September 2012 Almanac

OP

The American Orthotic & Prosthetic Association SEPTEMBER 2012

&

WWW.AOPANET.ORG

THE MAGAZINE FOR THE ORTHOTICS & PROSTHETICS INDUSTRY

Documentation and

Denial What you don’t know about physician records and recovery audits could cost you

INSIDE: 2012 AOPA National Assembly Exhibit Directory and Floor Plan Is V-OP Right for Your Business?

Comfort, security, reliability All in one vacuum system.

Start with the new Triton Harmony® foot, which integrates the functionality of the Triton carbon fiber foot with the proven Harmony® P3 vacuum technology.

Patients get reduced volume loss plus better proprioception and connection for increased safety and comfort. All this in an integrated one-piece foot design!

Add the innovative Anatomic 3D PUR Urethane Liner (thicker where protection is needed and thinner where flexibility is required). Combine it with the ProFlex sleeve for easy flexion and a secure seal.

Contact your sales representative at 800.328.4058 for more details.

www.ottobockus.com

DAW’s SLK beats all other MPKs for most active patients.

OPEN FORUM WELCOME... See you in Boston Booth #213

in w n i Aw and

ou for y patient your

NO OTHER

TGK-5PSØSLK TGK-5PS1ØSLK

Microprocessor Knee

can match the SLK

(800) 252-2828

www.daw-usa.com

Copyright © 2012 DAW Industries, San Diego, CA. All rights reserved.

Raize

Aeris Performance from Emotis

from Hosmer

Isocentric RGO from Center for Orthotics Design

BT-4 Oven from OTS Corp

OAK Orthosis from Fillauer LLC

Dynamic Walk from Centri

Motion Foot from Motion Control

Visit Fillauer at AOPA Boston Booth 219 Fillauer LLC 1.800.251.6398 • Hosmer 1.800.827.0070 Motion Control 1.888.696.2767 Center for Orthotics Design 1.800.346.4746 Centri +46 8 505 332 00 • OTS Corp 1.800.221.4769 AD335/07-30-12

O&P Almanac CONTENTS

SEPTEMBER 2012, VOLUME 61, No. 9

COLUMNS

Cover Story

24 Documentation and Denial

By Tora Estep Prosthetists and orthotists have experienced record levels of claims denials over the past year, following OIG’s “Questionable Billing Practices” report and DME MACs’ subsequent zerotolerance audit and claims review policy.

While practitioners work tirelessly to encourage physicians to provide proper documentation for the services they are prescribing, AOPA and the O&P Alliance are pursuing measures to challenge the initial report and ease the burden for O&P professionals.

Feature

34 Gone to the Dogs

By Lia K. Dangelico Adding a veterinary component to your practice can be an attractive business option as more pet owners turn to O&P to improve and prolong the quality of life for their dogs and cats. But there are many challenges to consider before becoming a “V-OP” provider—including proper education, financial considerations, and the politics of partnering with veterinarians.

SPeCIAL FEATURE

56 2012 Exhibit Directory

Use this listing and floor plan to navigate your visit to AOPA’s 2012 National Assembly Expo.

18

Reimbursement Page Know where to send the bill for inpatient services to Medicare beneficiaries

40

Ask the Expert Learn the requirements of PDAC’s coding verification process

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

46

AOPA Headlines News about AOPA initiatives, meetings, and more

54 AOPA Membership 00 Applications 66 Marketplace 68 Jobs

Opportunities for O&P professionals

73 Calendar 78

Ad Index

80

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.

SEPTEMBER 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

Kelly O’Neill, manager of membership and meetings, 571/431-0852, koneill@AOPAnet.org

O&p Almanac

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

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

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

&

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

Lauren Anderson, coordinator, membership operations and meetings, 571/431-0843, landerson@AOPAnet.org

BOARD oF DIRECTORS

AOPA Bookstore: 571/431-0865

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

Communications Steffanie Housman, content strategist, 571/431-0835, shousman@AOPAnet.org Steven Rybicki, communications manager, 571/431-0835, srybicki@AOPAnet.org Government affairs

Lia K. Dangelico, contributing writer, 703/914-9200 x24, ldangelico@strattonpublishing.com

OP Almanac

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

Officers

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 Treasurer James Weber, MBA, Prosthetic & Orthotic Care Inc., St. Louis, MO Immediate Past President James A. Kaiser, CP, Scheck & Siress, Chicago, IL 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, OrPro Inc, Irvine, CA Russell J. Hornfisher, MBA, MSOD, Becker Orthopedic Appliance Co., Troy, MI

O&P HISTORY

A Look Back in Time

Alfred E. Kritter, Jr., CPO, FAAOP, Hanger Inc., Savannah, GA Eileen Levis, Orthologix LLC, Philadelphia, PA Ron Manganiello, New England Orthotic & Prosthetic Systems LLC, Branford, CT Mahesh Mansukhani, MBA Ă–ssur Americas, Aliso Viejo, CA

Get your fill at www.oandplibrary.org/op!

A digital archive of issues ranging from 1975 to 1988 of O&P Journal, predecessor of the O&P Almanac.

4

O&P Almanac SEPTEMBER 2012

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

Our Comfort Is Preferred

By Your Patients!

Beautiful Design, Details and Construction Lead To Increased Patient Compliance.

Our Shape To Fit Line of Compression Wear NOW Includes Thigh Highs and Panty Hose.

Men’s Active Comfort Collection

From A Family of Comfort. ©2012 Dr. Comfort All Rights Reserved

AT IN THE A GLANCE NEWS

Veterinary Services in the United States If you are considering expanding your O&P practice to partner with veterinarians or provide O&P services for pets, these statistics may be helpful‌

Current Careers

Salaries

Predicted Job Growth

$82,040

61,400

36% $65,060

12%

6,300

Number of veterinarian jobs in 2010

Number of orthotist/prosthetist jobs in 2010

Median pay for veterinarians in 2010

Median pay for orthotists and prosthetists in 2010

Predicted rate Predicted rate of employment of employment opportunity growth opportunity growth for orthotists/ for veterinarians prosthetists from from 2010 to 2020 2010 to 2020

Sources: Bureau of Labor Statistics Occupational Outlook Handbook, www.bls.gov/ooh.

62%

Percentage of U.S. households that have a pet.

30,000 Estimated number of veterinary clinics in the United States.

$580-$875 Average annual cost of dog ownership, excluding the first year.

$13.4 billion Total spent on veterinary care by U.S. pet owners in 2011.

$248

Amount U.S. dog owners spent on routine vet visits in 2011. (An additional $407 was spent on surgical vet visits.)

28

Number of veterinary schools in the United States.

Sources: American Pet Products Association, www.4vetclinics.com; American Society for the Prevention of Cruelty to Animals, www.aspca.org; Association of American Veterinary Medical Colleges, www.aavmc.org.

6

O&P Almanac SEPTEMBER 2012

The Revolutionary RUSH ™ Foot

The future has arrived!

CARBON FIBER

The future is the RUSH foot by Ability Dynamics! RUSH is made from Flexeon, an incredibly durable composite fiber material that also provides extraordinary flexibility.

Flexeon is durable, flexible and provides dynamic feedback. The high-energy return of this remarkable foot enables amputees to easily traverse even the most aggressive terrain. Best of all, it’s virtually indestructible allowing the wearer to engage in all their desired activities with total piece of mind.

Visit us at booth #1524 at AOPA

At Ability Dynamics, we’ve taken advantage of the latest in advanced composite material technology to create the revolutionary RUSH foot.

The RUSH foot finally provides prosthetists and amputees with a real solution.

VISIT ABILITYDYNAMICS.COM OR CALL US TOLL-FREE AT: 855-450-7300

IN THE NEWS

Oscar Pistorius, the South African sprinter, made history last month as he became the first bilateral amputee to compete in the Olympic Games.

Born without fibulas in both legs, Pistorius underwent below-knee amputation as an infant. With the help of his “Cheetah” blade-shaped artificial limbs, he has earned world records in the double-amputee 100-, 200-, and 400-meter dashes. For his astonishing speed, Pistorius has been affectionately dubbed “Blade Runner” and “The Fastest Man on No Legs.”

Additionally, Pistorius has competed against his able-bodied contemporaries, performing quite well despite his physical limitations.

On August 4, Pistorius got the chance to take part in the Olympic men’s 400-meter dash, though his road to London was not an easy one. In 2007, the International Association of Athletics Federations banned Pistorius from able-bodied competition, after research suggested that his running blades gave him an unfair advantage over competitors. Aided by a team of scientists and lawyers, Pistorius disproved the preliminary findings

and appealed his case to the Court of Arbitration in Sport—and ultimately gained the approval of the International Olympics Committee.

At the Olympics, Pistorius finished his first heat in second place with a time of 45.44 seconds before being eliminated in the semifinals, during which he finished eighth. Not one to focus on defeat, Pistorius believes he is just getting started. Looking ahead, he states, “In 2016, I’ll probably be at my peak in Rio. I’m looking forward to that more than anything.” No matter what the future holds for Pistorius, his mark on sporting history has already been made; his inclusion in the 2012 Olympics denotes a new benchmark for accomplishment for individuals with prosthetic limbs.

Photo: LOCOG

Oscar Pistorius Makes Historic Olympic Debut

Pistorius’ achievements have not been lost on his able-bodied competitors. Kirani James, the sprinter from Grenada who finished first ahead of Pistorius at the Olympic semifinals, showed admiration for his disabled rival by swapping racing bibs with him after the race had concluded.

“I really respect and admire the guy; I just see him as another athlete and another competitor, and more importantly I see him as another person,” says James. “He is out here making history, and we can all respect and admire that.”

2,300-Year-Old Artificial Leg Discovered in China A prosthetic leg recently unearthed in an ancient tomb in Xinjiang Region, China, has been confirmed as the earliest prosthetic limb in human history, according to Guangming Daily. The leg was discovered among wooden tools and a skeleton that had an amputation of the right leg and deformed thigh bones.

Archeologists claim the artificial leg dates back some 2,300 years, which means it predates Capua

8

O&P Almanac SEPTEMBER 2012

prostheses by several hundred years.

The Capua prostheses—ancient Roman inventions—had been widely recognized as the earliest recorded prosthetic limbs.

The artificial leg discovered in China was a structure composed primarily of wood, approximately 3.5 inches long. The upper and lower halves of the leg were laced together by leather strings, forming what was described a “relatively adjustable” joint.

IN THE NEWS

HHS Posts HIPAA Audit Protocol

The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) has posted the Health Insurance Portability and Accountability Act (HIPAA) audit protocol on its website. The OCR HIPAA audit program analyzes processes, controls, and policies of selected covered entities pursuant to the Health Information Technology for Economic and Clinical Health (HITECH) Act audit mandate, which is legislation created to stimulate the adoption of electronic health records and supporting technology.

According to the HHS website, OCR established an audit protocol that contains the requirements to be assessed through the performance audits. The audit protocol is organized around modules that represent separate elements of privacy, security, and breach notification. There are 77 audit procedures for the HIPAA Security Rule and 88 procedures for the combined Privacy and Breach Notification Rules. The combination of these multiple requirements may vary based on the type of covered entity selected for review.

