Games.

Oscar Pistorius, Blake Leeper, Jerome Singleton, and 12 other athletes were part of the Össur contingency at the Games.

The Rehabilitation Institute of Chicago has welcomed four new residents: Shenan Hoppe-Ludwig, Jed Newhardt, Tony Goldenstein, and Kathryn Johnson, CP.

A multidisciplinary team comprising researchers from Rice University; the University of Houston; and TIRR Memorial Hermann has been awarded a $1.2 million grant to further the development of and validate a noninvasive brain-machine interface (BMI) to a robotic orthotic device for upper-limb rehabilitation. The neurotechnology will interpret brain waves that let a stroke patient willingly operate an exoskeleton that wraps around the arm from the fingertips to the elbow. The grant was awarded by the National Institutes of Health and the President’s National Robotics Initiative.

Touch Bionics debuted shorter, narrower digits for i-limb digits during AOPA’s National Assembly in Boston.

The digits enable a wider group of wearers to have access to a partial hand prosthesis.

The University of Texas at El Paso has joined forces with LIMBS International, an international nonprofit organization that provides ultra-low-cost prostheses around the world, to provide new research and education opportunities for students.

A team from the Vanderbilt University School of Engineering was honored with the Wyss Institute-IEEE Engineering in Medicine and Biology Society Award for Translational Research for its work on a robotic prosthetic leg. Members of the team included mechanical engineering graduate students Brian E. Lawson and Amanda M. Huff as well as Michael Goldfarb, PhD.

your next move… if you’re currently working as an orthotic or prosthetic assistant, you’re already ahead of the game. gain recognition for your knowledge, training and experience. the next move is all yours.

A NEW Phase for the ABC Assistant Program Pathway 1 Expires September 30, 2012

Pathway 2 Expires December 31, 2012

Pathway 3

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Effective JANUARY 1, 2013 • candidates must meet the requirements of current pathway 2 - pluS -

• pass a disciplineSpecific exam

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Serving the orthotic, proSthetic, and pedorthic profeSSion for over 60 yearS.

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Reimbursement Page

By Kathy Dodson, AOPA government affairs department

Compliance Program Must-Haves Seven steps to an effective strategy

T

oday’s crazy environment of uber documentation requirements means it’s hard enough not to have Medicare question your filed paperwork due to its in-depth documentation demands. So, it’s only natural to be really unhappy if Medicare dings you on the normal, day-to-day documentation it has required all along.

A compliance program can make sure that doesn’t happen. Once in place, it will give you and your staff time to concentrate on the documentation that is harder to obtain.

A good compliance program consists of seven elements: • developing standards of conduct and written policies/procedures • selecting a compliance officer • implementing effective training and education • establishing open lines of communication • auditing and monitoring your program • enforcing standards • detecting offenses and taking corrective action.

Let’s review the importance of each step.

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O&P AlmAnAc NOVEMBER 2012

Step 1:

Develop standards of conduct and written policies/procedures.

Standards of conduct are statements about the principles that guide your organization; adherence to them should be considered mandatory for continued employment. For example, your standards might specify that you only bill for services actually rendered, your intent to follow all of the rules and guidelines of federal and state laws as they pertain to health care, and the fact that you will deal with violations appropriately. You need to make sure your statements, which need not be lengthy, adequately convey how you want to run your business.

Because these policies are important, each employee should be given a copy to read and asked to sign a statement of receipt. You also should provide annual follow-up training to emphasize the importance of adherence to the policies/standards.

Once standards are in place, your next action should be to review and update your policy and procedures

manual or create one if none currently exists. That document is extremely critical because it details the day-today operations of your company and provides guidance on how to carry out business functions in a correct and efficient manner. New employees, who should be provided a copy and expected to read it, will find the manual especially helpful. In addition, any outside auditors will find that it describes your intent for the company to operate in an appropriate and ethical manner. During your review, remember that the policies are the “position” statements (e.g.,“We will bill insurance companies in a timely manner”), while the procedures are the “how-to” statements (e.g., a list of the steps necessary to bill on a timely basis).

While you want to ensure that your policies and procedures are all-inclusive, you should not feel like you will be judged by the thickness of your manual. Just be certain to cover both the development and submission of claims, as well as office administration.

?

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Reimbursement Page

works, what doesn’t, and how you can improve. They should not fear retaliation if they bring less-than-welcomed news to management. Isn’t it better to find out from an employee that there is a problem than to have it exposed during an audit?

Establishing open lines of communication doesn’t simply mean ongoing complaint sessions with no attempt to fix the problem. Employees should be encouraged to offer solutions to help ensure there’s a quick remedy. Your staff needs to feel like this is “our” problem, not just “your” problem, and that they are part of the solution.

Step 2:

Select a compliance officer. This role can be filled by either an individual or a committee, but the selected entity must be able to devote the time to learn the company’s standards of conduct and policies/procedures.

The compliance officer will be responsible for making certain, to the extent feasible, that all employees are following the appropriate procedures and carrying on the business of the company in an acceptable manner. The officer will also be the go-to person for answers to compliance questions and should have direct access to your company’s top management (e.g., president or board of directors.) You also should make clear to the officer that his/her input is wanted and, if the officer has to bring a violation to the attention of management, he/she will not suffer any negative consequences.

Step 3:

Implement effective training and education. Conducting compliance training is as important as creating all the right documents. Having a beautiful compliance manual that just sits on the shelf and is ignored by the staff is worse than not having one at all. Education is the way to prove to the outside world (e.g., auditors) that you know what to do and do your best to

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O&P AlmAnAc NOVEMBER 2012

educate your staff concerning how the business must operate.

How you want to provide that training is your decision. You may want to set aside a day once or twice a year for education. Some offices find it easier to do an hour of training once a month during a staff meeting to review several policies in order to cover them all by the end of the year. You also can tailor your education to your audience.

For example, if your front office staff contacts insurance companies to determine coverage, you may not need to review that task with practitioners.

Just use common sense to decide who must be trained on what, and make sure everyone reads your standards of conduct manual.

Also, it’s a good idea to log attendance at each training session so no one can come back and say, “You never told me that.” An attendance log also demonstrates to auditors that you are serious about compliance and willing to take the time to keep staff educated.

Step 4:

Establish open lines of communication. Each company will develop this next step—letting your staff know you have an open door policy—in its own unique way. Your employees need to know you welcome their input on how the company is operating—what

Having a beautiful compliance manual that just sits on the shelf and is ignored by the staff is worse than not having one at all.

Step 5:

Audit and monitor your program.

Let’s say you implement a whiz-bang program, then just sit back and trust that all is well. Was implementing your program worth the work? Unless you monitor it, you will never know if all that time and investment made sense. So, you also need to set up an auditing program to periodically make sure your policies and procedures are being followed and to learn if anything needs updating, correcting, or deleting.

You are free to determine what pace of auditing works best for your company: weekly at staff meetings, a couple of hours once a month, or some other time frame. But certainly, do it more than once a year. If you wait too long between audits, things can get really out of whack and could end up costing you a lot of refunded money.

n

Step 6:

Enforce standards.

What happens if you find problems? That decision rests on whether the issue was caused by a mistake or was deliberate, how long it has been going on, whether there was adequate training on the appropriate procedure, and how much it will potentially cost the company.

Your response can range anywhere from simple correction of the problem and reeducation of the staff to termination and perhaps even prosecution, depending on the severity of the issue.

However you decide to enforce the rules, you must be consistent for all employees. Determine which issues might be the most common and decide ahead of time what disciplinary actions you will take; that will keep you from having an inappropriate response when you are in the midst of a crisis. As part of staff training, make sure everyone is aware that you take compliance seriously and that infractions will be dealt with appropriately

and consistently. For emphasis, give them a copy of the enforcement guidelines. Having this message come across as concern for an important issue and not as a threat will be important if you want your staff to be behind you should problems arise down the line.

Step 7:

Detect offenses and take corrective action. After you’ve dealt with the personnel side of the issue in step 6, you have to deal with how to fix the actual problem, often with the insurance company. For example, what steps do you take to make the problem known to the correct authorities, refund any improper payments, fix internal procedures to avoid a repeat of the problem, and set up future audits to make sure the problem doesn’t occur again? If the issue is big enough, the involved insurer may require you to write a plan of action to demonstrate how you will eliminate the problem going forward. Once the

Reimbursement Page

issue is solved, be sure to make any necessary corrections to your policies/ procedures.

The entire process might sound like a lot of work, especially if you are dealing with an intense Medicare audit.

But implementing such a program will help eliminate any common errors that can hamper a well-run office and slow down cash flow even more. To help you set up this program, AOPA developed an “AOPA Compliance Program” CD that contains everything you need for implementation, including boilerplate, time-saving policies and procedures you will find helpful. Contact the AOPA Bookstore at 571/431-0865 for more information. a Kathy Dodson, formerly senior director of government affairs, is a consultant for AOPA. For questions about this column, contact Joe McTernan at jmcternan@ AOPAnet.org.

NOVEMBER 2012 O&P AlmAnAc

17

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O&P AlmAnAc NOVEMBER 2012

COVER STORY

By deBorah conn

o

ne of the most important components of an orthotic foot or ankle intervention—the shoe—is too often the least regarded, according to many pedorthists. In fact, “the shoe is the ultimate orthotic device,” says Robert Schwartz, C.Ped., owner of Manhattan-based Eneslow Shoes and Pedorthics. “It is the foundation and frame for all other devices and the foot.”

Unfortunately, shoes get short shrift. Insurance does not reimburse for shoes, with the exception of diabetic footwear, and, other than pedorthists, health professionals are not trained in footwear therapy. Patients tend to judge shoes more by their appearance than their function and desire specific kinds of footwear for different settings.

“Shoes can be one of the hardest things we do,” says Dennis Janisse, C.Ped., president and CEO of Milwaukee-based National Pedorthic Services. “They have to be the right size and width, the right shape− and, for most patients, the right style and color.” Yet the success of any foot orthosis, from an AFO to an orthotic insert, depends on the proper choice of shoe.

For an effective orthotic intervention, “you have to have a marriage between the foot, the shoe, and the orthotic,” explains William Boettge, executive director of the Pedorthic Foundation. “A good orthotic matched with the wrong type of foot or the wrong shoe will not work. If the shoe is too short or long or wide or narrow, you’re not going to get the kind of foot management that you want.”

Robert Schwartz, C.Ped.

Dennis Janisse, C.Ped.

NOVEMBER 2012 O&P AlmAnAc

21

TiPS on Advising Patients Whether your patients need shoes as part of an orthotic intervention or they want to avoid foot problems that stem from ill-fitting or badly designed footwear, experts offer the following suggestions: •

Suggest patients go shoe shopping in the afternoon, not the morning. “Feet get larger as the day wears on,” notes Robert Schwartz, C.Ped., owner of Manhattan-based Eneslow Shoes and Pedorthics. “If you try on shoes later in the day, you have a better chance of getting the proper fit.”

•

Check wear patterns on the patient’s current shoes. “Look for excessive wear in an area to see what the forces are that the shoe is affecting, inside and out,” Schwartz says. “The outsole is very telling in how a person walks.”

•

Check and recheck shoe fit, inspecting the shoes with feet inside, patient standing, to be sure they are the right size.

• Typically, people want their toes to touch the end of the shoe, so the heel doesn’t slip, says Dennis Janisse, C.Ped., president and CEO of Milwaukee-based National Pedorthic Services. “But it’s okay for the heel to move,” he explains, “and a short shoe can contribute to plantar fasciitis and other problems.” Allow at least 3/8 of an inch of toe room from the tip of the longest toe to the end of the shoe.

•

When working with diabetic patients who want their shoes to fit snugly, Schwartz suggests going up a half size rather than increasing two widths. “Don’t give them big boxes, but add enough room.

Education is an important component of the treatment.”

22

O&P AlmAnAc NOVEMBER 2012

William Boettge

the Basics: Size, Construction, Materials, Comfort While size is an obvious consideration in selecting an appropriate shoe, the range of sizes, particularly width, is limited in today’s footwear. “Feet come in many different widths, but you’re lucky to find a shoe available even in narrow-medium or mediumwide,” says Boettge. When a shoe isn’t sufficiently wide, patients will usually go for a larger size, which can cause problems with slippage and comfort.

Shoes need to match the shape of the feet. A pointed toe box is not suitable for a wide foot with stubby toes, for example, and tapered toes won’t fit in a squared-off shoe. A shoe with a high heel or a flat with a low-cut profile offers little to hold the foot in place, unlike shoes with laces or straps across the midfoot that keep the foot from pushing forward.

To provide stability, footwear should have as much contact as possible with the ground, and that can be difficult to find. “Today’s trends in shoe styles are probably the worst,” notes Ted Colaizzi, C.Ped., of Colaizzi Pedorthic Center in Pittsburgh. “When we want to control biomechanics and foot position, we want as much shoe touching the floor as possible. But fashionable design features reduce contact between the shoe and the walking surface.”

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Shoe materials play an important role as well. Synthetic lining materials that don’t breathe contribute to a warm, damp environment for the foot, which can lead to blisters, fungi, and infection.

Synthetics are seldom best for the upper part of the shoe because they are not as forgiving as leather. “Upper materials should have some give,” says Schwartz. The way the leather is cut and sewn together has an impact on comfort as well, he explains. “Good shoe designers know how to put the leather together, so the shoe will stretch in the same direction as the foot, from side to side.”

Soles that provide some shock absorption and cushioning, yet are lightweight, are preferable, particularly as patients age.

Patient comfort in a shoe is an important sign that the fit is appropriate—with some exceptions. Diabetic patients who have compromised sensation in their feet tend to want shoes that fit snugly, so they feel securely attached. But tight shoes are exactly the wrong choice for neuropathic patients because friction can compromise the skin and, unnoticed and untreated, can result in ulcers and infection.

Shoes for different Conditions

Ted Colaizzi, C.Ped.

Many shoes today are constructed with removable insoles, enabling pedorthists to insert an orthotic. For some interventions, a pedorthist wants a shoe that allows the entire sole bottom to be detached, leaving behind only the upper. “Rather than adjusting the plastic molded bottom, we prefer to remove it and create a therapeutic replacement,” says Colaizzi.

The placement of seams often matter with patients who have bony protuberances, such as bunions.

Typically, fewer parts means a lighter, less structured shoe; more parts tend to create more stability. Depending on the goal, either is desirable. “People with rigid, fixed deformities need a softer, more flexible shoe,” explains Schwartz.

“Those with flexible feet need a more stable environment to support the foot, and therefore, the whole body.”

24

O&P AlmAnAc NOVEMBER 2012

While every foot is unique, pedorthists treat some conditions more frequently than others, starting with fundamental procedures that incorporate shoe guidelines.

Plantar fasciitis, an inflammation of the thick tissue on the bottom of the foot, is a common disorder, says Schwartz. It calls for a supportive, stable shoe, perhaps with a slightly higher heel. “Most people with plantar fasciitis need some orthotic intervention, such as an arch support or a heel lift,” he says.

For some of his patients with this condition, Colaizzi constructs an orthotic that supports the arch but offloads the band of tissue running the length of the foot. He recommends shoes with bottoms that absorb impact but are not too flexible.

Forefoot problems, such as bunions, hammertoes, and metatarsal pain, need a higher, wider toe box and a shockabsorbent sole, according to Schwartz.

Arthritic conditions of the midfoot are common among older people, says

Colaizzi. “For this, we are looking at enhancing support and not getting too aggressive. The shoe needs to improve stabilization and support, and allow the whole foot to touch the floor.” Patients need a shoe that can be modified with an insert to treat this condition.

Diabetic shoes are the only footwear covered by insurance, yet “we’ve ended up being somewhat dictated to by reimbursement, and that’s not a good thing,” says Jannise. The goal of diabetic shoes is to accommodate the foot, to eliminate any areas of high pressure. “I prefer soft leather, which will mold to subtle changes in the foot,” he says. Fewer seams also present fewer opportunities for aggravating the skin.

The overlooked importance of shoes—in both the prevention and treatment of foot problems—is frustrating to many pedorthists.

They see the prevalence of style over substance and the damage that can cause. Pedorthists, the only medical professionals who include footwear in their purview, are well positioned to educate their patients and the wider population that shoes are literally the basis of our relationship with the ground. “If you don’t have the right shoe,” says Janisse, “nothing else, including the body, can function properly.” a Deborah Conn is a contributing writer to O&P Almanac. Reach her at debconn@ cox.net.

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AOPA’S 2012 NATIONAL ASSEMBLy SETS RECORDS AND LAyS FOuNDATIONS OF SuCCESS FOR AN INDuSTRy IN TRANSITION

rom September 6-9 a record number of O&P professionals—2,300—from 17 countries convened at the Hynes Convention Center in Boston for the 2012 AOPA National Assembly and combined meeting with the New England Academy Chapter. They came for a chance to learn from and connect with the top minds and innovators in the field. And with a wide range of educational sessions and demonstrations from 180 of the world’s leading manufacturers, participants left with the skills and tools needed to begin building a better tomorrow for themselves, their organizations, and their patients.

“As we look to the future, we can expect challenging conditions,” said AOPA President-Elect Thomas Kirk, PhD, as he addressed members during the annual business meeting. He explained how AOPA is carving out an increased role in leading regulatory reform and protection; disseminating information on emerging alternative delivery models and payment structures; conducting cost and comparative effectiveness studies; and developing the industry’s value-added message.

“AOPA has dedicated resources and energies to accomplishing these tasks, but this is not enough,” he continued.

“The real game changer will be the involvement by you and the other associations. All of us have to work together, and if we do, we will be successful in exploiting the opportunities that always accompany change.”

That same sentiment of teamwork and expanded thinking were reflected in all of the clinical and business sessions, on the expo floor, and throughout the conference.

Facilitating History

26

With a heavy emphasis on positioning O&P facilities for success in the brave new world of health care, this year’s educational and general sessions focused on arming practitioners and business owners of all types with the skills and knowledge necessary to benefit their facilities and patients.

O&P AlmAnAc NOVEMBER 2012

TImE TO KIcK BAcK Although this year’s AOPA National Assembly set precedents on many levels, participants also had the opportunity to unwind and rekindle connections with colleagues from all over the world during some outstanding social events.

• A little rain couldn’t keep 92 attendees away from the Green Monster and Fenway Park, which celebrated its 100th anniversary this year. Although the hometown favorites were not victorious, a great time was had by all.

• The fifth annual O&P PAC Wine Tasting and Auction raised approximately $28,000 to benefit the O&P PAC. This new favorite event was hosted by AOPA President-Elect Anita Liberman-Lampear, MA, and her husband Alan, who educated participants as they tasted varieties from around the world.

• Three attendees scored big this year. Congratulations to Peter Bentley of CN Waterhouse Leather Co., who took home the $5,000 grand prize at the “Hit a Home Run” prize giveaway. In addition, Lee Mantelmacher, CPO, of KISS Technologies won $100, and Daniel Tellijohn, CP, of Prosthetic Labs of Rochester won $50.

“As provisions of the Affordable Care Act become effective, [they] will place huge demands on your ability to position your company successfully as a serious player,” said AOPA President Thomas DiBello, CO, LO, FAAOP, while introducing keynote speaker Max Bazerman. “One of your first challenges may be to find your place in an accountable care organization. Part of that challenge rests on the fact that O&P providers do not account for a huge slice of the ACO pie—just as our slice of the Medicare

pie is less than one quarter of one percent.”

Bazerman, Straus professor from Harvard Business School, specializes in helping people develop strategies for successful negotiations, regardless of their size or position. His discussion focused on how facilities can create value and draft mutually beneficial agreements by sharing information, making multiple offers at one time, and more.

“Before you are involved in a negotiation, think about your alternatives in order to determine value,” he advised. “If you don’t know what someone values, give that person multiple offers. Their reaction will give hints at what they value.”

Bazerman also warned against having tunnel vision during the negotiation process and used a video exercise to demonstrate how easy it is to miss obvious opportunities when we are too narrowly focused on specific details.

Other innovative sessions at this year’s National Assembly that had participants thinking broadly included: • A two-day technical summit for professional technicians, co-hosted by the OPTA. Day 1 consisted of seven sessions dedicated to the principles of quality control, molding, thermoforming, metal contouring, and joint alignment. Day 2 featured several sessions devoted to various techniques such as lean manufacturing and fabrication of custom TLSHOs. NOVEMBER 2012 O&P AlmAnAc

27

Makoewn Your y 2012 AOPA AwARD wInnERS ERS

AOPA Lifetime Achievement Award Wade Barghausen, CPO (e)

Edwin and Kathryn Arbogast Award alison Linberg, dPt

r o t s i H

Howard R. Thranhardt Award Jason Kahle, CPO, FaaOP (pictured above) and Jason Highsmith, dPt, CP, FaaOP

Howard R. Thranhardt Award Paul taylor, CFtS

Otto and Lucille Becker Award Marina Musicus, MS

Ralph R. “Ronney” Snell, CPO, FAAOP, Legislative Advocacy Award—thomas Guth, CP 28

O&P AlmAnAc NOVEMBER 2012

Sam E. Hamontree, CP, Business Education Award “The View From Above: Build Your O&P Business by Thinking on Top of the Box, Not Outside It” Jeff Nemeth, CPO, FaaOP

• A half-day session on the effects of AFOs on balance, presented courtesy of AAOP and part of the organization’s certificate program.

• A concurrent session focusing on skin health and common problems associated with O&P device use.

• An expanded two-day program devoted to post-mastectomy education, featuring discussions on various mastectomy procedures from a surgeon’s perspective, business considerations for including postmastectomy services, lymphedema, and fitting best practices.

• A new pedorthic education session spanning two days and covering the specialty from all angles—biomechanics, clinical care, research, treatment options, and disease management.

Aside from the critical industry knowledge gained at the educational sessions, some of the biggest news came from the AOPA Annual Business Meeting, at which members voted to amend AOPA bylaws for the first time in a decade. Three key changes now provide for electronic voting, the modification of criteria for board of directors positions, and a two-year transitional period when the number of board seats will increase to 16 in 2013 and then return to 14 seats in 2015.

Specifically, the number of board seats allocated to patient-care facilities was reduced from five seats to three, while the number of supplier-member seats increased from one to two. These changes reflect current industry trends in facility consolidation and increasing contributions to advocacy, research, and other AOPA missions by supplier members.

In addition, members approved adding a second non-designated at-large director seat and two additional designated directors, each serving two-year terms. The first will be a clinical at-large director elected by members.

The second will be a health-care director whose “qualifications and background would bring a ‘health-care world view’ to the table.”

“These changes level the playing field and make the organization more representative of the field as it exists today,” DiBello told members. “We need to move forward with this makeover of our governance and position ourselves to think [in terms of the] big picture.

We need to make sure that when they snap the health-care photo decades from now, O&P will still be in the picture.” a

2013 O&P World Congress Planning Committee From top left: Thomas F. Fise, JD; Michael Orendurff, PhD; Bernhard Budaker; Dianne Farabi; Karen Peters; Ed Finnegan; Jon Batzdorff, CPO; Frank H. Bostock, CO, FAAOP; Thomas Kirk, PhD; Anthony Potter; Marlo Ortiz Vazquez del Mercado, PO; Klaas Postema, MD, PhD; David A. Boone, CP, PhD, MPH; Robert S. Kistenberg, MPH, CP, LP, FAAOP; Jack E. Uellendahl, CPO; Geza Kogler, CO, LO, PhD, L.Ped, MSPO, LO; Andrea Giovanni Cutti, MEng, PhD; and Jose Miguel Gomez, MD, LO. From bottom left: Tina Moran, CMP; Kelly O’Neill; Stephanie Olivio-Schulte; Brad Mattear, CPA, CFo; Aaron Leung, PhD; Thomas V. DiBello, CO, LO, FAAOP; Nerrolyn Ramstrand, PhD; and Mark Geil, PhD.

Planning Underway for 2013 O&P world congress Next year’s conference will be unlike any other. Some of the brightest minds from around the world met in October to begin planning one of the biggest events for the orthotics, prosthetics, and pedorthic profession: the 2013 O&P World Congress, Sept.

18-21, 2013, at the Gaylord Palms Resort & Convention Center in Orlando/Kissimmee, Florida.

Held for the first time in the United States, this international event promises to be a game changer for the O&P industry and will take the place of next year’s National Assembly. It is co-sponsored by AOPA, US-ISPO (International Society for Prosthetics and Orthotics), and the German Association of Orthopaedic Technology for O&P, Rehabilitation, Home Health Care.

The October planning session yielded a great deal of international cooperation. “A conference that calls together health-care professionals from all over the world requires high-quality,

comprehensive ideas and content from the clinical thought leaders from all countries,” said AOPA President-Elect Thomas Kirk, PhD. “This is precisely the caliber of individuals that came together for the two-day planning session in Orlando. The experience, qualifications, and collaboration of the participants were exceptional and will yield an outstanding conference.”