TRANSITIONS

people in the news

Hanger Clinic has announced several additions to its staff: Theodore Barlow, C.Ped, at its Lafayette, Colorado, patient-care clinic; Haley Branch, CPO, at its patient-care clinic in Denver; Dustin Brooks, CO, at its Kissimmee, Florida, patient-care clinic; Ty J. Oswald, CP, at its Salt Lake City/Provo, Utah, patient-care clinics; Michael Pierce, CPO, at its Macon, Georgia, patient-care clinic; John Ross, C.Ped, at its Denver patient-care clinic; Floyd Thompson, C.Ped, at its Roseburg, Oregon, patient-care clinic; and Jacqueline Ziegler, CO, at its Springfield, Illinois, patient-care clinic.

In addition, Hanger Clinic has hired Eugene DeMarco, CPO, as clinic manager of its Brooklyn, New York, patient-care clinic, and Ronald Moccia Jr. as area clinic manager in its Sebring and Winter Haven, Florida, patientcare clinic area.

10

O&P Almanac SEPTEMBER 2012

Advanced Arm Dynamics’ Northeast Center of Excellence in Philadelphia has added two staff members: Marc Brog, MS, OTR, OTRL, will serve as rehabilitation coordinator, and Maureen O’Connor will serve as business development manager.

In addition, Advanced Arm Dynamics’ Midwest Center of Excellence in Waterloo, Iowa, has hired Jay Pfalzgraf as the new business development manager.

OPAF has awarded the 2012 Dale Yasukawa Scholarship to Jeff Henderson, CO. Henderson is enrolled in the prosthetics program at the Northwestern University ProstheticsOrthotics Center in Chicago, and will be serving his prosthetic residency with Virginia Prosthetics in Charlottesville, Virginia.

Disabled athletes Jessica Long and Kyle Maynard were awarded 2012 Excellence in Sports Performance Yearly (ESPY) awards in the category of athlete with a disability. Long is a swimmer who won 15 gold medals and set four world records over the past year. Maynard summited Africa’s Mt. Kilimanjaro, becoming the first quadruple amputee to do so without assistance.

Andy Schmitz has been hired

by OPGA as member development coordinator. He will be responsible for membership recruitment and retention in addition to coordinating special vendor projects.

Ottobock has announced two promotions: Kathy Schuerman will serve as executive director of finance, U.S. HealthCare, and Matt Swiggum will serve as vice president of mobility solutions, U.S. HealthCare.

Ottobock also has hired Will Perry as an upper-limb sales specialist.

from immobilization through support

patented* system enables a full spectrum of care Not all back braces are alike!

For patients with a compromised spine, molded, rigid plastic, gender specific, custom or custom fitted TLSO back braces provide: • Faster mobilization • Reliable pain relief • Greater protection against accidental re-injury • Earlier hospital discharge, usually within 24-hours

• Superior fit and education for improved patient compliance • Reduced risks of multi-part, fits all, TLSO-like braces

Ask your local ABC/BOC Certified Orthotist about “straps and strings” braces.

Research suggests1,2 that an inappropriate TLSO-like3 back brace is the same as no brace!

Embrace excellence for your patients, choose the VertAlign® Spinal Support System.

See us at the AOPA, booth #911 #911 for urgent, independent info supporting TLSO use for practitioners & patients.

from The Bremer Group Company

Embracing Excellence www.bremergroup.com The Bremer Group Company • 11243-5 St. Johns Industrial Parkway So. • Jacksonville, FL 32246 904-645-0004 • 904-645-0990 Fax • bremergroup@bremer.net

For more information or to request a system, see your VertAlign representative or call 800-428-2304. *U.S. Patent No. 5,718,670.

1 Bailey C, Dvorak M, Nadeau M, et. al., No orthosis is equivalent to TLSO for the treatment of thoracolumbar burst fractures without neurologic injury: results from a multicenter RCT. Spine J 2011;11(suppl 10):1s-2s. | 2 Bailey C, Dvorak M, Nadeau M, et. al., No orthosis is equivalent to TLSO for the treatment of thoracolumbar burst fractures without neurologic injury: results from a multicenter RCT. SpineLine 2011; Nov/Dec:18. | 3 Study used a LSO with T-bar and straps.

VertAlign is a registered trademark of the Bremer Group Company. Copyright, The Bremer Group Company, 2012. All rights reserved. 12-1848-001

IN THE NEWS

FDA Proposes Medical Device ID System The U.S. Food and Drug Administration (FDA) has released a proposed rule that would require most medical devices distributed in the United States to carry a unique device identifier (UDI). Congress passed legislation in 2007 directing the FDA to develop regulations establishing a UDI system for medical devices. A UDI is a unique numeric or alphanumeric code that includes a device identifier, which is specific to a device model, and a production identifier, which includes the current production information for that specific device, such as the lot or batch number, the serial number, and/or expiration date.

A UDI system has the potential to improve the quality of information in medical device adverse event reports, which the FDA said will help identify product problems more quickly, expedite target recalls, and improve patient safety.

The FDA is creating a database that will include a standard set of basic identifying elements for each UDI, and will make most of it available to the public so that users of a medical device can look up information about the device. The UDI does not indicate, and the FDA’s database will not contain, any information about who uses a device, including personal privacy information.

The requirements for device labels and device packages to bear a UDI would be phased in over several years. AOPA members may recall PDAC/CMS efforts earlier this year to institute an O&P device labeling system. AOPA successfully opposed the program as being duplicative of FDA’s UDI program and pointing out only FDA had authority to regulate medical device labeling. PDAC withdrew the requirements.

For more information, visit the FDA’s website at www.fda.gov.

CMS Updates PECOS Website The Centers for Medicare & Medicaid Services (CMS) has redesigned the homepage and login screen of the Provider Enrollment, Chain, and Ownership System (PECOS) website. According to National Government Services’ Jurisdiction B Durable Medical Equipment Medicare Administrative Contractor, CMS made the changes to provide an easier way for users to register for a PECOS account and update personal information.

12

O&P Almanac SEPTEMBER 2012

The redesigned website also features helpful links, including PECOS enrollment tutorials, the Ordering and Referring List, and the Revalidation Notice Sent List.

Browsers can also use the site to check if their revalidation application has been received and processed by the Medicare Administrative Contractor.

In addition, the site features a reassignment report available for all organizations and individuals that are accepting reassignments.

The first name in suspension liners, introduces a breakthrough line of prosthetic socks

ALPS’ Flat Bed manufacturing process provides precision control of Shape Control -shape and thickness, without adjusting yarn volume or tension, which can lead to non-uniform wear or constriction in unwanted areas.

Because ALPS does not remove fibers to create its soft feel, the Mat Free -sock does not lose volume and will not mat down over time.

Proprietary manufacturing methods produce a sock with minimal Less Stretch -stretch - up to 1/3 the stretch of competitor’s socks. This ensures sock thickness is maintained over the life of the sock.

Available in 1-ply, 3-ply or 5-ply and color coded for easy identification

Coolmax provides moisture management to move perspiration Coolmax® Fibers -away from the body to keep wearer cool and comfortable.

® Order with No Hole (N), Hole (H) or Reinforced Hole (HR) in sizes to fit distal circumferences of 8”-14”

800.574.5426 • www.easyliner.com

IN THE NEWS

MSOP Program To Debut at Baylor A new Master of Science in Orthotics and Prosthetics Program (MSOP) at Baylor College of Medicine (BCM) will enroll its first class of students in June of 2013. Jared Howell, program director, describes the curriculum as “a paradigm shift in orthotics and prosthetics education, designed to train graduates to be clinical leaders, business managers, consumers of research, and curious innovators.”

The program will integrate a 12-month basic science and didactic year with an 18-month dual-residency program. Students will complete their training and residency experiences in a 30-month period, making them eligible to sit for their board exams immediately upon graduation.

TRANSITIONS

BUSINESSES in the news

The American Academy of Orthotists and Prosthetists announced the results of its recent election of officers and board of directors. Bruce “Mac” McClellan, CPO, LPO, FISPO, FAAOP, is the new president; Mark D. Muller, MS, CPO, FAAOP, is immediate past president; Michelle J. Hall, CPO, FAAOP, is president-elect; Phillip M. Stevens, MEd, CPO, FAAOP, is vice president; and M. Jason Highsmith, PT, DPT, CP, FAAOP, is treasurer. Peter Rosenstein, executive director of the Academy, serves the executive board as ex-officio.

The Amp1 Basketball team, the only touring team of stand-up amputee basketball players in the nation, is being featured in a social media campaign by Nike/Jordon shoes. The goal of the “Rise Above” campaign is to demonstrate how basketball is helping people around the world to rise above limitations. Nike created five

14

O&P Almanac SEPTEMBER 2012

BCM’s new MSOP program will be housed within the School of Allied Health Sciences. Core science classes, such as anatomy, research methods, and medical ethics, will be taught by Baylor’s established faculty members who have long been involved in medical and allied health education.

O&P-specific classes will be taught by full-time and adjunct faculty members with varied clinical specialties and skill sets.

The MSOP program will align with standards from the National Commission for Orthotic and Prosthetic Education. Upon accreditation and graduation, students will qualify to apply for ABC board exams.

Additional information is available at www.bcm.edu/alliedhealth. a

minifilms supporting this idea. The film featuring the Amp1 team is titled #RISEABOVE LIMITS.

Tanzania. The prostheses are intended for patients in camps populated by albino children and adults whose limbs were amputated by local warlords.

The Amputee Coalition and OPAF’s First Clinics are sponsoring the first of seven Limb Loss Education Days on September 29, in Manassas, Virginia.

The day features education, celebration, and recreation, and is free to all amputees and their families.

Ottobock, headquartered in Duderstadt, Germany, was honored as the top family business in Europe during the CampdenFB Families in Business Awards in Amsterdam, Netherlands.

The Board of Certification/ Accreditation International (BOC) has announced the development of a personalized web portal, “MyBOC,” where BOC practitioners can submit continuing education units and view and print their updated records immediately upon entering them.

College Park Industries, headquartered in Fraser, Michigan, has donated prosthetic feet in both child and adult sizes to the Step by Step Mission in

Veterans International Cambodia, a project of The International Center, is seeking international medical experts to cycle through a new private clinic in Phnom Penh, Cambodia. The Handa Rehabilitation Center will provide Cambodians who can afford rehabilitation services a place to obtain them, while generating donations to assist with the rehabilitation needs of the poor. Interested practitioners should contact Joseph House, program coordinator, at jhouse@theintlcenter.org.

Orlando KAFO/HKAFO ®

LOWER EXTREMITY FRACTURE BRACING SYSTEM

For over 20 years, Orthomerica Products, Inc. has been offering effective non-operative and postoperative treatment solutions for lower extremity fractures and range-of-motion restriction.

Orlando KAFO/HKAFOs are modular, lightweight and can be ordered and stocked as components, making them immediately available, or custom assembled to your measurements. Orthotists choose from a wide selection of femoral and tibial components, hip joints, knee joints and shoe inserts to meet individual patient needs.

Anatomically designed pelvic components offer a variety of shapes and sizes to accommodate even the most difficult to fit patient. Unique, patented hip joints control flexion/extension and abduction/adduction. These joints control range of motion of the affected limb and provide adjustability throughout the rehabilitation process. Thigh and tibial components promote further stability through circumferential compression of soft tissue. Standard or special order knee joints control sagittal plane motion. The shoe insert provides the final link in the mechanical chain of support by allowing limited or full range of ankle motion as indicated.