“The group of individuals gathered by the event’s clinical content chairman, David A. Boone, CP, PhD, MPH, was impressive,” added Thomas DiBello, CO, LO, FAAOP, AOPA’s president. “They included a ‘who’s who’ of researchers and clinicians from around the world. The day was very well-organized, and the quantity and quality of the work done was impressive—a true testament to the quality of the group. This all bodes well for an outstanding Congress in September.”

Mark your calendar now to take advantage of these opportunities:

• Take part in superior clinical education. The Congress will feature the best speakers from around the world. Hear from physicians, researchers, and top-notch practitioners.

• Participate in practical learning opportunities and live demonstrations.

• Prepare for the massive changes that U.S. health-care reform is sure to bring, and its influence on global health policy.

• Network with an elite and influential group of international professionals.

• Visit the largest display of exhibits in the United States for the orthotic, prosthetic, and pedorthic profession.

Individuals interested in becoming a presenter or organizing a scientific symposium at the 2013 O&P World Congress should contact Tina Moran at 571/431-0808 or tmoran@aopanoet.org before Jan. 3, 2013.

NOVEMBER 2012 O&P AlmAnAc

29

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Accomplishments Insights into the 2012 Legislative and Regulatory Scorecard

F

or the O&P community, 2013 is shaping up to present one big challenge after another. Patient-care facilities are facing recovery audit contractor (RAC) audits, comprehensive error rate testing (CERT) audits, pre-payment reviews, and other over-the-top CMS fraud prevention measures that are disrupting cash flow and affecting patient care. Those measures also impact suppliers who are seeing their receivables swell. AOPA is doing everything possible to reverse these onerous burdens imposed on our members, but we need your ongoing support to continue our efforts. In addition to fighting the battles listed above, we’re tackling other issues as well. Please review our Top 20 Accomplishments Scorecard for a more complete picture.

Achieved AOPA-inspired introduction of the Medicare O&P Improvements Act in both houses of Congress (S. 2125 and H.R. 1958), which, if enacted, would save $250 million through fraud prevention provisions. Five bipartisan co-sponsors from the Senate Finance Committee and 10 bipartisan co-sponsors in the House of Representatives are helping lay the groundwork for reintroduction in the next Congress unless provisions are included as a “pay for” in a lame duck spending bill.

1

Sought and received CMS clarification of the physician documentation issue by permitting like prosthetic device replacements without physician visits or physician orders. CMS also listened to AOPA’s recommendation and agreed that prosthetists’ notes are considered part of a patient’s medical record and are relevant when determining medical necessity. AOPA’s aggressive work for more improvement on this topic continues.

2

32

O&P AlmAnAc NOVEMBER 2012

Persisted in our push for O&P inclusion in “Essential Health Benefits” by publishing a state-by-state compilation of data identifying which benchmark plans designated by Health and Human Services (HHS) Secretary Kathleen Sebelius include O&P coverage. That data can help members encourage selection of plans with O&P benefits.

3

Convinced the U. S. Treasury Department and IRS that O&P medical devices qualify for the same exemption from the 2.3 percent excise tax mandated by the Affordable Care Act (ACA) that applies to eyeglasses, hearing aids, and contact lenses. Further clarification was sought through AOPA’s testimony and written comments to make sure the exemption applies both to O&P manufacturers and patient-care providers. Those solutions remain tentative pending issuance of final regulations expected shortly.

4

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AOPA WORKING FOR YOU

Challenged a Pricing, Data Analysis, and Coding (PDAC) proposal that samples be submitted for coding verification on all custom ankle-foot orthoses (AFOs) with LCodes L1940, L1960, and L1970, and prefabricated AFOs L1930, L1932, and L1971. The proposal was indefinitely postponed shortly before the effective date.

5

Analyzed a list of more than 60 orthotic codes CMS considered for off-the-shelf (OTS) competitive bidding inclusion, many of which, in AOPA’s view, strayed from the statutory language of “minimal self adjustment” to define eligible orthotics. AOPA’s Coding and Reimbursement Committee, AOPA volunteer leaders, and staff conducted a painstaking fact-finding and literature review to produce a 479-page code-by-code rationale on the code’s eligibility. AOPA deemed fewer than a dozen codes eligible; thus far, no OTS orthotic has been included in Round 2 or in the rebid of Round 1 of competitive bidding.

6

Fought the RAC audits triggered by the questionable conclusions in a HHS Office of Inspector General Report. The audits consume an inordinate amount of members’ time and disrupt patient care. AOPA meetings with key CMS officials, including Administrator Marilyn Tavenner, have made moderate headway in curbing the ruinous audit ramifications, but there’s no question that much still needs to happen for fairness to prevail. During an October 15 Meeting with AOPA representatives, Tavenner promised proposed “middle ground” solutions by December 1.

7

Surveyed AOPA members to build the case for RAC audit reform and, by submitting samples of egregious claims’ denials, have helped persuade even the CMS Administrator “a middle ground” must be found.

8

Brought expert testimony to two separate hearings on Veterans Affairs (VA) procurement and private provider choice issues by House VA Subcommittees.

This is an ongoing battle to seek uniformity on how each VA facility interprets policies to make sure patient choice is present and procurement enables amputees to have the best technology.

9

Successfully challenged PDAC’s authority to propose medical device labeling requirements citing FDA’s exclusive authority on medical device labeling.

10

Passed muster in becoming a Standards Development Organization recognized by the American National Standards Institute anticipating that the Foot Project Report submitted to CMS more than one year ago may be AOPA’s first effort at developing an O&P standard.

12

Continued the forceful public relations program in national magazines to educate the public and health policy decision makers on O&P contributions to restoring patient quality of life. Ads appeared in Time, Newsweek, and Businessweek. Transit ads near HHS headquarters and Congress derided confusing signals Medicare is sending on amputee prosthetic care and physician documentation.

13

Informed members on the changing landscape of the Food and Drug Administration’s (FDA’s) scrutiny of O&P central fabrication facilities and conducted a day-long education seminar on FDA compliance.

14

15

Produced an outstanding National Assembly in collaboration with the New England Chapter of the AAOP. Innovations included subject-specific roundtables (which were a big hit), a new mobile phone app enabling members to put their personal Assembly schedule on their smartphones, co-sponsorship of the first annual OPTA Technical Fabrication Competition for practitioners and residents, and a display of 50 winning technical posters selected by the American Society of Biomechanics.

16

17 18 19

the Rest of the Scorecard Expanded research pilot grant funding through the Center for O&P Learning and Outcomes EvidenceBased Practice, which doubled in size each of the four grants to $15,000, in addition to support for ongoing costeffectiveness studies and comparative effectiveness research.

11 34

O&P AlmAnAc NOVEMBER 2012

Presented the second AOPA Manufacturers’ Coding Workshop to help members succeed in their applications for new LCodes.

Took pride in the O&P Almanac again receiving the prestigious Certificate of Excellence from Graphic Design USA. Introduced a new money-saving program for members that provides UPS discounts up to 30 percent for Next Day Air and up to 70 percent discounts for freight shipments.

Revamped content and expanded AOPA Essential Coding and Billing Seminar scheduled in four different locations for easier accessibility for members.

Hosted our first planning sessions for AOPA-sponsored World Congress, a global O&P event in the western hemisphere, scheduled for September 18-21, 2013, at the Gaylord Palms Resort in Orlando, Florida. More than a dozen countries are represented on the planning committee. a

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AOPA HEADLINES

Follow AOPA on Facebook and Twitter Follow AOPA on Facebook and Twitter to keep on top of latest trends and topics in the O&P community. Signal your commitment to quality, accessibility, and accountability, and strengthen your association with AOPA, by helping build these online communities.

Like us on Facebook at: www.facebook. com/AmericanOandP with your personal account and your organization’s account!

Follow us on twitter: @americanoandp, and we’ll follow you, too!

Contact Steffanie Housman at shousman@ AOPAnet.org or 571/431-0835 with social media and content questions.

top 5 Reasons to Follow aOPa: 1. Be the first to find out about training opportunities, jobs, and news from the field.

2. Build relationships with others working in the O&P field.

3. Stay in touch with the latest research, legislative issues, guides, blogs, and articles—all of the hot topics in the community.

4. Hear from thought leaders and experts.

5. Take advantage of special social media follower discounts, perks, and giveaways.

AOPA 2012 Operating Performance Report Available Now Are you curious about how your business compares to others? This updated survey will help you see the big picture. The Operating Performance Report provides a comprehensive financial profile of the O&P industry, including balance sheet, income statement, and payer information organized by total revenue size, community size, and profitability. The data was submitted by more than 130 patient-care companies, representing 1,050 full-time facilities and 68 part-time facilities.

The report provides financial performance results as well as general industry statistics. Except where noted, all information pertains to fiscal year 2011 operations.

Purchase the 2012 Operating Performance Report at the AOPA Bookstore, www.aopanetonline.org/store.

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O&P AlmAnAc NOVEMBER 2012

Take This BOAT for a Ride Create your own secure and confidential web pages on the BOAT—a tool specifically tailored to help O&P business owners manage their businesses for greater profit and quality patient care.

By using this tool, you not only will examine the financial fitness of your business, you also will be pushed to identify and better understand your competition, market conditions, referral sources, and internal effectiveness. Use the BOAT to create budgets, track your finances, and participate in the annual Operating Performance and Compensation surveys.

The new AOPA Patient Satisfaction Survey (required by certifying bodies) will be accessed through the BOAT site, which will be free to those firms using electronic data capture devices. All information is confidential and secure.

Members can sign up for the BOAT website by going to www.AOPA-BOAT.com and clicking on the orange “Register for BOAT” button on the bottom right-hand section of the screen. The direct link for the registration page is www.iisecure.com/BOAT/Register.asp.

Once you have registered and logged in, visit the tutorial video on the landing page.

AOPA HEADLINES

Follow This Lead: Build Relationships With Congressional Candidates AOPA members hoping to influence legislators about important O&P issues should follow the example of Jim Kaiser, CP, LP, AOPA’s immediate past president and current president of the Illinois Society of Orthotists, Prosthetists, and Pedorthists (ISOPP). Kaiser has been fostering a mutually beneficial relationship with Tammy Duckworth, the Democratic nominee in Illinois’s 8th congressional district for the U.S. House of Representatives.

Duckworth, a patient at Scheck & Siress O&P Inc., where Kaiser is a partner, is the former Assistant Secretary for Public and Intergovernmental Affairs in the U.S. Department of Veterans Affairs, and the director of the Illinois Department of Veterans Affairs.

Duckworth is an Iraq War veteran and former U.S. Army helicopter pilot whose severe combat wounds cost her both of her legs and damaged her right arm.

AOPA Past President Jim Kaiser, CP, LP, shown with Tammy Duckworth, the Democratic nominee in Illinois’s 8th congressional district for the U.S. Awarded the Purple Heart for her combat injuries, House of Representatives. she continues to serve as a Lieutenant Colonel in the Illinois Army National Guard.

Kaiser’s meeting with Duckworth, where he was able Kaiser met with Duckworth October 8. He also to deliver an AOPA Political Action Committee check in participated in a disability roundtable with Duckworth support of her campaign, is an example of AOPA members and Rep. Jim Langevin (D-Rhode Island) in addition to building long-term relationships with political candidates attending a meet-and-greet discussion on disability rights who support O&P issues on behalf of patients. and awareness.

Master Medicare Enrollment Procedures—Join the Audio Conference November 14 Join AOPA November 14 at 1 p.m. EDT for an AOPAversity Mastering Medicare Audio Conference that will cover the basics of Medicare Enrollment Procedures. Learn strategies and techniques from an AOPA expert who will address these topics: 1. Reviewing new Medicare Enrollment Standards 2. Reviewing the Medicare Enrollment Application 3. PECOS vs. the 855S Form 4. Differentiating between a participating Medicare provider and a nonparticipating Medicare provider.

AOPA members pay just $99 to participate ($199 for nonmembers), and any number of employees may listen

on a given line. Participants can earn 1.5 continuing education credits by returning the provided quiz within 30 days and scoring at least 80 percent. Contact Devon Bernard at dbernard@AOPAnet.org or 571/431-0854 with content questions.

Register online at https://aopa.wufoo.com/forms/2012telephone-audio-conferences/. Contact Stephen Custer at scuster@AOPAnet.org or 571/431-0876 with registration questions.

NOVEMBER 2012 O&P AlmAnAc

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AOPA HEADLINES

AOPAversity Mastering Medicare New Codes for 2013—Join the Audio Conference December 12 The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires all payers to use Healthcare Common Procedure Coding System (HCPCS) Codes. The end of the year marks the beginning of new codes and modifier changes that will take effect Jan. 1, 2013. Do you have a plan in place?

Ensuring your practice is sound may prevent unnecessary audits down the road. As we prepare for a new year, join AOPA December 12 for an AOPAversity Mastering Medicare Audio Conference that will focus on new codes and medical policy changes for 2013—and why those should be an important part of your business operation. An AOPA expert will address the following issues: 1. New HCPCS codes effective Jan. 1, 2013 2. Verbiage changes to existing codes and how they may affect your business 3. Codes that will no longer be used as of Jan. 1, 2013 4. Additional changes to the HCPCS system 5. AOPA’s interpretation of why the changes took place.

www.savewithups.com/aopa

AOPA members pay just $99 to participate ($199 for nonmembers), and any number of employees may listen on a given line. Participants can earn 1.5 continuing

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O&P AlmAnAc NOVEMBER 2012

education credits by returning the provided quiz within 30 days and scoring at least 80 percent. Contact Devon Bernard at dbernard@AOPAnet.org or 571/431-0854 with content questions.

Register online at https://aopa.wufoo.com/forms/2012telephone-audio-conferences/. Contact Steve Custer at scuster@ AOPAnet.org or 571/431-0876 with registration questions.

UPS Savings Program aOPa Members now save up to 30% on UPS Next Day Air® & International shipping!

Sign up today at www.savewithups.com/aopa!

Take advantage of special savings on UPS shipping offered to you as an AOPA Member.

Through our extensive network, UPS offers you access to solutions that help you meet the special shipping and handling needs, putting your products to market faster.

AOPA members enjoy discounts for all shipping needs and a host of shipping technologies. Members save: 1. Up to 30% off UPS Next Day Air® 2. Up to 30% off International Export/Import 3. Up to 23% off UPS 2nd Day Air®

al i c e Sp S! ng Savi

All this with the peace of mind that comes from using the carrier that delivers outstanding reliability, greater speed, more service, and innovative technology. UPS guarantees delivery of more packages around the world than anyone, and delivers more packages overnight on time in the US than any other carrier. Simple shipping! Special savings! It’s that easy!

AOPA HEADLINES

Log On to AOPAversity Online Meeting Place for Free Education does not get any more convenient than this.

Busy professionals need options––and web-based learning offers sound benefits, including 24/7 access to materials, savings on travel expenses, and reduced fees. Learn at your own pace—where and when it is convenient for you.

For a limited time, AOPA members can learn and earn for FREE at the new AOPAversity Online Meeting Place: www.AOPAnetonline.org/education.

Take advantage of the free introductory offer to learn about a variety of clinical and business topics by viewing educational videos from the prior year’s National Assembly.

Earn CE credits by completing the accompanying quiz in the CE Credit Presentations Category. Credits will be recorded

by ABC and BOC on a quarterly basis.

AOPA also offers two sets of webcasts: Mastering Medicare and Practice Management.

Coding Questions Answered 24/7

• Mastering Medicare: Coding & Billing Basics: These courses are designed for practitioners and office staff who need basic to intermediate education on coding and billing Medicare.

• Practice Management: Getting Started Series: These courses are designed for those establishing a new O&P practice.

Register online by visiting www.aopanet.org/index. php?option=com_content&view=article&id=74&Itemid=382.

24/7

AOPA members can take advantage of a “click-of-themouse” solution available at LCode-Search.com. AOPA supplier members provide coding information about specific products.

You can search for appropriate products three ways––by L code, by manufacturer, or by category. It’s the 21st century way to get quick answers to many of your coding questions.

Access the coding website today by visiting www.

LCodeSearch.com. AOPA’s expert staff continues to be available for all coding and reimbursement questions.

Contact Devon Bernard at dbernard@AOPAnet.org or 571/431-0854 with content questions.

If You’re Paying More Than 1.9%, You’re Paying Too Much AOPA has partnered with Bank of America Merchant Services to offer credit card processing rates as low as 1.9 percent to AOPA members. Many members are paying more than 2.5 percent, and if you’re handling $500,000 a year in credit card transactions, the 0.6% savings is like getting a 200 percent return on your membership dues investment.

To enroll, contact 888/317-5402 or email tellmemore@bankofamericamerchant.com. AOPA encourages members to request an audit of a recent processing statement to identify the savings they would enjoy.

Discover Employment Opportunities at AOPA’s Online Career Center As an O&P professional, you can make a difference every day. Job opportunities abound throughout the country, and the need for O&P professionals is increasing rapidly. Currently, 100 percent of O&P program graduates find employment, and most choose to make it a lifelong profession.

If you’re seeking employment, access the most recent jobs available. If you’re recruiting, reach the most qualified candidates by posting your job on AOPA’s Online Career Center.

Visit http://jobs.AOPAnet.org, or email Stephen Custer at scuster@AOPAnet.org with questions.

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AOPA HEADLINES

Special Thanks to Our O&P PAC Contributors The O&P PAC would like to acknowledge and thank the following AOPA members for their recent contributions to and support of the O&P PAC*: J. Laurence Allen, CPO

April Groves, CO

Steven Mirones, CO, C.Ped.

Michael Allen, CPO, FAAOP

Michael Hall, CPO

Ted Muilenburg, CP

Rudy Becker Sr.

Rita Hammer

George Newton, CPO

Kel Bergmann, CPO

Michael Hamontree, MBA

Michael Oros, CPO

David Bow, CPO

Russell Hornfisher, MBA

Rodney Pang, CPO

George Breece

Joe Huntsman, MBA

Patty Petersen

Terri Bukacheski, CP

Fran Jenkins

Gerri Price, CFom, C.Ped.

Alan Burke, BOCO

David Johnson, CO

James Price, CPO, FAAOP

Erin Cammarata, RTO

Rahul Kaliki, PhD

Walt Racette, CPO

Jim Campbell, CO, FAAOP, PhD

Marc Karn, CP

Daryl Reuter

Maureen Canter

John Kenney, CPO, FAAOP

John Roberts Jr., CPO

Frank Caruso, CO

Tom Kirk, PhD

Scott Schneider

Ken Cornell, CP

Al Kritter, CPO, FAAOP

Eric Schopmeyer, CO

Glenn Crumpton, CPO

Harry Layton, CPO, FAAOP

Mark Smith, CP

Charles Dankmeyer, CPO

Jon Leimkuehler, CPO

Chris Snell

Joe Davant

Robert Leimkuehler, CPO

Anthony Squiccuarini, CPO, C.Ped.

William DeToro Jr., CPO

Eileen Levis

Peter Thomas, Esq.

Martin Diaz, BOCO, C.Ped.

Pam Lupo, CO

Paulette Vaughn

Thomas DiBello, CO, FAAOP

Gary Mahler

Bernie Veldman, CO

Jeff Erenstone, CPO

Ann Mantelmacher

Frank Vero, CPO

Troy Fink

Lee Mantelmacher, CPO

James Weber, MBA

Rick Fleetwood, MPA

Salvatore Martella, CPO

Jeff Wensman, CPO

John Galonek, CO

Kathy Mascola, BOCPO, CO, LPO

Steven Whiteside, CO, FAAOP

Carey Glass, CPO, FAAOP

Kevin Matthews, CO

Jon Wilson, CPO

Eddy Gosschalk, CPO

Brad Mattear, CPA, CFo

James Young Jr., CPO, FAAOP

Garrett Griffith

Sean McKale, CO

The O&P PAC advocates for legislative or political interests at the federal level that have an impact on the orthotic and prosthetic community. To achieve this goal, committee members work closely with members of the House and Senate to educate them about the issues, and help elect those individuals who support the orthotic and prosthetic community.

To participate in the O&P PAC, federal law mandates

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O&P AlmAnAc NOVEMBER 2012

that you must first sign an authorization form. To obtain an authorization form, contact Devon Bernard at dbernard@ AOPAnet.org. a *Due to publishing deadlines this list was created on Oct. 9, 2012, and includes only donations received between Aug. 28, 2012, and Oct. 9, 2012. Any donations received or made after Oct. 9, 2012, will be published in the next issue of O&P Almanac.

AOPA APPLICATIONS

The officers and directors of the american Orthotic & Prosthetic association (AOPA) are pleased to present these applicants for membership. Each company will become an official member of AOPA if, within 30 days of publication, no objections are made regarding the company’s ability to meet the qualifications and requirements of membership.

At the end of each new facility listing is the name of the certified or state-licensed practitioner who qualifies that patient-care facility for membership according to AOPA’s bylaws. Affiliate members do not require a certified or state-licensed practitioner to be eligible for membership.

At the end of each new supplier member listing is the supplier level associated with that company.

Supplier levels are based on annual gross sales volume: Level 1: equal to or less than $1 million Level 3: $2 million to $4,999,999 Level 2: $1 million to $1,999,999

OrthoPro Services LLC

Landra Prosthetics & Orthotics Inc. 14725 Northline Road Southgate, MI 48195 734/281-8144 Fax: 734/281-1258 Category: Patient-Care Member Julie Landra

OrthoPro Services LLC 2502 Moore Station Road Dublin, GA 31021 478/272-6522 Fax: 478/272-3992 Category: Patient-Care Member Sarah Hayes

OrthoPro Services LLC 634 First Street Macon, GA 31201 478/742-0212 Fax: 478/742-0236 Category: Affiliate Member Parent Company: OrthoPro Services LLC, Dublin, GA

711 N Jefferson Street Albany, GA 31701 888/474-4113 Category: Affiliate Member Parent Company: OrthoPro Services LLC, Dublin, GA

Peter Harsch Prosthetics 5955 Pacific Heights Blvd., Ste. B San Diego, CA 92121 619/203-5252 Category: Patient-Care Member Lauren McVey-Harsch

Specialized Orthopedic Solutions Inc. 6851 Canby Avenue, Ste. 102 Reseda, CA 91335 323/960-2400 Fax: 323/230-8821 Category: Patient-Care Member Elizabeth Nadasi

Yale New Haven Hospital 20 York Street New Haven, CT 06510 203/200-2273 Category: Patient-Care Member Jeanette Brooks, CMF a

Level 4: more than $5 million.

MEMBER VALUE GUIDE www.AOPAnet.org

AMERICAN ORTHOTIC & PROSTHETIC ASSOCIATION (AOPA)

Member Benefits

Experience the Benefits of AOPA Membership Membership in AOPA is one of the

•

•

•

Challenging RAC and CERT audit policies implemented this past year by overly aggressive CMS contractors is AOPA’s number one priority.

All options are on the table to eliminate these burdensome and patient harming practices.

Your Voice in Washington. AOPA’s staff and the lobbying team of former CMS Administrator, Tom Scully of the Alston & Bird law firm and Nick Littlefield, former chief of staff for Sen. Ted Kennedy and now a partner in the Foley Hoag law firm bring years of healthcare knowledge and experience to the issues of O&P. AOPA’s efforts help assure equitable reimbursement policies in these uncertain financial times to ensure quality patient care.

Making Your Voice Stronger.

The O&P Political Action Committee supports candidates who understand the unique contribution the O&P community makes to restoring lives and hope.

MISSION

Experience the Benefits of AOPA Membership The mission of the American Orthotic and Prosthetic Association is to work

best investments that you can make in the future of your company.

for favorable treatment of the O&P business in laws, regulation and services; to help members improve their management and marketing skills; and to raise awareness and understanding of the industry and the association.

•

Making Your Voice Connect.

AOPA’s Annual Policy Forum brings O&P leaders to Washington to receive high level briefings and to deliver the O&P story personally to their members of Congress.

•

Expert Reimbursement and Coding Guidance. AOPA’s reimbursement specialists provide coding advice and keep you up-to-date on the latest Medicare quality standards, billing rules and regulations. Answer all of your questions related to O&P coding, reimbursement and compliance—via telephone or email.

Members have unlimited access to AOPA staff experts.

•

Cost Effectiveness Research.

The changing climate of health care is moving to a patient driven process and is demanding more and more evidence of cost effectiveness to measure outcomes. AOPA has funded the first in a series of research projects that will measure the cost effectiveness of timely O&P treatment of patients with the same diagnoses as patients who did not receive treatment. More cost effectiveness research projects will be necessary and are simply too expensive for individual O&P businesses to undertake. AOPA can aggregate the resources of the field to conduct this vital research.

2013 AOPA Annual Membership enrollment is now open. Call 571/431-0876 to request an application form, or visit www.AOPAnet.org.

Join today!