INDICATIONS

FEATURES

• Post-op hip revision patients • Post-op lower extremity fractures

• HKAFO limits hip rotation and provides adjustable abduction/adduction and flexion/extension control

• Patients needing stability following the removal of external fixation devices

• Choice of several tibial components, hip joints, knee joints and shoe components

• Non-operative fractures

• Lined or unlined femoral/tibial components

• Fracture management following internal fixation • Orthotic rotational control for patients with chronic hip dislocation

• Custom-to-measurements phoned, faxed or e-mailed for same day shipment • Prefabricated components can be assembled on-site

Available in individual prefabricated components, pre-assembled, custom-to-measurements (all shipped same day) or custom-to-cast.

800-446-6770 | orthomerica.com © 2012 Orthomerica Products, Inc. All Rights Reserved.

MOMENTUM

{

Come and see us at

AOPA Show in Boston - Booth #1505,

G E T

September 6th - 9th, 2012

C O N N E C T E D

W I T H

U S

T H R U

{

BR ACE STARTING AT

P

D

A C

A

P

P

R

O

V

E

D

L0627 L0631 L0637 L0456 L0462 L0464

NEW VENUM $75

STEALTH $109

OASIS $95

VERTAMAX / EVOTEC $69

EXPANDER Call for Price

1.888.982.8181 • 1.770.513`.7380

•

www.optecusa.com

$ n

Reimbursement Page

By Joseph McTernan, AOPA government affairs department

Paying By the Rules

18

O&P Almanac SEPTEMBER 2012

Know the guidelines for billing for inpatient services

D

etermining who should be billed for inpatient services provided to Medicare beneficiaries can get complicated. The AOPA reimbursement staff answers more member questions regarding this issue than any other. This month’s Reimbursement Page discusses some of the more complex issues regarding who is ultimately responsible for paying for the O&P services you provide.

The location where an orthosis or prosthesis will be used usually determines who is responsible for paying the claim. In most cases, a Medicare beneficiary will come to your office to receive an orthotic or prosthetic device and subsequently use the completed device in his or her home.

In this scenario, the rules are simple: Your claim should list the place of service as 12 (Home) and be submitted to the appropriate Durable Medical Equipment Medicare Administrative Contractor (DME MAC).

Sometimes, however, you will treat a patient during a hospital, rehab facility, or Medicare Part A covered skilled nursing facility (SNF) stay.

When this occurs, you usually may not submit your claim to the DME MAC. Acute care hospitals, rehab hospitals, and SNFs are paid for Medicare Part A services through a prospective payment system (PPS).

This system pays the facility a daily rate to cover the cost of all medically necessary services for the patient.

The payment is the same whether the hospital or SNF pays for the services through its own internal resources or through a vendor relationship with an outside provider.

When a hospital or SNF is unable to provide a service itself, the facility will use outside suppliers to provide the service. The hospital or SNF then must pay the outside supplier for its services, since the facility already has received payment in full for the patient’s care under the PPS.

KISS KISS WrapStrap-R® WrapStrap-R® CMP24/A, CMP24/B, CMP24/C, CMP24/D, CMP24/E, CMP24/F CMP24/A, CMP24/B, CMP24/C, CMP24/D, CMP24/E, CMP24/F

Available Available in in Beige, Beige, Gray Gray and and now now BLACK BLACK CMP24/E - Single CMP24/E - Single CMP24/F - 10 Pack CMP24/F - 10 Pack

Residue Free & Removable Linkage Residue Free & Removable Linkage Prevents Prevents • Sleeve Doffing Inversion • Sleeve Doffing Inversion • Sleeve Doffing Dislodging • Sleeve Doffing Dislodging • Under Sleeve Air Leakage • Under Sleeve Air Leakage Provides Provides • Reliable & Strong Support • Reliable & Strong Support • Low Profile, Full Adjustability • Low Profile, Full Adjustability • Tapeless, Removable Linkage • Tapeless, Removable Linkage

s at Visit u 12 20 AOPA h 917 Boot

For For More More Information Information Call: Call: 410-663-KISS 410-663-KISS (5477) (5477) www.kiss-suspension.com www.kiss-suspension.com

Copyright, KISS Technologies, LLC. KISS® is a registered trademark. US Patented 8182546B2, Patent Pending Worldwide. “All Rights Reserved” Made in U.S.A. Copyright, KISS Technologies, LLC. KISS® is a registered trademark. US Patented 8182546B2, Patent Pending Worldwide. “All Rights Reserved” Made in U.S.A.

n

Reimbursement Page

The hospital or SNF has the right to choose the vendor of its choice in this situation, so you should always work with the facility to agree upon payment terms prior to providing service to its patients.

While the two situations discussed above account for the majority of O&P billing scenarios, there are several important exceptions. You should be aware of these exceptions to ensure that you submit your claim properly.

The Two-Day Rule One exception to the general rule for billing the hospital or SNF is called the two-day rule, which states that a supplier may deliver a completed O&P device to a Medicare beneficiary during a Part A hospital or SNF stay within 48 hours of the patient’s anticipated discharge. As long as the device is not medically necessary during the remainder of the patient’s stay, and the patient is being discharged to a location that qualifies as his or her home, the supplier may bill the DME MAC directly for the device.

If an O&P device is needed as part of the patient’s recovery or rehabilitation in the facility, it must be paid for by the facility regardless of when it was delivered.

To qualify for this exception, the supplier must only be delivering the item in order to provide basic instruction on how to use and care for the device. The intent of the two-day rule is not to circumvent the responsibility of the hospital or SNF to provide its patients with medically necessary services. If an O&P device is needed as part of the patient’s recovery or rehabilitation in the facility, it must be

20

O&P Almanac SEPTEMBER 2012

paid for by the facility regardless of when it was delivered. O&P providers must be especially aware of this requirement as many inpatient facilities try to utilize the two-day rule to avoid having to pay for medically necessary items provided to patients who are under their care.

If you deliver an O&P device to a patient during a Medicare Part A hospital or SNF stay and all of the criteria to bill under the two-day rule have been met, the claim may be submitted to the DME MAC following the guidelines below.

• Date of service. Under normal billing circumstances, the date of service usually is the date that the completed device is delivered.

However, when submitting a claim under the two-day rule, the date of service is the patient’s discharge date from the inpatient facility.

Without this exception, the DME MAC would improperly deny the claim as the responsibility of the inpatient facility. While the two-day rule allows you to use the date of discharge as your date of service, the actual date of delivery should be documented in the patient’s chart in case there are questions later on.

• Place of service. Generally, the code selected should correspond with the location where the item will be used. This holds true under the

two-day rule. When billing under this rule, indicate a place of service code of 12 (Home).

Exhaustion of SNF Part A Benefits Medicare limits the number of days that it will cover Part A SNF services to 100 days per benefit period. A new benefit period begins with a mandatory hospital admission of at least three days followed by immediate admission to an SNF. As long as a minimum of 60 consecutive days have passed since the patient was last in a Medicare Part A SNF stay, a new benefit period may begin, staring with day one.

If a Medicare patient is in a Medicare Part A SNF stay for fewer than 100 days and is discharged, that patient remains eligible for the remaining days in the benefit period. For example, if a patient is in the hospital for hip replacement surgery and is discharged to an SNF where he or she stays for 30 days, that patient has 70 days of Medicare Part A coverage remaining for that benefit period. If after two weeks at home, additional SNF care is needed, the patient can be readmitted to the SNF (without an additional hospital stay) and receive another 70 days of Medicare Part A SNF coverage.

After 100 days of Medicare Part A SNF coverage within a benefit period, Medicare Part A no longer covers the

n

SNF stay. If the patient remains in the SNF, he or she must pay for room, board, and nursing expenses through personal funds or other insurance.

Medicare Part B will cover any orthotic and prosthetic care the patient needs.

When this is the case, you may submit your claim directly to the DME MAC for consideration.

It is important to note that 100 days is the Medicare Part A benefit limit and not an entitlement. In order for Medicare Part A to continue covering SNF care, the patient must continue to progress through therapy. Patients must be evaluated on a regular basis by the SNF staff. If the patient fails to progress, Medicare Part A will no longer cover the SNF stay and you may submit your claim to the DME MAC. When determining whether the patient is in a Medicare Part A SNF stay, it is always best to confirm the patient’s status with the facility business office. While therapists and physicians may provide you with limited information, the business

It is important to note that 100 days is the Medicare Part A benefit limit and not an entitlement. office will definitively know the exact Medicare status of any patient at any given time. If you can get this information in writing for inclusion in your files, it may prevent confusion later on regarding who is responsible for payment.

SNF Prosthetic Device Exceptions As discussed above, SNFs receive a per diem PPS payment to provide all medically necessary care for patients in a Medicare covered Part A stay. Beginning in April 2000, however, most prosthetic devices

1360 Sunset Ave Ferndale, WA 98248

O&P_almanac_custompadding_Sep2012.indd 2

ph: 800.848.7332 fax: 877.856.2160

Reimbursement Page

were excluded from the SNF PPS system because the high cost and relatively low volume of prosthetic services provided in SNF settings had resulted in an undue financial burden on SNFs. Excluding most prosthetic devices from the PPS allowed suppliers to bill their DME MAC directly instead of looking to the SNF for payment. While most prosthetic services have been excluded from the SNF PPS system, certain services, such as prosthetic socks, shrinkers, partial hand and partial feet prostheses, and immediate postsurgical prostheses continue to be included in the SNF PPS payment.

In addition, one prosthetic foot code, L5987, is not included in the PPS exemption list. These items, as well as all orthoses, must be paid for by the SNF when a patient is in a Medicare Part A covered stay.

A list of codes excluded from the SNF PPS can be found at www.cms. gov/Medicare/Billing/SNFConsolidatedBil ling/2012Update.html.

intl: + 00 1 360 543 9306 www.cascadedafo.com

7/30/2012 3:50:49 PM SEPTEMBER 2012 O&P Almanac

21

n

Reimbursement Page

Once at this page, scroll down to “Downloads” and select File 1—Part A Stay—Physician Services. (Although the file says “physician services,” this list is still applicable to O&P suppliers.)

Open the file. The list of exempt L codes begins at row 352. If a particular L code does not appear on this list, it is not exempt and you must make payment arrangements with the SNF.

The two-day rule would not apply in this particular scenario, either, because the patient is not being discharged to his or her home.

Likewise, if the medical necessity for a custom device occurs while the patient is at home, but delivery does not occur until after a Medicare Part A SNF admission, the item may be billed to the DME MAC using the date the medical necessity was established as the date of service and a place of service of 12.

It is important to note that when a hospital or SNF requires the services of an outside supplier for items subject to the Medicare Part A PPS system, it is the facility’s responsibility to make arrangements with the outside supplier. It is always in your best interest to negotiate the terms of your payment prior to delivering your services. While the absence of a contractual agreement does not in any way relieve the facility from its responsibility to pay for such items, making such an agreement

Transferring From Hospital or Home to SNF

www.savewithups.com/aopa

Another exception to regular billing rules occurs when a patient is being transferred from a hospital to an SNF. If a custom-fabricated O&P device is ordered for the patient while he or she is still in the hospital, but due to fabrication time, it is not delivered until after he or she arrives at the SNF, the hospital remains responsible for payment of the item. Medical necessity for the custom device was established while the patient was in the hospital, not in the SNF, so the SNF should not be billed.