NOVEMBER 2012 O&P AlmAnAc

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2012 Buyer’s Guide to Foot-Care

Buyer’s Guide to

Foot-Care The annual one-stop resource for O&P foot-care products and services

Contents 43

Footwear 43 Custom Footwear 43 Diabetic and extra-Depth Footwear

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insoles

44

Lower-Limb Devices and orthoses

46

Lower-Limb prostheses

48

Socks

50

Miscellaneous 50 CAD/CAM Casting and Fabrication 50 Compression hosiery

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O&P AlmAnAc NOVEMBER 2012

2012 Buyer’s Guide to Foot-Care

Footwear CUSTOM FOOTWEAR Apis Footwear Company 2239 Tyler Ave South El Monte, CA 91733 888/937-2747 www.bignwideshoes.com At Apis, we are committed to providing quality products that offer satisfying solutions for a variety of footwear problems.

Whatever the situation—hard-to-fit width and length, charcot, edema, bunion, hammer toes, or shoe modification—you name it, we have the products to accommodate each and every situation that practitioners see every day. We aim to relieve the pain of your patients and increase your bottom line.

For more information and free display samples, call our friendly customer service representatives at 888/937-2747.

Mt. Emey ThErApEuTic LinE–Accommodate, nEvEr correct!

Insoles Amfit Inc. Vancouver, WA 800/356-FOOT (3668) www.amfit.com Where Technology Fits. Perfectly.

Since 1977 Amfit has elevated the process of offering custom foot orthoses for any size office or practice. Offering programs to fit the needs of individual practitioners to large scale labs, Amfit has a custom solution to fit your needs.

With technology designed and built in the uS Amfit offers Accommodative and A5513 approved Diabetic options to Functional designs in carbon Fiber and polypropylene. Team up with Amfit to serve your practice and your patients at the highest level.

Learn more at www.amfit.com or call 800/356-FOOT (3668) today.

DIABETIC AND EXTRA-DEPTH FOOTWEAR

Cascade Dafo Inc.

Cascade Orthopedic Supply Inc.

Ferndale, WA 800/848-7332 www.dafo.com

Chico, CA 800/888-0865 www.cascade-usa.com

Dr. Comfort Mequon, WI 800/556-5572 www.drcomfort.com

SoleTech Inc. Claremont, NH 877-625-9494 www.soletech.com

cascade Dafo inc.’s latest addition to its popular Fast Fit® line of pediatric shoe inserts is the chipmunk™—a sub-mallelor, ucBL-style orthosis that’s a step forward in comfortable foot alignment. Ortho-engineered to control moderate pronation, the chipmunk is a low-profile solution with optimal support and comfort. its advanced design features a unique two-part system, combining internal alignment from molded foam contours with the stability of a flat external base. Like cascade Dafo’s other Fast Fit orthotics, the chipmunk is available in a wide range of pediatric sizes and is backed by our full, 90-day warranty.

For more, visit www.dafo.com.

Cascade Orthopedic Supply Inc. Chico, CA 800/888-0865 www.cascade-usa.com

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2012 Buyer’s Guide to Foot-Care DELCAM Salt Lake City, UT 877/335-2261, x153 www.orthotics-cadcam.com Build a Solution to Fit your Process We provide a full custom orthotic insole solution from scanning your patient’s foot through to manufacturing a perfect orthotic. All in an open platform so you can build a solution which meets your exact needs. Scan with iQube, Model with OrthoModel, Mill with OrthoMiLL and manage your orders with OrderManager. We will provide you with design and manufacturing methods that will reduce your costs improve the quality of your orthotics and the productivity or your clinic. isn’t it time for you to step into the digital laboratory? contact us today to learn how our innovative methods can help you at 877/335-2261, x153, or visit us online at www.orthotics-cadcam.com.

Dr. Comfort Mequon, WI 800/556-5572 www.drcomfort.com

SoleTech Inc. Claremont, NH 877/625-9494 www.soletech.com

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Lower-Limb Devices and Orthoses Allard USA Inc. Rockaway, NJ 888/678-6548 www.allardusa.com

Becker Orthopedic Appliance Co. Troy, MI 248/588-7480 www.beckerorthopedic.com

Cascade Orthopedic Supply Inc. Chico, CA 800/888-0865 www.cascade-usa.com

Fillauer Companies Chattanooga, TN 800/251-6398 www.fillauer.com Dynamic Walk from Centri The Dynamic Walk is an AFO made of a lightweight moldable carbon fiber composite material. The open heel construction allows for optimal fit and comfort with various shoe types. The Dynamic Walk provides dorsiassist with subtalar inversion and eversion control. This high activity design enables freedom of motion and allows for walking, running, and climbing stairs.

Features: • High quality dorsiflexion assist technology • Lightweight • High strength • Fits easily into normal or narrow shoes • Flexible for multi-plane action • Dynamic medial/lateral control • Enables athletic activity such as moderate running.

For more information, contact Fillauer companies at 800/251-6398 or visit www.fillauer.com.

2012 Buyer’s Guide to Foot-Care Motion Control Inc.

Motion Control Inc.

Salt lake City, UT 800/696-2767 www.utaharm.com

Salt Lake City, UT 888/MYO-ARMS www.UtahArms.com Motionfoot® from Motion Control A revolutionary hydraulic ankle/foot that improves the comfort and naturalness of walking, featuring:

• • • • • • •

Unparalleled 50° range of motion Low ankle height Unmatched stability walking down inclines Independent adjustment for plantar and dorsi flexion resistance Adjustable keel dynamics Manual Lock/Unlock for “fixed ankle” activities Fits foot sizes between 22-30 cm; weight limit 220 lbs; K2 or above activity level.

For more information, contact Motion control at 800/6962767 or visit www.utaharm.com.

Fillauer Companies Chattanooga, TN 800/251-6398 www.fillauer.com StepLock® from OTS Corp The StepLock® is a ratcheting, multi-position knee joint designed with the flexion contracture patient in mind.

Features and benefits: • Ten locking positions throughout knee flexion • Helps to increase the knee range of motion • Provides stability for standing before reaching full extension • Designed for knee flexion contracture management • Unlocks to enable sitting and reclining • Effectively blocks flexion while allowing free extension • Unparalleled strength plus a nickel plated finish for extra durability.

For more information, contact Fillauer companies at 800/251-6398 or visit www.fillauer.com.

Med Spec (ASO) Charlotte, NC 704/573-4040 www.medspec.com

MD Orthopaedics Wayland, IA 877/766-7384 www.mdorthopaedics.com

OPTEC USA Inc. Lawrenceville, GA 888/982-8181 www.optecusa.com

Orthomerica Products Inc. Orlando, FL 877/737-8444 www.orthomerica.com Heat Adjustable Spectrum AFO Products

by Orthomerica® Orthomerica gauntlets are now able to be worn throughout the patients’ volume changes via unlimited heat adjustments to the plastic material sandwiched between the leather or synthetic material. A unique plastic allows for a dynamic orthosis, saving both time and money for all concerned. Our innovative designs have been tested and refined in high volume orthotic centers. The resulting high-quality custom AFOs and gauntlets offer optimal fit and are less expensive in today’s ultra cost-conscious environment —without compromising comfort. Orthomerica’s experienced custom fabrication team deliver prompt and exceptional service at highly competitive prices.

For more information, call Orthomerica at 877/737-8444 or visit www.orthomerica.com.

Össur Americas Inc. Foothill Ranch, CA 800/233-6263 www.ossur.com

Ottobock Minneapolis, MN 800/328-4058 www.ottobockus.com Trace, Trim, and Walk Away!

The WalkOn® Trimable and the WalkOn® Flex AFOs by Ottobock offer high quality with quick customization. You now have a choice of support coupled with the simplicity of shaping the footplate with scissors, allowing you to deliver personalized solutions to your patients wherever they are. providing a symmetrical and fluid gait pattern with a natural heel strike and good energy return, the new AFO’s also give your patients the additional benefit of encouraging outward rotation of the foot during heel strike.

To learn more, contact your sales representative at 800/3284058 or visit www.ottobockus.com.

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2012 Buyer’s Guide to Foot-Care PEL Supply Co. Cleveland, OH 800/321-1264 www.pelsupply.com

•

• • •

PEL Offers T-Strap for Pes Valgus Control The new T-Strap from Allard uSA is another innovative ToeOFF™ Family product available from pEL Supply.

When an orthotic insole just isn’t enough, the T-Strap pulls the talocrual and subtalor joints laterally to position them back underneath the tibia.

Quick and easy to apply: Distal end attaches to bottom of the ToeOFF footplate—proximal “T” wraps around the ankle and attaches to any ToeOFF Family product lateral strut.

Easily adjusted to customize to the height of the patient’s medial malleous.

Plastazote inner core may be gently heated with dry heat to improve shape and fit.

Soft, breathable, yet supportive outer fabric.

IMPORTANT: T-Strap is intended only for use in conjunction with ToeOFF Family products AnD a custom orthotic appropriate to meet the patient’s foot positioning requirements.

For more information on T-Strap and all Allard ToeOFF products, contact pEL Supply 800/321-1264, fax 800/222-6176, email customerservice@pelsupply.com, or order online at www.pelsuppy.com.

Lower-Limb Prostheses Fillauer Companies Chattanooga, TN 800/251-6398 www.fillauer.com Aeris Performance from EmotisThe foundation of the Aeris performance is our successful ibex foot. The Aeris performance adds compliant composite Technology (ccT) that is derived by using multiple springs to increase the range of flexibility. The result is a unique Advanced Energy release (AEr) pylon design composed of nested parallel springs that enable the foot to react in a compliant manner at heel strike and then work together to create a dynamic transition from push-off to toe release. The AEr pylon takes advantage of independent spring action to provide smooth, stable progression while increasing the axial rotation which minimizes the forces transmitted to the residual limb.

For more information, contact Fillauer companies at 800/251-6398 or visit www.fillauer.com.

Fillauer Companies Chattanooga, TN 800/251-6398 www.fillauer.com Element DS from Emotis The Element DS’s design utilizes an innovative 3rd carbon composite spring that supports the foot in each phase of the gait cycle. From heel strike, to midstance and toe off; the result is a foot with unsurpassed smoothness, stability and energy return.

Features and benefits: • Smooth rollover and superior stability • Vertical shock and 60° of axial rotation • Innovative Micro-Slice technology for multi-axial performance • Adjustable heel wedge for fine tuning heel stiffness • Maintenance free design • Low profile design—6.5 in. build height • Durable; meets the ISO-22675 test standard.

For more information, contact Fillauer companies at 800/251-6398 or visit www.fillauer.com.

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2012 Buyer’s Guide to Foot-Care Fillauer Companies

Fillauer Companies

Chattanooga, TN 800/251-6398 www.fillauer.com

Chattanooga, TN 800/251-6398 www.fillauer.com

Element from Emotis The Element sets itself apart from two spring prosthetic foot designs by adding an innovative 3rd Element. Emotis has designed the Element to support each phase of foot function in the gait cycle—from heel strike, to mid-stance, to toe off.

The result is a foot with unsurpassed smoothness, stability and performance throughout the gait cycle.

Features and benefits: • Unique three element design • Smooth rollover and superior stability • Adjustable heel wedge for fine tuning heel stiffness • Innovative Micro-Slice technology for multi axial performance • Low profile design requires only 3.75 in. clearance (9.5 cm) • Durable; meets the ISO-22675 test standard • Incredibly lightweight only 11 oz. (310 g).

For more information, contact Fillauer companies at 800/251-6398 or visit www.fillauer.com.

Wave Comfort from Emotis The Wave comfort brings an exceptional level of comfort to the low and moderate activity user. The unique tri-spring design elements work in concert to provide seamless transition and stable progression from heel strike to toe off. The coupled springs react in a compliant manner that promotes a supple feel while maintaining the dynamic response expected in carbon composite feet.

Features and benefits: • Novel Tri-Spring design • Compact comfort • Unique Wave-Spring technology • Progressive dynamic response • Easily adjustable heel stiffness • Enhanced plantar flexion • Shock absorption • Balanced compliance • Smooth rollover • Low profile (4.0 in.) clearance • Lightweight—13.2 oz. (size 26 cm).

For more information, contact Fillauer companies at 800/251-6398 or visit www.fillauer.com.

Fillauer Companies Chattanooga, TN 800/251-6398 www.fillauer.com Ibex from Emotis The ibex is a leap forward in multiaxial foot design. The innovative micro-slices in the ibex pylon and the split heel plate provide controlled inversion/eversion for uneven terrain. The multi-axial design is energy optimized with a long carbon pylon and full length heel plate that allows the ibex to reach foot flat sooner and store more energy. The unique components of the ibex work together from heel strike to toe off to provide stability without sacrificing energy return. The ibex foot’s balanced performance gives amputees the confidence they need to meet life’s challenges head on.