22

O&P Almanac SEPTEMBER 2012

prior to providing services will help avoid misunderstandings.

Knowledge Is Power Understanding who should be billed, and under what circumstances, is very important for all Medicare suppliers. Your time, costly materials, and hard work are extremely valuable and deserve to be compensated.

Arming yourself with this knowledge will help eliminate confusion and ensure proper reimbursement. a Joe McTernan is AOPA’s director of coding and reimbursement services.

Reach him at jmternan@ AOPAnet.org.

Editor’s Note: For more information on this topic, see “AOPA Answers” on page 80 of this issue.

UPS Savings Program AOPA Members now save up to 30% on UPS Next Day Air® & International shipping, with additional savings starting at 70% on LTL Freight shipments.

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: • • • •

Up to 30% off UPS Next Day Air® Up to 30% off International Export/Import Up to 23% off UPS 2nd Day Air® 70% or more on UPS Freight®

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!

I’mPOSSIBLE Empowering Human Potential is our Mantra.

Hanger Clinic empowers people to break down barriers, while helping them achieve their dreams and full potential.

We are committed to clinical excellence and its broadening array of rehabilitative solutions for patients.

Each year, our teams deliver efficient and effective clinical solutions, innovative technologies and outstanding customer service to more than one million patients at more than 700 Hanger Clinic locations nationwide.

Our business is built on six core values: • Integrity • Clinical and Operational Excellence • Unsurpassed Customer Satisfaction

• Flexible and Entrepreneurial Operations • Creativity and Innovation • Shared Success

Empower yourself and attain your greatest potential. Discover the many opportunities at Hanger Clinic.

1-877-4HANGER www.hanger.com/careers 150 YEARS

700 CLINICS

1 VISION

Documentation and

Denial

Need-to-know information regarding physician records and the recovery audit processes

Y

ou’ve heard the stories from colleagues and have read the listserv posts: What started out as measures to fight fraud and abuse has turned into a nightmare for the O&P community and is threatening the future of small O&P businesses across the country.

For nearly a year, the physician documentation and recovery audit process has been a serious roadblock to care for amputee Medicare patients and the source of significant financial loss for hundreds of patient-care facilities. But how well managers and owners understand the requirements and rationale behind these processes—and the advocacy efforts being made on their behalf—may be the key to keeping their businesses viable in the foreseeable future.

How We Got Here Between 2005 and 2009, Medicare expenses for lowerlimb prostheses increased 27 percent, while the number of individuals who received those prostheses decreased about 2.5 percent, according to the Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services’ report “Questionable Billing Practices by Suppliers of Lower Limb Prostheses.”

24

O&P Almanac SEPTEMBER 2012

COVER STORY

By TORA ESTEP

SEPTEMBER 2012 O&P Almanac

25

payments) and frustrating, timeconsuming appeals processes.

“So the physicians are responsible for creating the right documentation, but the orthotics and prosthetics supplier is the one stuck with the bill if the DME MACs decide that the claim and the documentation supporting it are improper,” explains Joe McTernan, director of coding and reimbursement services, education, and programming for AOPA.

Points of Contention

The cost increase prompted the OIG’s report, which implied the Centers for Medicare & Medicaid Services (CMS) had been improperly billed, or even defrauded, for lowerlimb prostheses to the tune of more than $100 million in 2009 alone. Other specific findings of the report included the following: • $43 million in Medicare expenditures for lower-limb prosthesis claims that didn’t meet specific criteria, such as information about the patient’s functional level or incorrect billing for both limbs.

• $61 million in Medicare expenditures for claims that were not accompanied by a claim from a referring physician within five years.

• 267 suppliers with questionable billing.

In addition, the report found that the Durable Medical Equipment (DME) Medicare Administrative Contractors (MACs)—the contractors who process and pay claims for lower-limb prostheses for CMS—had “conducted varying degrees of program safeguard activities related to lower-limb prostheses.”

26

O&P Almanac SEPTEMBER 2012

In other words, the OIG Report implied that the DME MACs were falling down on the job.

Reaction from the DME MACs was swift. They issued a “Dear Physician” letter explaining to physicians and O&P providers what would be expected in terms of documentation, including descriptions of expected before-and-after functional levels and thorough assessments of the patient’s physical and cognitive capabilities.

In addition, the DME MACs initiated a new “zero tolerance” audit and claims review policy, which found that 96 percent of claims for lowerlimb prosthetics lacked sufficient physician documentation. Only months earlier, most of these claims were deemed appropriate by the DME MACs. The result has been devastating for patients and for the orthotics and prosthetics community. Although the total impact is not yet fully known,

by November 2011 the DME MACs had denied hundreds of claims for hundreds of thousands of dollars—and that was only the beginning. Hundreds of small O&P businesses now face nonpayment for devices they have already delivered (or having to return

Although the purpose of the OIG report was to highlight and reduce or even eliminate fraud in Medicare and Medicaid—a goal AOPA wholeheartedly supports—the report, which incorrectly implies many in the O&P community have engaged in fraudulent activity and the DME MACs weren’t paying attention, has several flawed premises.

For example, the OIG report suggests that submitting separate claims for left and right limbs is a red flag for fraud. AOPA, in its response to the OIG’s report—“New Physician Documentation Requirements Threaten Amputee Patient Access”—notes that such a suggestion shows the OIG’s lack of familiarity with the O&P field, where “long-standing policy for the claims for these [bilateral amputee] patients is that their prosthetic claims can legitimately be reported as both limbs in a single claim or separate claims for the right and left limbs respectively.”

Furthermore, the OIG report asserts that a claim for a prosthetic device that isn’t accompanied by a claim for treatment from the referring physician also is suspect—yet again revealing the OIG’s ignorance of O&P. As industry professionals know, when a patient has a problem with the prosthesis after the original fitting, he or she turns directly to the prosthetist, not to the referring physician (who is often the surgeon that removed the limb and rarely has further contact with the patient).

Another flawed premise of the report is its original impetus: the increase in the cost of lower-limb

prosthetics. Highlighting any cost increase as an indicator of fraud fails to account for the rapid advances in technology—which go hand-in-hand with increased expense—that have resulted from meeting the needs of amputees returning from the conflicts in Afghanistan and Iraq. And as AOPA noted in its response, another source of the cost increases was simply the annual increases in the fee schedule published

by Medicare.

Perhaps the greatest point of contention, however, is the OIG’s and DME MACs’ insistence on total reliance on physician documentation to show medical necessity. Essentially, the provider is not responsible for saying the patient needs the device; the decision and documentation about medical necessity must come from the physician.

“The DME MACs are exerting a lot of pressure and denying claims, not because of what is in the orthotist’s or prosthetist’s records, but on what is or is not in the prescribing physician’s documentation,” says McTernan.

“That’s causing such a problem because the physician often refers the patient to the orthotist or prosthetist precisely because he or she doesn’t have the expertise or the knowledge to document the information that Medicare or Medicaid is looking for. We run into situations where physician’s

documentation is very basic or nonexistent, and claims are being denied based on that fact, regardless of how much documentation there is in the practitioner’s records about the medical need.”

In other words, physicians send patients to O&P providers because they have specific expertise regarding the mechanics of the devices and how they will affect the patient. However, the providers’ comments and evaluation notes on the patient are not given weight by the DME MACs at this stage of the process as support for the documentation requirements to show medical necessity.

“It’s creating quite a quandary because the physicians have no incentive to document this information and are not paid anything by Medicare for the extra time it would take to generate documentation that would meet the DME MACs’ new documentation standard,” McTernan continues.

“The physician has no liability on the claim, because he or she is not the one billing for it. Yet without that documentation, providers’ claims get very much put at risk for something they have no control over. They don’t have the ability to control how good or how bad a physician’s documentation is for the services they are prescribing.

It’s been quite a battle.”

Unintended Consequences Widespread audits, claims denials, and heavy documentation requirements have had at least one negative side effect outside of the O&P provider community: delayed delivery of medically necessary care for Medicare beneficiaries.

To improve their chances of being reimbursed for the services they are providing, O&P suppliers have to collect all the documentation and information in the doctor’s records to ensure those documents exist before they provide the service, which delays delivery of service. As a result, Medicare recipients have to wait longer to receive the devices they require, and, in many cases, these are items they need immediately. For example, in the case of amputation, patients can’t walk until they receive the prosthetic leg. This may even create pressures on the prosthetist to undercode—that is, for the sake of getting the prosthesis to the patient, to provide a device that matches the partial physician documentation received to date, rather than waiting to deliver the right device to the patient once the appropriate comprehensive documentation has been received.

“This is ultimately a patient-care issue and a Medicare beneficiary issue,” McTernan notes, “and one of the results of these undue burdens on the provider community is that it delays delivery of care to the Medicare population.”

Fighting Back Although AOPA and the O&P Alliance (see sidebar on page 31) are pursuing efforts to modify the documentation requirements, there is no assurance that the current situation will be rectified for the foreseeable future. Providers can improve their chances of reimbursement, however, by making every effort possible to educate their referral sources about the documentation requirements under this changed policy.

28

O&P Almanac SEPTEMBER 2012

The Government Is Sending Amputees Mixed Signals.

The government is sending amputees conflicting signals. They say they support amputees receiving the prosthetics they need but then the bureaucracy makes it difficult to get prosthetics approved. Demands for more ill-defined physician documentation undermines any semblance of confidence that claims cost for custom fabricated artificial limbs will be reimbursed.

Consequently prosthetic wearers are left confused and isolated.

Let’s help disabled people get the prosthetics they need to lead full productive lives.

The first step is to go to AOPAnet.org.

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

NEW!

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

• pass a disciplineSpecific exam

for more information, visit abcop.org

American Board for Certification in Orthotics, Prosthetics & Pedorthics, Inc.

abcop.org (703) 836-7114

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

AOPA and O&P Alliance Regulatory Efforts

A

lthough many claims denials can be overturned, the time and effort required to go through the appeals process or to wheedle required documentation from physicians places an undue burden on O&P providers. Furthermore, some providers simply do not have the time or resources to go through the appeals process for all claims.

Recognizing how untenable the situation is, AOPA independently and with the O&P Alliance—a coalition among AOPA; American Academy of Orthotists and Prosthetists; American Board for Certification in Orthotics and Prosthetics; Board of Certification Accreditation, International; and the National Association for the Advancement of Orthotics and Prosthetics—has pursued several actions to challenge the Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services’ report, “Questionable Billing Practices

by Suppliers of Lower Limb Prostheses,” and the policy changes resulting from it. In his letter to AOPA’s membership, AOPA Executive Director Thomas F. Fise, JD, summarized actions to date, which include the following: • Joining with the O&P Alliance to write letters to and meeting with the Administrator of CMS, Marilyn Tavenner, and the Inspector General of OIG to challenge the report. The CMS administrator has acknowledged the problem and promised that some “middle ground” must be found to break the impasse but has not yet taken that action. However, as Joseph McTernan, AOPA’s director of coding and reimbursement services, education, and programming, notes, “The wheels at CMS turn notoriously slowly, and they are in a bit of a quandary themselves because they have a report out of the OIG saying they aren’t doing things properly and then us on the other side saying the restrictions are too hard, and so they are kind of stuck in the middle.”