For more information, contact Fillauer companies at 800/251-6398 or visit www.fillauer.com.

Fillauer Companies Chattanooga, TN 800/251-6398 www.fillauer.com Wave Sport from Emotis From extreme sports to light jogging, the Wave Sport has the performance active amputees desire. The Wave foot design uses an innovative wave spring between the pylon and heel plate to provide shock absorption and stability. The full heel plate allows it to be used in a foot shell and worn with standard athletic shoes.

Features and benefits: • Unique Wave-Spring heel technology • Designed for foot shell and most athletic shoes • Excellent shock absorption • Full length heel for greater stability and dynamics • “C-shaped” composite pylon for maximum energy return • Custom built for each patient • Modular adapters for easy alignment • Accommodates a wide range of activity levels.

For more information, contact Fillauer companies at 800/251-6398 or visit www.fillauer.com.

NOVEMBER 2012 O&P AlmAnAc

47

2012 Buyer’s Guide to Foot-Care Fillauer Companies Chattanooga, TN 800/251-6398 www.fillauer.com Raize from Hosmer The raize is a unique microprocessor ankle/foot system in a low profile, lightweight design. its plantar/dorsi-flexion range reduces damaging forces on the residual limb and greatly enhances stability on slopes and slippery surfaces. By simply pressing a button the wearer can control rollover resistance, lock or unlock the ankle, and adjust the heel height as needed.

Features and benefits: • Adjustable heel height and lock via control pod or remote fob • Adjustable plantar/dorsiflexion range and resistance via control pod or remote fob • Terrain accommodation mode aids gait on inclines and declines • Remote ankle lock for driving and donning shoes and socks • Intuitive computer interface for initial setup by prosthetist.

For more information, contact Fillauer companies at 800/251-6398 or visit www.fillauer.com.

Socks Cascade Orthopedic Supply Inc. Chico, CA 800/888-0865 www.cascade-usa.com

Comfort Products Inc. Croydon, PA 800/822-7550 www.comfortoandp.com

Knit-Rite Inc. Kansas City, KS 800/821-3094 www.knitrite.com SmartKnit® Seamless Socks SmartKnit® Seamles Socks are ideal for diabetic, arthritic and sensitive feet. core-spun, high-stretch fibers huG your feet comfortably like a protective second skin reducing risks from wrinkling and bunching.

Patented SmartKnit ® socks are truly seamless to eliminate pressure points found in other diabetic or traditional socks. non-Binding halo-Top™ fits comfortably to minimize indentations. Superior moisture wicking fibers and antimicrobial to inhibit odor in the sock help to keep feet dry and healthy. Enhance the effectiveness of recommendations for protecting patients’ feet with foot display and detailed patient brochures, explaining the important role diabetic socks play in management of diabetes.

For more information contact Knit-Rite today at 800/8213094 or customerservice@knitrite.com.

OPTEC USA Inc. Lawrenceville, GA 888/982-8181 www.optecusa.com

48

O&P AlmAnAc NOVEMBER 2012

EEZZFFlex lex L Liner iner

Practical PracticalMagic Magic Hardly Hardlyjust justa apretty pretty face,the face,theEZEZFlex FlexLiner Liner delivers deliversunequaled unequaledfunction function without withoutsacrificing sacrificinganything. anything.

Unified Flexible Front Unified Flexible Front

The unique fabricfabric on the The unique on the anterior surface provides anterior surface provides unlimited stretch over over the the unlimited stretch patella for greater elasticity patella for greater elasticity whilewhile reducing pressure on the reducing pressure on the knee knee and the of energy andamount the amount of energy required to flex required to the flexknee the knee

80% Less Vertical Stretch 80% Less Vertical Stretch Posteriorly Posteriorly

AsAs compared toto other Alps gelgel compared other Alps liners, virtually eliminating liners, virtually eliminating pistoning while minimizing pistoning while minimizing bunching behind the knee bunching behind the knee during flexion during flexion

Medial viewview of theofknee in flexion Medial the knee in flexion demonstrates the greater elasticity demonstrates the greater elasticity of theofanterior fabric to extend over over the anterior fabric to extend the front of theofknee.

Paring it with the front the knee.

Paring it with the limited vertical stretch posterior the limited vertical stretch posterior fabric reduces the overall efforteffort fabric reduces the overall expended by the to bend the the expended byamputee the amputee to bend kneeknee and increases comfort. and increases comfort.

AlpsAlps NewNew EZ EZ FlexFlex Liner Liner (anterior viewview shown (anterior shown above) is available in in above) is available 3mm or 6mm Uniform 3mm or 6mm Uniform thicknesses.

Eight sizes thicknesses.

Eight sizes fit circumferences of 16 fit circumferences of 16 cm cm to 44 to cm.

44 cm.

NOW NOW ININ STOCK: STOCK: Experience Our Commitment

ŠŠ 2010 ALPS. Rights Reserved.

2009 ALPS.AllAll Rights Reserved.

Antioxidants & EZ GelGel Antioxidants & EZ Protect Skin-Protect Skin--

Antioxidants in EZin Gel Antioxidants EZhelp Gel help protect the skin damage protect the from skin from damage caused by free caused by radicals. free radicals.

ALPS ALPS EZGelEZGel is perfect for those is perfect for those with with poor poor skin characteristics skin characteristics or sensitive tissues. or sensitive tissues.

Budget Friendly-Budget Friendly-No other liner liner on the No other onmarket the market provides this quality, durability provides this quality, durability and functionality at this and functionality at price... this price... absolutely no other! absolutely no other!

800.574.5426 800.574.5426 www.easyliner.com www.easyliner.com info@easyliner.com info@easyliner.com

2012 Buyer’s Guide to Foot-Care PEL Supply Co.

DELCAM

Cleveland, OH 800/321-1264 www.pelsupply.com

Salt Lake City, UT 877/335-2261, x153 www.orthotics-cadcam.com

PEL Supply Offers Hugger Top Soft-Sock® Soft and cuddly when worn next to the skin, the new hugger Top Soft-Sock® from Knit-Rite offers a more tailored fit, reduced rolling and bunching, and helps to maintain sock placement, while utilizing the stretching and fitting qualities of Lycra.

Knit-Rite says that their patented hemispherically knit three-dimensional distal end shape provides improved fit and comfort over the traditional flat knit envelope shape of prosthetic socks. now available from pEL Supply in white, pink, and black, the moisture wicking fibers of the Hugger Top Soft-Sock help to pull moisture away from the skin and inhibit odor in the sock.

For more information about Hugger Top Soft Socks or any fine Knit-Rite products, ccontact PEL Supply at 800/321-1264, fax 800/222-6176; email customerservice@pelsupply.com, or order online at www.pelsupply.com.

Build a Solution to Fit your Process We provide a full custom orthotic insole solution from scanning your patient’s foot through to manufacturing a perfect orthotic. All in an open platform so you can build a solution which meets your exact needs. Scan with iQube, Model with Or-thoModel, Mill with OrthoMiLL and manage your orders with OrderManager. We will provide you with design and manufacturing methods that will reduce your costs improve the quality of your orthotics and the productivity or your clinic. isn’t it time for you to step into the digital laboratory. contact us today to learn how our innovative methods can help you. contact us today to learn how our innovative methods can help you at 877/335-2261, x153, or visit us online at www.orthotics-cadcam.com.

Miscellaneous

COMPRESSION HOSIERY

CAD/CAM CASTING AND FABRICATION Amfit Inc. Vancouver, WA 800/356-FOOT (3668) www.amfit.com Where Technology Fits. Perfectly.

Since 1977, Amfit has elevated the process of creating custom foot orthoses in the computer age.

Superior equipment and software engineered and built in the uSA offer scan, design and fabrication capabilities at any volume. choose start to finish fabrication on-site using the contact Digitizer and cad/ cam Mill or instantly send finished files to Amfit central Fabrication via the contact Digitizer or Impress Scanner. Use Amfit Correct & Confirm software for unprecedented flexibility and control over creating accommodative and functional foot orthoses.

Learn more at www.amfit.com or call 800/356-FOOT (3668) today.

50

O&P AlmAnAc NOVEMBER 2012

Knit-Rite Inc. Kansas City, KS 800/821-3094 www.knitrite.com

JOBS

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

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

Mid-atlantic certified Orthotist / Technician ABc/BOc Fredericksburg, Virginia Mobility Prosthetics and Orthotics is looking for an energetic, experienced, and motivated orthotist. If you possess strong orthotic clinical and technical skills, you might be good for this position. We have a full lab performing in-house fabrication. Acute-care and pediatric experiences are a plus.

We offer competitive salary, bonus opportunity, and comprehensive benefits package.

Please fax your resume to:

Fax: 540/899-0129 Email: ctaylor.mobilitypando@verizon.net

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

$482 $634

$678 $830

Advertisements and payments need to be received approximately one month prior to publication date in order to be printed in the magazine. Ads can be posted and updated at any point on the O&P Job Board online at jobs.AOPAnet.org.

No orders or cancellations are taken by phone.

Ads may be faxed to 571/431-0899 or emailed to srybicki@ AOPAnet.org, along with a VISA or MasterCard number, the name on the card, and the expiration date. Typed advertisements and checks in U.S. currency made out to AOPA can be mailed to P.O. Box 34711, Alexandria, VA 22334-0711.

Note: AOPA reserves the right to edit Job listings for space and style considerations.

Responses to O&P box numbers are forwarded free of charge. Company logos are placed free of charge.

JOB BOARD RATES Visit the only online job board in the industry at jobs.AOPAnet.org!

member Rate $80

nonmember Rate $140

Increase exposure and save!

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

52

O&P AlmAnAc NOVEMBER 2012

Pittsburgh Tenure-stream prosthetics and orthotics faculty position now open at the University of Pittsburgh.

Qualifications: ABC certification and PhD related to orthotics and/or prosthetics. Minimum of three years of teaching, clinical, and/or research experience. Prior experience in teaching and/or research preferred. Evidence of and/or potential for productivity in scholarly activity, as shown through publications, research grants, and presentations.

Responsibilities: Responsible for teaching, service, and research in MS in O&P program, including/not limited to, program/curriculum development, evaluation, accreditation, clinical education, student recruitment, and developing/ expanding a research and development program. Participate in scholarly activity and secure independent research funding. Participate in professional service within the orthotics and prosthetics profession, service to RST and university at large. Participate in teaching and serve as a mentor to students.

As part of the University of Pittsburgh, the School of Health and Rehabilitation Sciences is an affirmative action institution and welcomes applications from military veterans, people from unrepresented minorities, people with disabilities, and other categories of underrepresented persons. People from throughout the world are encouraged to apply.

To apply, send curriculum vitae to:

Rory A. cooper, PhD chair, Department of Rehabilitation Science and Technology School of Health and Rehabilitation Sciences University of Pittsburgh 5044 Forbes Tower Sennott and Atwood Streets Pittsburgh, PA 15260

JOBS North Central

Northeast

cPO/cP/cO

certified Orthotist

Urbana, Illinois A well-established and reputable central Illinois O&P practice is seeking an energetic and motivated practitioner who demonstrates strong O&P clinical skills and experience to conduct comprehensive patient evaluations to determine orthotic and/or prosthetic needs, formulate and provide treatments, perform necessary protocols to deliver the best possible O&P services, and provide follow-up patient care.

The ideal candidate has excellent communication, patient care, and interpersonal skills and adheres to the ABC Canons of Ethical Conduct.

We offer full-time employees benefits and a competitive salary commensurate with experience.

Send resume to:

Vermont Yankee Medical, providing orthotic and prosthetic services for over 65 years, is looking for a certified orthotist ready to locate to Vermont. With five locations in some of the most scenic areas of the country, Yankee Medical offers a lifestyle that attracts professionals. Send your resume to:

Attn: John Ficociello Yankee medical 276 north Avenue Burlington, VT 05401 Email: jnf@yankeemedical.com

Email: pandoresume@gmail.com

www.aoPanet.org YOUR RESOURCE For the o&P Community

“ Six doctors came walking in my room, surrounded my bed and they told me I would not get up again.” Tina Mann Tina Mann

Today Tina Mann walks, hikes, rock climbs, bikes and lives life fully thanks to Hanger Clinic.

She was so inspired by her experience that she became an orthotic resident with us.

Clinic Manager

Competitive salaries/benefits, continuing education, leading edge technologies, management opportunities and even paid leaves to assist in humanitarian causes, all are part of Hanger Clinic career offerings.

• 1,000,000+ patients treated annually • 270,000+ orthotic and prosthetic products • 4,500+ employees Hanger, Inc. is committed to providing equal employment to all qualified individuals. All conditions of employment are administered without discrimination due to race, color, religion, national origin, sex, age, disability, veteran status, citizenship, or any other basis prohibited by federal, state or local law. Residency Program Info, contact: Robert S Lin, MEd, CPO, FAAOP Director of Residency Training and Academic Programs, Hanger Clinic, Ph. 860.667.5304; Fax 860-666-5386.

View our current positions and apply online at: www.hanger.com/careers or scan the QR code.

150 YEARS

700 CLINICS

Available Positions: Clinic Manager Mesa, AZ Akron, OH Waterville, ME

Burnsville, MN Lufkin, TX Tacoma, WA

Orthotist Mesa, AZ Parker, CO Jacksonville, FL Aurora, IL Springfield, IL Urbana, IL Portland, ME

Methuen, MA Jackson, MS Columbia, MO Lancaster, PA Beaufort, SC Spartanburg, SC Waukesha, WI

Prosthetist / Orthotist American Canyon, CA Portland, OR Grand Junction, CO Wilkes Barre, PA New London, CT San Antonio, TX Newark, DE Seattle, WA Pensacola, FL Longview, WA Tamarac, FL Olympia, WA Buffalo, NY Morgantown, WV Mayfield Heights, OH

1 VISION

NOVEMBER 2012 O&P AlmAnAc

53

JOBS

OP Almanac Online &

Reading the O&P Almanac has never been easier!

• access advertiser websites by simply clicking on hotlinks • access content with the click of a mouse or the touch of a smart phone • easily email your favorite articles to colleagues • Save articles as PDFs! Go to www.AOPAnet.org, click on ‘O&P Almanac Online’ today!

For information, contact Stephen Custer at 571/431-0876 or scuster@AOPAnet.org.

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

A NEW AOPAversity OPPORTUNITY!

The EDUCATION You Need From The

EXPERTS You Require AOPA Business

Management

Certificate Program

cPO San Diego, California Leading orthotics and prosthetics company is looking for an energetic and motivated individual with strong orthotic/ prosthetic skills and experience to provide comprehensive assessment, treatment, and follow-up for patients. Duties include assisting in day-to-day office activities such as but not limited to: 1. See in-office patients and perform comprehensive assessments to obtain an understanding of their orthotic/ prosthetic needs.

2. Formulate and implement treatment plans by performing a diagnosis-specific functional clinical examination that includes manual muscle testing, gait analysis, cognitive ability, range of motion, etc.

3. Perform the necessary procedures to deliver the appropriate orthotic/prosthetic services, including fabrication.

4. Abide by the Canons of Ethical Conduct instilled by ABC. 5. Physical requirements such as casting patients, assisting with lifting patients, walking/providing stability for patients, etc.

6. Excellent communication a must.

■ REFRESH YOUR KNOWLEDGE

AOPA is proud to announce the formation of a new Business Management Certificate program. The AOPAversity O&P Business Management Certificate is a comprehensive certificate program that will offer a series of business

■ DEVELOP BETTER BUSINESS PRACTICES

and management seminars to provide business owners, managers and practitioners of O&P patient care facilities, O&P manufacturers and distributors an opportunity to explore crucial business challenges—from finance, sales and marketing to business operations, reimbursement policies and management.

Pacific

■ ADVANCE YOUR CAREER ■ CREATE ONGOING RETURNS FOR YOUR COMPANY

SCOPe offers competitive salaries as well as an excellent benefits package for full-time employees. Salary is commensurate with experience.

All communications will be held in the strictest confidence.

Interested parties can send resumes via email to:

Get started today!

1.

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

The AOPA Business Management

2.

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

skills that are fundamental to the

3.

Complete a Module specific quiz for each program.

4.

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

54

O&P AlmAnAc NOVEMBER 2012

Certificate Program addresses success of an O&P business.

www.AOPAnet.org

Email: jobs@scop.net Fax to 858/292-5496 website: www.scop.net

JOBS

Director of Education and Technical Support

Pacific certified Prosthetist/Orthotist, certified Prosthetist, certified Orthotist

Chattanooga, Tennessee Fillauer Companies Inc. with corporate offices in Chattanooga, Tennessee, is seeking a director of education and technical support. Fillauer is a worldwide leader in orthotics, prosthetics, and fabrication equipment. Candidate should be an ABC-certified CPO or CP with experience in formulating and teaching educational programs. Excellent company benefits.

M/F/D/V Equal Opportunity Company Tennessee Drug-Free Workplace Send resume to:

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

Send resume to:

Email: humanresources@fillauer.com

certified Orthotist/Prosthetist Chattanooga, Tennessee Fillauer O&P, a Chattanooga, Tennessee-based patient care facility, is seeking a certified or board-eligible CPO practitioner. We offer competitive salary, bonus opportunity, and a comprehensive benefit package.

M/F/D/V Equal Opportunity Company Tennessee Drug-Free Workplace Send resume to:

Attention: Human Resources Inland Artificial limb & Brace Inc. Fax: 951/734-1538 Email: ialb720@hotmail.com

Southeast

Email: humanresources@fillauer.com

O&P Board Study Resources

cPO/cO/Orthotic Fitter

We can help you PASS your BOARDS All products updated to 2012 test standards.

Miami, Florida Well-established ABC-accredited facility in Miami is looking for self-motivated Florida State Licensed or eligible CPO/ CO/OF. Great opportunity to join fast growing private company in excellent location. Must have excellent interpersonal and communication skills to provide optimal patient care; must be bilingual English/Spanish. We offer competitive compensation package based on experience. Email your confidential resume to:

Email: pandomiami@gmail.com

Introducing our NEWEST Study Guide in PEDORTHICS

The ONLY Comprehensive Study Guides Specifically for Orthotics and Prosthetics

& Prosthetic

Association

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DiSCoVer more aoPa aDVertiSing oPPortunitieS.

2013

American Orthotic

mediakit Rates effective

Promoting

O&P Since

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Call dean Mather, advertising sales representative, at 856/768-9360 or email dmather@mrvica.com.

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

www.oandpstudyguide.com

1917

et.org

www.AOPAn

NOVEMBER 2012 O&P AlmAnAc

55

SEPtEmbEr 18-21, 2013 |

O r l a n d O, F l O r i d a , U S a g ay l o r D Pa l m S r e S o r t

don’t miss the opportunity to participate in an expanded national assembly in 2013 as aOPa and partners from around the world work to create an O&P World Congress experience for practitioners in the Western Hemisphere and around the world.

Visit www.opworldcongressusa.org for more information.

Expand your knowledge, grow your market presence and advance your career at this unique, global gathering of high visibility and importance.

Why you should plan to attend: • Research and development expenditures in the United States are more than $95 billion, making the United States the leader in medical innovation and creating the ideal location for a unique gathering of high visibility and importance.

• Superior Clinical Education featuring the best speakers from around the world. Hear from physicians, researchers, and top-notch practitioners.

• Practical learning and live demonstrations.

• Preparation for the massive changes that U.S. healthcare reform is sure to bring, and its influence on global health policy.

• Networking with an elite and influential group of professionals.

• Largest display of exhibits in the United States for the orthotic, prosthetic, and pedorthic profession • Ideal U.S. location chosen for travel ease and popularity.

Join Us next Year!

World Congress Esteemed Planning Committee represents the brightest minds in O&P from around the world USA Rep David Boone, Ph.D., Chairman Africa Mr. Masse Niang, CPO Bogota, Colombia Jose Miguel Gomez, MD China Dr. Aaron Leung, Ph.D. Europe Dr. Nerrolyn Ramstrand, Ph.D. Europe Klaas Postema, MD, Ph.D. German Assoc. Rep. Urs Schneider, Dr.-med.

Germany/USA Stephanie Olivo Germany/USA Rep Karen Lundquist, MBC India Ms. Ritu Ghosh Italy Andrea Giovanni Cutti, Ph.D. Panama Marlo Ortiz Vazquez del Mercado P.O US-ISPO Rep Robert Kistenberg, CPO US-ISPO Rep Diane Farabi USA Rep Jim Campbell, Ph.D. USA Rep Thomas DiBello, CO, LO, FAAOP USA Rep Thomas Gavin, CO USA Rep Mark Geil, Ph.D. USA Rep Geza Kogler, Ph.D. USA Rep Michael Orendurff, MS USA Rep Jack E. Ullendahl, CPO USA Rep Jason Wening, MS, CPO, FAAOP

CALENDAR

n■ YEAR-ROUnD TESTInG Multiple Choice examinations. BOC has yearround testing for Multiple Choice Examinations; candidates can apply and test when ready. Orthotist and prosthetist candidates can take the Clinical Simulation Examination in February, May, August, and November.

Applications are accepted any time, although seating is limited. For more information, visit www.bocusa.org or email cert@bocusa.org.

On-SITE TRAInInG Motion Control, Inc. On-site Training Course is focused on the expedited fitting of your first patient. Course Length: 3 days, CEUs: 19.5 hours (estimated). Recommended for prosthetists with a patient ready to be fit immediately.

For more information, call 888/696-2767 or visit www.

UtahArm.com. n■

n■

2012 n■ nOVEmBER 7-9 New Jersecy academy of Orthotists & Prosthetists 2012 annual Meeting.

Atlantic City. Bally’s Hotel and Casino. For details, contact Lisa Lindenberg at 973/609-2263 or visit www. njaaop.com.

nOVEmBER 10 Ultraflex: Pediatric Spasticity Continuing education Course, via Webex, 9–10 aM et. Covers clinical assessment of the pediatric neuromuscular patient with spasticity and using R1 and R2 for determining orthotic design for maintaining and improving muscle length.

Presenter: Keith Smith, CO, LO, FAAOP. Register at www. ultraflexsystems.com or call 800/220-6670. n■

PROmOTE EVEnTS In THE O&P AlmANAc

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

WORdS

Member Rate

Nonmember Rate

25 or less .................. $40 .................................$50 26-50 ........................ $50 .................................$60 51+ .................. $2.25 per word...............$3.00 per word Color ad Special: 1/4 page Ad ............. $482 .............................. $678 1/2 page Ad ............. $634 .............................. $830 BONUS! Listings will be placed free of charge on the attend O&P events section of www.AOPAnet.org.

Send announcement and payment to: O&P Almanac, Calendar, P.O. Box 34711, Alexandria, VA 22334-0711, fax 571/431-0899, or email srybicki@AOPAnet.org along with VISA or MasterCard number, the name on the card, and expiration date. Make checks payable in U.S. currency to AOPA. Note: AOPA reserves the right to edit Calendar listings for space and style considerations.

For information on continuing education credits, contact the sponsor.

Questions? Email scuster@AOPAnet.org.

n■ nOVEmBER 14 aOPaversity audio Conference–Medicare enrollment Procedures. For more information, contact Stephen Custer at 571/4310876 or scuster@AOPAnet.org.

n■ nOVEmBER 14 Ultraflex: Pediatric UltraSafeGait™ Continuing education Course, via Webex, 5–6 PM et. Covers assessment of pediatric pathological gait and influencing shank kinematics with the new Adjustable Dynamic Response™ (ADR™) technology. Presenter: Keith Smith, CO, LO, FAAOP. Register at www. ultraflexsystems.com or call 800/220-6670. n■ nOVEmBER 19 WillowWood: discover LimbLogic® vS via Webex, 1:30 PM et. Critical components and operation discussed. Covers interpreting feedback from fob and basic fabrication processes for system. Credits: 2.5 ABC/2.5 BOC. To register online, visit www.willowwoodco.com. n■ nOVEmBER 20 WillowWood: LimbLogic® vS for technicians via Webex, 1:30 PM et. Learn essentials of elevated vacuum socket fabrication using available socket adaptors with LimbLogic VS. Learn how to deal with airtight issues, unit operation, and diagnostics that will keep the system optimal for patient use.

Credits: 2.5 ABC/2.5 BOC. Visit www.willowwoodco.com. n■ nOVEmBER 27 Ultraflex: adult UltraSafeStep® Continuing education Course, via Webex, Noon–1 PM et.