• Inspiring a letter from Sen. Ben Cardin (D-Maryland) to Tavenner urging CMS to work with the O&P community to make sure timely patient care isn’t compromised.

• Meeting with Peter Budetti, MD, the head of the CMS Program Integrity Office, which seems to agree that most physicians are not experts on prosthetics and orthotics, and are not the ones to whom patients turn when they have a problem with their device.

• Meeting with some of CMS’s full-time, internal medical directors, who noted that when the physician places a provider’s observations, notes, and recommendations in the patient file, they do indeed become part of the physician’s documentation and records.

• Writing to the DME MAC medical directors, challenging the part of the “Dear Physician” letter that indicated provider documentation does not constitute proof of medical necessity because of conflict of interest. (In other words, the providers would provide documentation that serves to put more money in their pockets.) The medical directors responded that all AOPA objections to their letter were without merit.

• Together with O&P Alliance partners, meeting with OIG representatives and contesting specific OIG conclusions. The OIG report authors and other staffers did not acknowledge any problems in their report, although they seemed surprised the report had precipitated such immediate action from the DME MACs and caused such a disruption in patient care.

• Providing Senate Finance Committee staff with documentation of egregious claims denials and urging hearings on CMS contractors overreaching their authority.

• Communicating with staff at the American Medical Association, which is sympathetic to the documentation and audit problems the O&P community faces. Evidently, physicians in general have been under increasing amounts of pressure from CMS to provide documentation without additional payment, and patients and O&P providers have suffered the collateral damage in that battle. As Catherine Graf, JD, director of regulatory affairs at AOPA, notes, “There is not a lot of incentive for the physicians to do this additional documentation. It seems as though more documentation is wanted from the physicians by CMS, and this is a way to try and force the O&P field to strongarm the physicians into providing it.”

• Conducting a survey of AOPA patient-care members to determine whether reimbursement fears are impacting patient care in O&P. • Communicating with the Amputee Coalition and several congressional offices to determine the potential adverse effects on patients.

SEPTEMBER 2012 O&P Almanac

31

“A lot of physicians refer out and may not have a lot of familiarity with the documentation requirements under the changed policy,” says Catherine Graf, JD, director of regulatory affairs at AOPA. Providers can help themselves by offering referring doctors information about some of the requirements, such as descriptions of the five functional (K) levels, which range from 0 to 4. The functional levels are important to identify correctly because they are critical in determining the medical necessity for specific devices and because the use of certain devices is restricted to specific levels.

Additional information required in physician documentation includes a thorough assessment of the patient’s physical and cognitive capabilities.

Practitioners also need to recognize that preparing this much documentation is labor-intensive for physicians, and they have nothing to lose if they fail to comply. Practitioners may need to develop good diplomacy skills to get the documents they require. But it’s often a frustrating and difficult process. AOPA has seen a letter from a physician group notifying an O&P provider to stop sending requests for documentation as they are all trashed, without response.

In case of an audit that results in a claim denial for lack of physician

32

O&P Almanac SEPTEMBER 2012

documentation, AOPA recommends members to get those claims into the Medicare claims appeals process immediately.

“We are hearing from many of our members that they are not having much success at the early levels of appeal,” says McTernan, “but at the third level of appeal, which is a hearing before an administrative law judge, or ALJ, many of the claim denials are being overturned because the administrative law judge found the practitioners’ documentation to be sufficient to document the medical need. Administrative law judges have a unique ability; they are not bound necessarily by Medicare policy. Their responsibility is to the Social Security Act, which is the law that essentially outlines the coverage requirements for Medicare, so they have a lot more leeway in making their appeal decisions.”

O&P providers need to ensure their own documentation is thorough and in-depth. Although provider notes are not considered in the initial stages of recovery audits, they can still make a big difference.

As frustrating, economically and professionally, as it is for practitioners to be caught in this war of attrition between physicians and Medicare, all of the advocacy efforts by AOPA and

others have prompted some incremental “back-tracking” by CMS: • Medicare has now stated that prosthetists’ notes and records are legitimately part of the patient’s medical file.

• Medicare has acknowledged that the OIG references to the absence of any visit between the patient and his/her referring physician as evidence of fraud are misplaced, and that the patient is much more likely to have seen another physician, e.g., a primary care physician, rather than the original referring physician (often a surgeon).

• Medicare says that “if a supplier is replacing an old prosthesis and there is no upgrade in the model, the supplier does not need a physician order.” (Clearly CMS will need to modify some of its existing regulations for this change to have meaning.)

• Contrary to the original DME MACs’ position that an order for a new prosthesis must be supported by a face-to-face physician/patient visit, in its recently released physician payment regulations, CMS announced specifically that, at present (and pending possible specific rules for O&P that may follow later), there is no face-to-face physician/patient visit requirement for O&P. AOPA continues to look closely at the legitimacy, fairness, and timing of CMS and the DME MACs articulating specifics of the physician documentation requirements, including whether those requirements pass muster in terms of CMS’s own rule-making obligations, and whether they are inappropriately being applied retrospectively to claims that were filed before those specific requirements were ever articulated. a

Tora Estep is a contributing writer to O&P Almanac. Reach her at tora.thurisaz@ gmail.com.

By Lia K. Dangelico

e n GtootheDogs Veterinary orthotics and prosthetics is a growing industry—mostly due to the demand for canine orthotics.

Is it right for your business?

Photo: My Pet’s Brace

Greta wears a hock paw orthosis with Tamarack joints

34

O&P Almanac SEPTEMBER 2012

Expanding Animal Care Most O&P professionals spend time working on animals in training and early on in their careers, and many are taught that animals can operate just fine on three legs. While that may be true, it’s also true that an existence on three legs ordinarily leads to limited mobility, limb breakdown, and severe pain issues. Over the past decade, further exploration into those issues and the evolution of specialized veterinary care has shown that orthotic and prosthetic solutions can improve the length and quality of life for injured and amputee animals.

The veterinary industry in the United States is composed of a multitude of disciplines, as well as a large number of referral centers that offer physical therapy, surgery, dentistry, neurology, and more to a wide range of animals, from pigs to cows to pet rabbits. For most V-OP professionals, this is where their

Photo: My Pet’s Brace

Y

ou’ve probably noticed that pets, especially dogs, have experienced a status upgrade in recent years. The traditional family pet many of us grew up with—the loyal and hardworking Old Yeller or the adventurous farmhand Lassie—has been replaced by pets that are primped and pampered by their owners.

With more than 77 million dogs belonging to more than 43 million owners in the United States, dogs and other pets are no longer just companions; they are often considered a beloved member of the American family. Pet owners are willing to go above and beyond to care for their four-legged friends.

Enter veterinary orthotics and prosthetics (V-OP). In its recent study, “Pet Health: Products and Services,” the Freedonia Group reports spending on pet care is projected to increase by 7.2 percent to $21.5 billion by 2014.

While pet health care is undoubtedly a growing industry, is it the right move for your practice? O&P Almanac recently talked to several V-OP professionals to find out.

Morgan wears a carpal paw hyperextension orthosis

involvement begins. According to Jim Alaimo, CPO, co-owner and founder of animal orthotic and prosthetic care facility My Pet’s Brace, in Morgantown, Pennsylvania, 50 percent of the referrals he receives comes from specialized referral centers and their surgeons; the other half comes from general practice veterinarians.

Many pet owners turn to orthotics and prosthetics as a more affordable or feasible alternative to expensive or risky surgeries. While one might think cost is the most noted deterrent keeping an owner from choosing pricey surgery for a pet, according to research by the American Pet Products Association, Americans will spend an estimated $52.87 billion on their pets in 2012, with $13.59 billion going toward medical care. Most often, an owner will turn to O&P because the animal has been deemed unfit for surgery due to its age or a severe medical condition.

Ten or 15 years ago, sick and injured pets were often euthanized because no other alternatives were available, but V-OP provides a second chance at life— and a high-quality one at that.

“Families are willing to do whatever it takes in order to help their dog live as long as they can,” says Alaimo.

“Dogs are living much longer than they used to because they are getting the specialized care that they never had before.”

(Almost) Strictly Canine For Alaimo and his partner Mark Hardin, who handles the business side of their company, less-than-desirable circumstances led to an opportunity to “do something fun” in the world of V-OP. After their previous employer downsized their division, the duo was out of work and wondering where life would take them next. Both lifelong dog lovers, the partners decided to do a little research, and their findings showed that the number of pets in American households was growing, with 25 percent of families owning more than one. From there, they noticed a real need was emerging for quality, specialized animal care—more specifically, canine care.

Started 18 months ago by Alaimo and his partner, My Pet’s Brace is one of just three businesses in the United States that provides orthotic and prosthetic strictly to animals.

Ninety-nine percent of the company’s business is treating dogs with injuries or limb loss, and Alaimo’s beloved dog Strider is not only the company mascot but is listed as chairman of the board on the company website.

Jeff Collins, CPO, a lower-limb amputee, was drawn into the world of animal O&P when a veterinarian wanted to perform surgery on his beloved black Labrador Stash for a

SEPTEMBER 2012 O&P Almanac

35

Q&A

With Kevin

Carroll,

Hanger’s Vice President of Prosthetics O&P Almanac asked Kevin Carroll, MS, CP, FAAOP, vice president of prosthetics for Hanger Clinic, a few questions about the growing animal O&P industry. With 30 years of experience as a practicing clinician, Carroll helped to develop WintersGel, the innovative liner material used to successfully fit Winter the dolphin—recently featured in the film Dolphin Tale—with a prosthetic tail.

O&P Almanac: What are some of the biggest differences between creating orthotic/prosthetic devices for humans and creating them for animals?

Carroll: Communication is certainly a big difference with animal vs. human patient care. With human patients, we’re able to communicate directly with them, unless of course we’re working with a child and need to communicate with the parent. With animal patients, we have to communicate with their owners, and pay very close attention to the animal’s body language.

Additionally, animals’ anatomies are very different than the anatomy of a human. Working very closely with veterinarians, we must have an understanding of the particular animal we’re working with—whether it be a bird, dog, dolphin, sea turtle, etc. The different anatomies of animals can also require different types of components than we use when providing care to our human patients. Some of which need to be special ordered, and some, such as the WintersGel liner used to fit a prosthetic tail on Winter the dolphin, are created throughout the research and development process.

O&P Almanac: How big of a cost difference is there between the two?

Carroll: The time and involvement to fit an animal with a prosthetic or orthotic device is almost identical to that of providing care to a human, so the cost is very comparable. In some cases, it may even take longer to build a device for an animal since we’re working in a completely different territory and it is not something we’re used to.

O&P Almanac: Why do you think the veterinary O&P field is experiencing such growth? What is the draw for professionals?

Carroll: With a greater awareness of the availability of orthotic and prosthetic devices for animals, owners of animals are more willing than ever to manage cost for their pets. There are also higher expectations for people to care for animals. I think it’s a great way to give back to society. A lot of times, we go into it with the goal of helping the animals, but, at the end of the day, they end up giving more to us than we give to them.

36

O&P Almanac SEPTEMBER 2012

partial cranial cruciate ligament (CCL) tear. Between jobs at the time, Collins didn’t have the $2,500 necessary for the surgery, so he worked to fabricate a knee orthosis for Stash instead. The project propelled him to research and develop a plan to start his own business, K-9 Orthotics & Prosthetics, based out of Nova Scotia, Canada.

Getting Down to Business Alaimo and Collins were clear about the logistics of their businesses and how they make them work. From inception to opening their doors for the very first time, their companies were founded on extensive research within the industry, a solid business plan, and a bit of hope. After their businesses were fully operational, Alaimo and Collins readily identified need-to-know information for those considering the field.

Assuming his business would be 50 percent orthotics and 50 percent prosthetics, Alaimo says he was surprised to find the work was far less balanced than that.

“When you get into animal O&P, you learn very quickly that it’s not really a prosthetics business,” he says. “It’s an orthotics business—that’s where the real need is.”

Despite the fact that “prosthetics” is in the name—and often gets most of the attention and fanfare—it’s important to note that this is essentially a canine orthotics business. And while the industry is growing by the day, going into business is “never a sure bet,” says Collins.

Adding that there are no shortcuts at the canine level, Collins stresses the importance of knowing that “you’re going to charge nearly a fraction of the price you would pay for a human application in comparison to the canine applications,” so it will be a cheaper process—but only in cost to the client. “Finding a balance between quality materials and effective designs while pricing accordingly varies in the market place,” says Collins. “I would rather be known for quality than cheapness.”

Photo: My Pet’s Brace

Whether starting out in V-OP, transitioning into it, or adopting it into your practice, it is essential to first make sure you have the room and the hours to take it on. To provide the most comprehensive, ethical care, animal services should take place either at a separate location or during designated hours, separate from human care. Adding on to existing buildings or incorporating an after-hours schedule are options for those who seek to do both.

But there is a crucial person to the process who is outside the V-OP clinic: the veterinarian. In an effort to operate their business just like a typical human facility, Alaimo and his partner decided early on they would involve a veterinarian in the decision-making process and require a prescription for every device they provide.

“We are not veterinarians trained to diagnose these injuries, so we wanted to make sure that we keep the veterinarian involved so we can provide what the dog really needs,” says Alaimo.

Proud owners pose with their Beagle, who wears a stifle brace

But, warns Collins, that relationship is “not as straightforward as you think.” As with most things in business, there are the inherent politics involved in the process of working alongside veterinarians.

“There are some vets that just don’t believe in orthotics at all and won’t refer clients; however, there are more and more sport medicine and rehabilitation specialist vets exploring the orthotic and prosthetic

W NE IGN S E D

SEPTEMBER 2012 O&P Almanac

37

Photo: My Pet’s Brace

Alaimo fits a patient with a stifle orthosis

options available to their patients,” he says. “So there are some academia and political issues to be worked out there between the veterinary practice and the O&P practice.”

Compared to the world of human care that often is rife with reimbursement roadblocks, V-OP professionals find animal care can be a refreshing departure.

“In this field, when you provide a brace or prosthesis for a dog, you can see immediate results, and you can see that you’re doing some good,” says Alaimo. “The people that are coming to you are the people who really want the services and are willing to pay for them without question...we’re dealing with people who really want to help their pets.”

Pushing for Education Although each professional has his or her own method of fabricating devices and providing care, most can agree on one thing: the value of animal O&P education. It’s increasingly important for everyone from veterinarians to pet owners to learn what this practice has to offer and that it is a viable option for pets.

Both Alaimo and Collins say

38

O&P Almanac SEPTEMBER 2012

educating veterinarians and clients is their biggest challenge. While people might find it easy to accept that O&P offers health-care solutions, they might find the financial responsibilities, especially in difficult economic times, harder to welcome.

Orthotic braces are typically fabricated out of lightweight polypropylene, co-polymer, and polyethylene, which are durable, long-lasting, and easy to clean. Carbon graphite or pre-impregnated composites can be used in braces for extremely active dogs or those with weight issues. A typical brace can be provided to a dog with a knee injury for approximately $700; that’s a viable option when you consider that surgery could cost upwards of $3,000.

V-OP “gives owners and their pets another alternative that they never had before,” says Alaimo. Plus, he adds, with surgery there are no guarantees.

After the operation, a very active dog could easily blow out that knee again.

Typically, most animal amputations are done at the hip or the knee, and after the fact it becomes very difficult to fit an animal for a device when there is no knee or elbow joint.

By advocating for amputations that are lower down on the leg—below the

knee or below the elbow— Alaimo notes that he can provide a device that fits properly and “provides equal balance. . . and more four-legged support,” which will help avoid further injury and stress to the other limbs and the spine.

The most common injury in dogs is to the CCL, which functions to stabilize the tibia.

According to the American Kennel Club Canine Health Foundation website, “lameness in the rear leg is the most common sign of a CCL rupture. Other symptoms can include pain and swelling of the joint.”

Orthotics for CCL injuries account for about 50 percent of devices sold.

Carpal and tarsal injuries also are common, each accounting for about 25 percent of business.

While constant educational advocacy is challenging, the work makes it all worthwhile. Alaimo and Collins state that giving animals back their quality of life is the most rewarding part of their jobs.

Another benefit: O&P pet health care can bring immediate results. Once a dog that has been held back because of a knee injury gets fitted with a brace, he or she can immediately be observed prancing around the office. It’s a great feeling, says Alaimo, “getting that response back from the owners of how much more the dog can do and how much happier it is, that his tail is wagging again.”

After all, he says, a wagging tail is a dog’s way of saying “thank you.” a Lia K. Dangelico is a contributing writer to O&P Almanac. Reach her at ldangelico@strattonpublishing.com.

Noble Hinge™ Technology PROVIDING THE MAXIMUM IN PROTECTION, COMFORT AND ADJUSTABILITY

The DeRoyal ® OSO is designed to fit close to the body and give the patient the support they need without interferring with their daily activities.

DeRoyal ® Noble Hinge™ Technology is a unique and innovative combination of high quality, lightweight hardware built into a flexible panel. This creates a formable frame that captures the unique shape of an individual’s anatomy and, when locked into place, creates a rigid foundation of support.

DeRoyal Industries, Inc. | 200 DeBusk Lane, Powell, TN 37849 | 865.938.7828 or 888.938.7828 | www.deroyal.com

n

Ask the Expert

By Devon Bernard, AOPA government affairs department

PDAC Pointers

Understanding PDAC and Its Coding Verification Process With the recent AFO/KAFO policy revision to have certain AFOs reviewed and verified by the PDAC and the subsequent removal and postponement of that requirement, AOPA was inundated with calls and emails about the PDAC and the coding verification process. This installment of Ask the Expert will provide some background on the PDAC and its role in orthotic and prosthetic coding, and will shed some light on the coding verification process.

Q. A.

Who/What is the PDAC?

Effective August 18, 2008, Noridian Administrative Services, LLC became the new Pricing, Data Analysis, and Coding (PDAC) contractor. The PDAC assumed functions previously provided by Palmetto GBA and the Statistical Analysis DME Regional Carrier (SADMERC).

As part of its contract with Medicare, the PDAC has the following responsibilities: • Provide data analysis support to other Medicare contractors including the Durable Medical Equipment Medicare Administrator Contractors (DME MACs) and the Zone Program Integrity Contractors (ZPICS).

• Guide manufacturers and suppliers on the proper use of the Healthcare Common Procedure Coding System (HCPCS) for Medicare billing purposes, through product reviews and coding verifications.

• Maintain the Durable Medical Equipment Classification System (DMECS).

• Conduct national pricing functions for DMEPOS services.

• Assist CMS with DMEPOS fee schedules.

As part of that contract, the PDAC also is required to have an orthotist/prosthetist on staff to help with any questions regarding orthotics and prosthetics.

40

O&P Almanac SEPTEMBER 2012

n

Ask the Expert

Q. A.

What is a PDAC coding verification?

A coding verification is the process that allows manufacturers or distributors to request an official Medicare coding decision, or assignment of code(s), on any DMEPOS item. The PDAC’s coding decision is then binding when billing Medicare for the product, which was reviewed. In essence, if you are billing Medicare for that item, you must use the code or codes assigned to the product by PDAC.

Q. A.

Who can submit an item or product for PDAC coding verification?

Q. A.

Are manufacturers required to receive a coding verification for all of their products?

Previously anyone, including individual practitioners, could request a PDAC coding verification. That changed in August 2010. Now, only the manufacturer or the distributor of the product in question can submit the revised coding verification application.

No. The coding verification process can be either voluntary or mandated by a DME MAC medical policy or by a PDAC announcement.

Q.

Because the PDAC coding verification process is not always mandatory, what are the benefits of a manufacturer requesting verification?

A.

The main benefits would be peace of mind and for use as a marketing tool. By requesting verification, the manufacturer can say it has a Medicare-approved code, and its product will be listed on the DMECS list, which O&P facilities and the public can view and search.

Q. A.

What items still require PDAC coding verification in order to be billed to Medicare?

As stated earlier, PDAC verification can be mandatory based on a specific policy or PDAC announcement. Below is a breakdown of items by policy/ announcement and code that require PDAC verification: • LSO/TLSO Policy: Any prefabricated spinal orthoses described by codes L0450, L0454-L0472, L0488-L0492, L0625-L0628, L0630, L0631, L0633, L0635, L0637, and L0639. Any custom-fabricated spinal orthoses fabricated by a central fabrication facility or manufacturer described by codes L0452, L0480-L0486, L0629, L0632, L0634, L0636, L0638, and L0640. If you fabricate a custom LSO or TLSO in-house and provide it directly to the patient, you don’t have to have the product verified by the PDAC. However, if requested, you must be able to provide a list of materials used and a description of your fabrication process.

• Diabetic Shoe Policy: All prefabricated diabetic shoe inserts (A5512) must be reviewed and verified by the PDAC. Custom-fabricated inserts (A5513) also require PDAC coding verification if fabricated by a central fabrication facility or manufacturer. If you fabricate a custom insert in-house and provide it directly to the patient, you don’t have to have the insert verified by the PDAC. However, if requested, you must be able to provide a list of materials used and a description of your fabrication process.

• KO Policy: A prefabricated double upright knee orthosis described by code L1845.

• AFO/KAFO Policy: A prefabricated multiligamentous support described by code L1906 (as of April 1, 2012).

• PDAC Announcements: A cervical collar described by code L0174 and a functional electric stimulator described by code E0770.

Q. A.

Where can I see a list of PDAC verified products?

To view a complete list of all items that have received a PDAC coding verification, visit the PDAC website: www.dmepdac.com. Click the link on the left-hand side of the page that reads “Search DMECS for Codes and Fees,” or go to www.dmepdac.com/dmecsapp/do/search. Once you open the window for the DMECS, scroll to the bottom of the page, and use the search engine for the DMEPOS Classification List. That search engine allows you to search products by manufacturer/distributor, HCPCS code, product name, product/model number, or classification (i.e., lower-limb orthoses, lower-limb prostheses, etc.).

42

O&P Almanac SEPTEMBER 2012

Q.