Focuses on normalizing adult pathological gait with the utilization of Adjustable Dynamic Response™ (ADR™) knee and ankle

technology. Presenter: Marc Kaufman, CPO. Register at www.ultraflexsystems.com or call 800/220-6670. n■ nOVEmBER 29 Ultraflex: Complex Orthopedic Rehabilitation Continuing education Course, via Webex, Noon–1 PM et. Focuses on Ultraflex combination dynamic and static stretching orthosis for addressing complex orthopedic rehabilitation goals and restoring range and function. Presenter: Jim Rogers, CPO, FAAOP. Register at www.ultraflexsystems.com or call 800/220-6670. n■ DEcEmBER 1 aBC: Certification exam application deadline.

Applications must be received

by Dec. 1 for individuals seeking to take the winter 2013 ABC certification exams for orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, therapeutic shoe fitters, and orthotic and prosthetic technicians. Contact 703/8367114, email info@abcop. org or visit www.abcop.org/ certification. n■ DEcEmBER 4-6 WillowWood: OMeGa® tracer® training. Mt. Sterling, OH. This hands-on class covers both orthotic and prosthetic software tools, scanner applications and tasks, ‘by measurement’ shape creation, advanced tool usage, and creating custom liners. Attendees work with patient models.

Must be current OMEGA Tracer facility to attend.

Credits: 18.5 ABC/18.5 BOC. Visit www.willowwoodco.com.

NOVEMBER 2012 O&P AlmAnAc

57

CALENDAR

n■ DEcEmBER 5 Ultraflex: Pediatric UltraSafeGait™ Continuing education Course, via Webex, 8–9 aM et. Covers assessment of pediatric pathological gait and influencing shank kinematics with the new Adjustable Dynamic Response™ (ADR™) technology. Presenter: Keith Smith, CO, LO, FAAOP. Register at www. ultraflexsystems.com or call 800/220-6670. n■ DEcEmBER 7-8 aBC: Prosthetic Clinical Patient Management (CPM) exam. The application deadline for this exam was Sept. 1, 2012. Contact 703/836-7114, email info@ abcop.org, or visit www.abcop. org/certification. n■ DEcEmBER 10 WillowWood: LimbLogic® vS applications Practitioners Course. Mt. Sterling, OH. Course covers various clinical aspects of LimbLogic VS applications: static and dynamic socket fitting, vacuum pump configurations, fob operation, system evaluation, liner options, alignment, and troubleshooting. Credits: 7.0 ABC/7.0 BOC. Registration deadline was Oct. 25, 2012.

Contact 877/665-5443 or visit www.willowwoodco.com. n■ DEcEmBER 11 WillowWood: LimbLogic® vS applications technicians Course. Mt. Sterling, OH. Learn all aspects of fabricating LimbLogic VS for various applications: socket materials, controller configurations and care, fob operation, troubleshooting.

Fabricate sockets following recommended techniques for airtight socket designs.

Credits: 9.75 ABC/9.75 BOC. Registration deadline was Oct. 25, 2012. Contact 877/665-5443 or visit www. willowwoodco.com.

58

O&P AlmAnAc NOVEMBER 2012

n■ DEcEmBER 12 aOPaversity audio Conference–are You Ready for the New Year? 2013 New Codes and Policies. For more information, contact Stephen Custer at 571/431-0876 or scuster@AOPAnet.org.

n■ SEPTEmBER 18-21 O&P World Congress.

Orlando. Gaylord Palms Resort. Attend the first U.S.-hosted World Congress for the orthotic, prosthetic, and pedorthic rehabilitation profession. To register, contact Stephen Custer at 571/4310876 or scuster@AOPAnet.org.

2013 n■ JAnUARY 4-5 aBC: Prosthetic Clinical Patient Management (CPM) exam. The application deadline for this exam was Sept. 1, 2012. Contact 703/836-7114, email info@ abcop.org, or visit www.abcop. org/certification.

FEBRUARY 20-23 39th academy annual Meeting & Scientific Symposium. Orlando.

Caribe Royale Orlando.

Contact Diane Ragusa at 202/380-3663, x208, or email dragusa@oandp.org. n■

n mARcH 1-2 Oklahoma association for O&P annual Meeting.

Tulsa, OK. Marriott Southern Hills. For more information, visit www.okaop.org, contact Jane Edwards at 888/388-5243, or email jledwards88@att.net. n■ mARcH 15-16 PrimeFare West Regional Scientific Symposium 2013.

New Location. Denver.

Denver Marriott City Center.

Contact Jane Edwards at 888/388-5243 or visit www.primecareop.com. n mARcH 21-23 2013 annual Meeting of the International africanamerican Prosthetic Orthotic Coalition. Atlanta.

Georgia Tech Hotel and Conference Center. Contact Tony Thaxton Jr. at 404/8750066 or email thaxton.jr@ comcast.net. Visit www.iaapoc. org for more information.

2014 n■ FEBRUARY 26 - mARcH 1 40th academy annual Meeting & Scientific Symposium. Chicago. Hyatt Regency Chicago. For more information, contact Diane Ragusa at 202/380-3663, ext.

208, or dragusa@oandp.org.

SEPTEmBER 3-6 97th aOPa National assembly. Las Vegas.

Mandalay Bay Resort & Casino. For more information, contact AOPA Headquarters at 571/431-0876 or info@ AOPAnet.org. n■

2015 n■ FEBRUARY 18-21 41st academy annual Meeting & Scientific Symposium. New Orleans.

Hyatt Regency New Orleans.

For more information, contact Diane Ragusa at 202/3803663, ext. 208, or dragusa@ oandp.org. n■ OcTOBER 7-10 98th aOPa National assembly. San Antonio.

Henry B. Gonzales Convention Center. For more information, contact AOPA Headquarters at 571/431-0876 or info@AOPAnet.org.

2016 n■ mARcH 9-12 42nd academy annual Meeting & Scientific Symposium. Orlando. Caribe Royale Orlando. For more information, contact Diane Ragusa at 202/380-3663, ext.

208, or dragusa@oandp.org. n■ SEPTEmBER 15-18 99th aOPa National assembly. Orlando. Gaylord Palms Resort. For more information, contact AOPA Headquarters at 571/431-0876 or info@AOPAnet.org. a

AD INDEX

COMPaNY

PaGe

PHONe

WeBSIte

ALPS

49

800/574-5426

www.easyliner.com

American Board for Certification in Orthotics, Prosthetics & Pedorthics

13

703/836-7114

www.abcop.org

Arizona AFO

C4

877/780-8382

www.arizonaafo.com

Becker Orthopedic

25

800/521-2192

www.beckerorthopedic.com

Cailor Fleming Insurance

9

800/796-8495

www.cailorfleming.com

DAW Industries

1, 51

800/252-2828

www.daw-usa.com

Dr. Comfort

C3, 5

800/556-5572

www.drcomfortdpm.com

Ferrier Coupler Inc.

17

800/437-8597

www.ferrier.coupler.com

Fillauer

2

800/251-6398

www.fillauercompanies.com

Friddle’s Orthopedic Appliances

35

800/369-2328

www.friddles.com

KISS Technologies LLC

33

410/663-5477

www.kiss-suspension.com

OPTEC

18, 19, 30, 31

888/982-8181

www.optecusa.com

Orthomerica Products

23

800/446-6770

www.orthomerica.com

Orthotic and Prosthetic Study and Review Guide

55

Össur Americas Inc.

7

800/233-6263

www.ossur.com

Otto Bock HealthCare

C2

800/328-4058

www.ottobockus.com

PEL Supply

15

800/321-1264

www.pelsupply.com

®

www.oandpstudyguide.com

Statement of Ownership, Management and Circulation (required by U.S.P.S. Form 3526) 1. Publication Title: O&P Almanac 2. Publication No.: 1061-4621 3. Filing Date: 9/28/12 4. Issue Frequency: Monthly 5. No. of Issues Published Annually: 12 6. Annual Subscription Price: $59 domestic/$99 foreign 7. Complete Mailing Address of Known Office of Publication (Not Printer): American Orthotic & Prosthetic Association, 330 John Carlyle St., Suite 200, Alexandria, VA 22314 8. Complete Mailing Address of Headquarters or General Business Office of Publisher (Not Printer): Same as #7 9. Full Names and Complete Mailing Addresses of Publisher, Editor, and Managing Editor: Publisher: Thomas F. Fise, address same as #7. Editor: Josephine Rossi, Stratton Publishing & Marketing, Inc., 5285 Shawnee Road, Suite 510, Alexandria, VA 22312. 10. Owner (Full Name and Complete Mailing Address): American Orthotic & Prosthetic Association, same as #7 11. Known Bondholders, Mortgagees, and Other Security Holders Owning 1 Percent or More of Total Amount of Bonds, Mortgages, or Other Securities: None. 12. The purpose, function, and nonprofit status of this organization and the exempt status for federal income tax purposes: Has Not Changed During the Preceding 12 Months. 13. Publication Name: O&P Almanac 14. Issue Date for Circulation Data Below: September 2012

15. Extent and Nature of Circulation: a. Total number of Copies (Net Press Run) b. Paid and/or Requested Circulation (1) Paid or Requested Outside-County Mail Subscriptions (2) Paid In-County Subscriptions (3) Sales Through Dealers and Carriers, Streeet Vendors, Counter Sales, and other non-USPS Paid Distribution (4) Other Classes Mailed through the USPS c. Total Paid and/or Requested Circulation d. Free Distribution by Mail (1) Outside-County as Stated on Form 3541 (2) In-County as Stated on Form 3541 (3) Other Classes Mailed through the USPS e. Free Distribution Outside the Mail f. Total Free Distribution g. Total Distribution h. Copies Not Distributed i. Total (Sum of 15g and h) Percent Paid and/or Requested Circulation

Avg. No. Copies Each Issue During Preceding 12 Months

Actual No. Copies of Single Issue Published Nearest to Filing Date

14,523

17,936

13,970 0 0

15,415 0 0

0 13,970

0 15,415

0 0 0 378 378 14,348 451 14,799 97%

0 0 0 2,360 2,360 17,775 519 18,294 87% NOVEMBER 2012 O&P AlmAnAc

59

AOPA ANSWERS

O&P Detective Work answers to your questions regarding classifying O&P and investigating RaCs AOPA receives hundreds of queries from readers and members who have questions about some aspect of the O&P industry. Each month, we’ll share several of these questions and answers from AOPA’s expert staff with readers.

If you would like to submit a question to AOPA for possible inclusion in the department, email Editor Josephine Rossi at jrossi@strattonpublishing.com.

Q.

I keep seeing and reading notices about competitive bidding. Is O&P exempt from competitive bidding?

A.

Yes and no. Prostheses are legislatively exempt from the competitive bidding program. Most orthoses also are exempt from the competitive bidding process. The only O&P items that could be part of the competitive bidding process are off-the-shelf (OTS) orthoses, or items that require minimal self-adjustment.

Round 1 of the competitive bidding program and its subsequent re-bids and Round 2 of the competitive bidding program do not contain any OTS orthoses.

Q.

How can I find out what items/services the Recovery Audit Contractors (RACs) are reviewing?

A.

The RACs are required to publish the areas of vulnerability or issues they are targeting for their recoupment activities. You may visit each RAC’s website to view what issues or types of claims each one is auditing. It may be wise to review the areas of vulnerability not only in your jurisdiction, but in other jurisdictions as well.

1. The RAC for Jurisdiction A is Performant Recovery (formerly Diversified Collection Services), and its website is www.dcsrac.com.

To find the issues under review, click on the “Provider Portal” link on the top of the page.

2. The RAC for Jurisdiction B is CGI, and its

60

O&P AlmAnAc NOVEMBER 2012

website is http://racb.cgi.com. To find the issues under review, click on the “Issues” link on the top of the page.

3. The RAC for Jurisdiction C is Connolly Inc., and its website is www.connollyhealthcare.com/ RAC. To access the issues under review, locate the “Important Links” box found on the righthand side of the website.

4. The RAC for Jurisdiction D is HealthDataInsights, and its website is http:// racinfo.healthdatainsights.com. To locate the issues under review, click on the “New Issues” link on the top of the page.

Q. A.

Does the FDA classify O&P items as Class I or Class II devices?

Most O&P items have been classified as Class I devices by the Food and Drug Administration (FDA). The FDA classifies Class I devices as those that pose minimal potential harm to the patient and have a record of safe use by the patient community.

Since O&P items are considered Class I devices, they are not subject to a lot of regulatory control by the FDA. Some of this regulatory control is the need for items to go through the premarket notification process or the 501(K) process, but because O&P items are considered Class I devices they are exempt from the 501(K) requirements.

This exemption can be located in Code of Federal Regulations, Title 21, Part 890. However, items such as cranial remolding helmets are considered as Class II devices. a

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