If an item requires PDAC verification and the product I wish to provide is not listed on the PDAC website, how do I bill Medicare for the item?

A.

The answer will depend on the specific Medicare Medical Policy or PDAC coding guidelines announcement, which required the item to be verified and listed on the PDAC website. Typically, you would have to use the code A9270 (non-covered item or service).

Q.

When reviewing the PDAC coding verification application, most people had questions in reference to Section B.1, Marketing and FDA Information.

Are orthotic and prosthetic items identified as Class I or Class II devices, and are they 501(K) exempt?

A.

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. Because 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. That exemption can be found in Code of Federal Regulations Title 21 Part 890. a Devon Bernard is AOPA’s manager of reimbursement services. Reach him at dbernard@AOPAnet.org.

AOPA has held two Coding Workshops to assist members seeking LCodes. Email Devon Bernard if you have interest in attending a future workshop.

www.LCodeSearch.com

24/7 Expert Coding Advice 24/7

•

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.

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.

SEPTEMBER 2012 O&P Almanac

43

T I M I N G

{

Come and see us at

AOPA Show in Boston - Booth #1505,

G E T

September 6th - 9th, 2012

C O N N E C T E D

W I T H

U S

T H R U

{

LSO & LP DESIGNS

LITE L0627

PRO L0631

MAX L0637

X L0637

OPTEC is proud to present our NEW VENUM spinal system which is ideal for patients requiring firm spinal support. With its unique and mechanically advanced closure system, The VENUM makes it a snap to don & doff with minimal effort. Its slick weightless construction is breathable, hypoallergenic and nearly undetectable under clothing, without compromising maximum comfort. Due to the ergonomic design of the brace, patient therapy participation is promoted by adjusting the level of support.

1.888.982.8181

•

1.770.513`.7380

•

www.optecusa.com

AOPA HEADLINES

AOPA WORKING FOR YOU

Election Year Opportunities for

O&P

M

ore and more O&P professionals are taking proactive steps to ensure the issues of importance to patients and facilities are known to their state and federal legislators. By making contact with House and Senatorial candidates during campaigns, we open the door for further discussions—and perhaps even commitments—after they’ve won the election.

The O&P agenda has one thing in its favor: Few, if any, of our issues require more government spending.

In fact, if enacted, the O&P Medicare Improvements Act (H.R. 1958 and S. 2125) will likely save $250 million over the next five years through curbing fraud and abuse. That example provides a wonderful talking point to share with all candidates at the federal level. At the state level, there’s growing evidence that timely O&P intervention actually saves money by avoiding expensive co-morbid conditions resulting from limb loss or impairment and lack of mobility. With the Medicaid squeeze likely to continue for some time, cost savings can be an important point to press home to candidates.

46

O&P Almanac SEPTEMBER 2012

(And during these tough economic times, what better message is there than cost-savings?)

As an O&P professional, you’d probably like to know how you can help further our agenda at the state level during this election year, but don’t know where to start. The following list provides a few ideas: • Host a fundraiser for a candidate of your choice. If hosting isn’t appropriate, offer to furnish food or beverages for an upcoming event.

Campaign managers know the ins and outs of what’s legal and what isn’t. Just be aware that what you can do for state candidates may be different than what the law allows for federal election campaigns.

• If you can’t host a fundraiser, you can always invite candidates to visit your facility. To really impress your candidate, think about bringing the local O&P community and several patients together in one facility. Seeing the size of the O&P constituency and hearing how O&P makes a difference in the lives of patients can be enlightening for candidates.

• Volunteer your services: canvass your neighborhood, distribute campaign leaflets, place signage at your residence, man a phone bank, or ensure the campaign headquarters is stocked with snacks and beverages.

• Contributing to the campaign is a surefire way to get your phone call returned when the candidate is elected or re-elected. While you may not always get a call from the legislator, you’re sure to hear from a member of the staff and that’s often just as good.

• Because O&P causes are often viewed as “feel good” issues, you could use O&P issues as door openers. Once you’ve developed two-way communications, you can always press for the O&P causes important in your state.

At the federal level, during the AOPA Policy Forum last April, your peers dealt with the following legislative issues. This list provides some guidance on the issues you should also press home to Senate and Congressional candidates.

INTRODUCING THE TACTICAL SOLEUS FOOT, BUILT FOR THE HEROES AMONG US. Its lighter, stronger and more rugged design can overcome barriers whether on the front line or the home front.

Engineered and manufactured right here in the U.S.A, the Tactical Soleus is only available for a limited time.

The foot was inspired by Dale Beatty, Military Veteran, bilateral amputee and co-founder of Purple Heart Homes. His organization is committed to no Veteran left behind and provides personalized housing solutions for service-connected, disabled Veterans and their families.

Starting on July 4, 2012, College Park will donate $200 of each Tactical Soleus purchase directly back to Purple Heart Homes.

For more information visit phhusa.org or call 800.728.7950

www.college-park.com/tactical

AOPA HEADLINES

AOPA WORKING FOR YOU

Medicare Orthotic and Prosthetic Improvements Act (S. 2125/H.R. 1958 in current Congress) prohibits Medicare from reimbursing unlicensed providers mandated by Medicare Transmittal 656; only pays qualified providers as required in Section 427 of the Benefits Improvement And Protection Act of 2000 (BIPA); adopts a revised payment system for O&P that links the practitioner qualifications with the level of complexity of the care being provided; and limits deemed accrediting bodies to those experienced in O&P. If enacted, estimated to save $250 million over the next five years.

Insurance Fairness for Amputees Act (S. 773/H.R. 4175 in current Congress) provides that insurers offering O&P coverage must provide benefits equal to other surgical and medical benefits with no limits or lifetime caps. The Act doesn’t require government funding or enforcement.

It doesn’t mandate O&P coverage, just equality of coverage if offered.

Restoring mobility often means restoring livelihoods, which transforms government support recipients into taxpayers.

Injured and Amputee Veterans Bill of Rights (H.R. 805 in current Congress) would require Veterans’ Affairs (VA) to inform veterans with limb loss and other injuries of their rights to choose a provider adequate for their needs and obtain a second opinion for treatment decision.

VA would post those rights on its website and in all facilities, and create a complaint system so those rights have “teeth.”

Another hot button for us at the federal level is to make sure the U.S. Treasury Department and IRS adopt a final rule that exempts O&P devices from the onerous 2.3 percent medical device tax. As a result of AOPA efforts,

48

O&P Almanac SEPTEMBER 2012

the proposed rule does exempt O&P on the same basis that hearing aids and eyeglasses are exempt.

Regulatory issues, such as being included in the definition of essential health benefits, may be both federal and state issues. Make sure your state selects the best benchmark plan that includes O&P benefits as an essential health benefit to ensure the best patient care.

You also need to speak with candidates about unfair burdens being placed on patients requiring them (or you) to nag the physician to provide adequate documentation for needed services, particularly lowerlimb prostheses. As you know, CMS is imposing over-the-top physician documentation requirements that threaten timely patient care and device delivery.

Education Is Key To ensure you have all the facts on these and several other issues members dealt with at this year’s Policy Forum, go to the AOPA homepage (www.

AOPAnet.org), and select the Legislative and Regulatory pull-down menu and click on Policy Forum. You’ll find issue papers for each of the O&P public policy concerns—both legislative and regulatory. Download them to help educate your candidates.

Election season is a great time to build relationships, particularly

with incumbents who have sat or are sitting on committees important to O&P. Those committees on the senate side include Appropriations, Budget, Finance, Health, Education and Pensions, and the Veterans Affairs Committees. On the House side, committees important to O&P include Appropriations, Budget, Education and the Workforce, Veterans Affairs, and Ways and Means.

Go to www.Senate.gov or www.House. gov and click Senator or Representative to view lists of incumbents and their committee assignments.

Just a little bit of extra effort in building relationships now with candidates will go a long way in furthering the continued ability of the O&P community to deliver the quality of care that makes lives function so much better.

One final note: AOPA takes no position on presidential politics, but many AOPA members have a favorite candidate and back their choice with campaign contributions. Do yourself and the O&P community a favor by coding your check or credit card contribution to reflect you are a member of the O&P community. That action will go a long way in helping O&P gain White House recognition. For President Obama, donations should include the code 4702570; for Mitt Romney, the code is 5767. a

AOPA HEADLINES

Introducing the AOPA National Assembly App Planning for the 2012 AOPA National Assembly is now faster and easier with AOPA 2012—the official mobile application for the event.

Compatible with the most popular devices, iPhone and Droids, the app allows users to flag the exhibit hall booths they want to visit, manage their education schedule, and navigate the new hallways of the National Assembly. In addition, users can take session notes directly in the app and even email them back to the office. The app’s convenient dashboard keeps users’ schedule front and center, while connecting them to the latest social media buzz.

To get the app, visit your device’s app store and search for AOPA 2012. Not able to install an app? Don’t worry, the same content also is available on a mobile-optimized website: http://assemblyapp.org/. And, don’t forget to follow AOPA on twitter at @AmericanOandP for additional behind the scenes Assembly news and tips!

Learn Everything You Need to Know About the FDA— Join the Audio Conference October 10 Join AOPA October 10 at 1 p.m. EDT for an AOPAversity Mastering Medicare Audio Conference that will cover what your facility needs to know regarding the U.S. Food and Drug Administration. Learn strategies and techniques from an AOPA expert who will address the following topics:

50

O&P Almanac SEPTEMBER 2012

• • • • •

An overview of the FDA What the FDA is responsible for regulating Where the FDA’s authority derives from How medical devices are regulated Important information on the Unique Device Identification System (UDI) proposed rule.

The cost of participating is $99 for AOPA members ($199 for nonmembers), and any number of employees may listen on a given line. Participants can earn 1.5 continuing education credits by returning the provided quiz within 30 days and scoring at least 80 percent. Contact Devon Bernard at dbernard@AOPAnet.org or 571/431-0854 with content questions.

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

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

AOPA HEADLINES

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: • Reviewing new Medicare Enrollment Standards • Reviewing the Medicare Enrollment Application • PECOS vs. the 855S Form • 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.

Master Medicare in Las Vegas: Essential Coding & Billing Techniques Seminar

Discover Employment Opportunities at AOPA’s Online Career Center

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

AOPA experts will provide the most up-to-date information to help O&P practitioners and office billing staff learn how to code complex devices, including repairs and adjustments, through interactive discussions and much more.

Meant for practitioners and office staff, this advanced two-day event will feature break-out sessions for these two groups to ensure concentration on material appropriate to each.

Basic material that was covered in AOPA’s previous Coding & Billing seminars has been converted into nine one-hour webcasts. Register for the webcasts on AOPA’s homepage.

Register online for the “Mastering Medicare: Essential Coding & Billing Techniques” seminar in Las Vegas at https://aopa.wufoo.com/forms/2012-mastering-medicare-lasvegas/ or contact Devon Bernard at dbernard@aopanet.org, 571/431-0854.

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

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

Visit http://jobs.AOPAnet.org, or email Steven Rybicki at srybicki@AOPAnet.org with questions.

52

O&P Almanac SEPTEMBER 2012

PreStride4™

Stride4 Stance Control Assessment Orthosis switch between locked and stance control modes of operation. This feature provides the clinician with the option of locking the joint when necessary. When the lock option is selected and engaged, the joint will allow approximately 3° of flexion to provide some shock absorption to the patient.

Intended as an evaluation tool for our new Stride4™ stance control knee joint system, the PreStride4 may be used in combination with a physical examination to assess candidacy for stance control orthotic management.

The PreStride4 is a modular and fully adjustable stance control KAFO that may be fitted in a controlled clinical setting to most adults who are between 5’ 2” and 6’ 2” in height. The overall height of the orthosis is quickly and easily adjusted by releasing the spring loaded knobs located on the medial and lateral uprights. Calf and thigh bands are also easily adjusted for varying A-P depths.

The joint body of the patent pending Stride4 knee joint is comprised of a four bar linkage mechanism; the upper and lower aspects of the joint do not purely rotate about one fixed center of rotation.

Instead, the joint motion involves some translation, in addition to rotation, to more closely mimic anatomical knee motion.

A button on the Stride4 allows the clinician to

In the stance control mode of operation, the four bar linkage mechanism provides stability when the orthotic knee joint is fully extended. An integral extension assist spring housed within the midsection assists with knee extension, while an adjustable extension stop allows the practitioner to adjust and fine tune the point at which the joint enters into its stable/locked state. If desired, the extension stop can be fully adjusted to eliminate the stability feature to facilitate free motion.

9008

An additional advantage of the PreStride4 is that it may be used as an effective gait training tool during rehabilitation.

Order No. 9008-L 9008-R Rev. 7/12

©2012 Becker Orthopedic Appliance Co., All rights reserved.

(800) 521-2192 (248) 588–7480 BeckerOrthopedic.com

Side Left Right

AOPA Applications

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

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

At the end of each new supplier member listing is the supplier level associated with that company. Supplier levels are based on annual gross sales volume: Level 1: equal to or less than $1 million Level 2: $1 million to $1,999,999

Level 3: $2 million to $4,999,999 Level 4: more than $5 million.

Wilmington Orthotics & Prosthetics 3909 Oleander Drive, Ste. E Wilmington, NC 20403 910/395-5755 Category: Patient-Care Member Mariska Truesdale, PT, CPOA, CFom a

177 Thorton Drive Hyannis, MA 02601 800/322-1177 Fax: 508/771-2300 Category: Supplier Member Peter Bentley

2021 S. Waverly, Ste. 300 Springfield, MO 65804 417/886-8881 Fax: 417/881-8223 Category: Patient-Care Member Christa Vahl, CFO

ARTech Laboratory Inc.

O&P Board Study Resources

ARTech Laboratory Inc.

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

Midlothian, TX 888/775-5501 www.artechlab-prosthetics.com

Introducing our NEWEST Study Guide in PEDORTHICS

The ONLY Comprehensive Study Guides Specifically for Orthotics and Prosthetics

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

www.oandpstudyguide.com

O&P Almanac SEPTEMBER 2012

295 Columbia Road Dorchester, MA 02121 617/436-6110 Category: Patient-Care Member Paul Martino, CP

C.N. Waterhouse Leather Co. Inc.

Alpha Omega Orthotics & Prosthetics

54

United Prosthetics Inc.

The loss of a limb causes deep emotional trauma. Apart from the obvious difficulties with mobility and self-care, the disturbance in body image requires significant emotional readjustment. Our objective is to eliminate the stigma associated with the disfigurement. As opposed to the robotic or mannequin look of traditional prosthesis, our restorations have a natural appearance since they are sculpted and painted to match the opposite limb. Without close examination, ARTech’s prostheses are virtually undetectable.

It is our privilege to work in an industry that gives self-sufficiency, mobility, and self confidence back to those with amputations and birth defects.

For more information, call 800/775-5501 or visit www.artechlab-prosthetics.com.

s at Visit u 12 20 AOPA h 917 Boot

Simple As :

1.

3.

2.

Visit www.kiss-suspension.com or Call 410-663-KISS (5477) Š 2011, U.S. Patent, Patent Pending Worldwide KISS is a registered trademark

Exhibit Directory

2012

332

333

Th ea t

er -P PT

S 8' tag X e 12 '

On the following pages is an advance look at the companies that will be exhibiting at the 2012 AOPA National Assembly. You’ll find website information and booth numbers for each exhibitor—use this guide and floor plan to organize your visit to the Exhibit Hall. Better yet, check out their websites now and plan ahead!

SOUTH LOBBY

ESCALATORS

AliMed Inc. ........................................ 1031 www.alimed.com

20'

116

112

Allard USA Inc. ..........................904 www.allardusa.com

Fillauer Companies Inc

20' Spinal Technology 20'

SPS 20'

18' DAW Industries Inc 20'

117

213

24'

108

209

Endolite 50'

207

102

205

Sponsors

56

O&P Almanac SEPTEMBER 2012

32'

18'

Ottobock 50'

308

ALPS.....................................................1605 www.easyliner.com Alternative Prosthetic Services Inc. ................................... 1300 www.alternativeprosthetics.com

WillowWood

50'

20'

304

305

505

300 302

301

LOBBY

DIAMOND

>

Aetrex Worldwide Inc ...................427 www.aetrex.com

317

105 201

Advanced O&P Solutions LLC .....1627H www.aopsolutions.com

F

40'

219

20' iWalk

104

ADN-Extremity Games .........................1737 www.adnpage.org

525

32'

60'

110

106

Adaptec Prosthetics LLC............... 1305 www.smartpucket.net

Boston Brace 30

427

327

121 118

114

Abletech Orthopedics Corp. ..............112 www.wellcare-supports.com ACOR Orthopaedic Inc. ................... 731 www.acor.com

re se nt

at

Ability Dynamics LLC ....................1524 www.abilitydynamics.com

Pr od uc tP

Bold listings indicate the exhibitor is a member with the American Orthotic & Prosthetic Association (AOPA). indicates the exhibitor is a Supplier Plus Partner with AOPA. Exhibitors as of August 9, 2012.

16'

18' Aetrex Worldwide Inc 20'

18' BSN Medical 20'

io n

18'

HYNES

SCALE IN FEET 0

JOHN B. HYNES CONVENTION CENTER, BOSTON, MA CONVENTION CENTER 2 LEVEL 2 - EXHIBIT HALLS C &• DLeVEL AND AUDITORIUM

10

20

30

40

50

NORTH Charging Station

741

840 842

940 942

841

941

1040 1042 1041

1140

Charging Station

20'

1640

1740

1642

N

20'

1840

1940

1842

WALKWAY

N 730

93

737 735

N 730

93

835

834

Exhibitor Lounge

832

6' TABLE

20'

20' AOPA

830

731

18'

20' Vorum Corp 20'

20'

GAME

Orthocare Innovations

1034

1035

1134

1033

1132

1031

1130

1029

1128

FOOD

Arizona AFO 931 20'

20'

20'

824

Vibrant Technologies

822

823

820

Trulife

30'

20'

925

1025

1126 1124

20'

Cascade Orthopedic Supply Inc 30'

Proteor

30'

919

817

816

1133

1532

1131

1530

917

1129

1528

1127

1526

1125

1524

1123

1522

1121

1520

1119

812

20'

611

711

20'

811

20'

709

808

Dr. Comfort

30'

Euro International Inc 20' 605

707

912

20'

911

20'

908

705

20'

805

804

1010

20'

30' 20'

904

1012

18' AMFIT Inc. 20'

1113

1512

1011

1111

1510

Comfort Products Inc

907

30'

905

1004

1627G

1627H

20'

1835

OPGA Village

SureStep 50'

1627I

16' 16'

1529

Townsend Design 30'

16'

1627B

20'

1827

1627J

1627E 1627F

1627A

20'

18'

16'

1627C

18' Össur Americas Inc

Becker Orthopedic Appliance Co 30'

FOOD

50'

1819 18'

1514

1115

20' Medi USA 20'

20'

1517

1017

1016

1627D

1518

WALKWAY

18'

1836 20'

18' PEL Supply Co 20'

18'

18'

20'

OPTEC USA, INC

Orthomerica Products Inc

1813

20'

FDC

ALPS 50'

18'

Freedom Innovations LLC

1605

18' Steeper USA 20'

College Park Industries Inc 30'

40'

1505

20'

Orthomerica Products Inc

18'

1713 18'

50'

1005

screen

20'

717

18'

20' Touch Bionics 20'

30'

1534

20'

20' 723

1135

9'

1637 1638 1736 1737

20'

6' x 20' stage

625

935

1536

20'

AOPA ARENA

30'

1037

AOPA

826

Grace

1036

829

828

729

30'

1137

937

1705

SERVICE CENTER

PAY PHONES

screen

0'

6 - 9, 2012 SeptEMBER 6-9,SEPTEMBER 2012 • BOSTON

1907

FDC NonFDC NonFDC

1805

1305

1205

WALKWAY 20'

700

20'

800

801

900 901

1000 1001

SIGN-IN COUNTER

ENTRANCE TO HALL "C"

ENTRANCE

1100 1101

1200 1201

1300

1301

1400 1401

1500 1600 1601

1602

LOBBY

REGISTRATION New Products

8'

8'

Raffle

1800 1801

1900 1901

1903

LOBBY

ENTRANCE

Boston CVB

8'

1m

The

Placee!

Platinum

6m

GOLD

ENTRANCE TO HALL "D"

SIGN-IN COUNTER

To B

Silver

n

AMERICAN ORTHOTIC & PROSTHETIC ASSOCIATION 2012 exhibit HALL ASSEMBLY floor plan AOPA NATIONAL

SEPTEMBER 2012 O&P Almanac

57

2012 exhibit directory

American Academy of Orthotists and Prosthetists (AAOP) ............. 333 www.oandp.org

AON O&P Insurance Program .........1526 www.insurance4op.com Apis Footwear Co. .........................1029 www.bignwideshoes.com

American Board for Certification in Orthotics, Prosthetics and Pedorthics (ABC) ............................1528 www.abcop.org American Central Fabrication ...................................... 1201 American Orthopedics Manufacturing Corp. ................... 1901 www.americanomc.com

American Orthotic & Prosthetic Association (AOPA) ......................... 925 www.aopanet.org American Plastics ................................1801 www.americanoandp.com American Prosthetic Components Inc. .............................. 118 www.apcomponents.com AMFIT Inc. ......................................1011 www.amfit.com Amputee Coalition ....................... 1840 www.amputee-coalition.org Anatomical Concepts Inc. ........... 205 www.anatomicalconceptsinc.com

Arizona AFO Inc. ...............................931 www.arizonaafo.com

BREG Inc. .......................................................1101 www.breg.com

ARTech Laboratory Inc. .............. 1601 www.artechlab-prosthetics.com

The Bremer Group Company ........ 911 www.bremergroup.com

Aspen Medical Products .............. 834 www.aspenmp.com

Brightree LLC ................................ 1627A www.brightree.com

Atlantic Rim Brace Mfg. Corp. ..... 116 www.spinalbraces.com

BSN Medical .......................................327 www.bsnmedical.com

ATLAS International ..................... 700 www.atlasortho.com

Bulldog Tools Inc. ......................... 304 www.bulldogtools.com

Bauerfeind USA ........................................ 1113 www.bauerfeindusa.com

C.N. Waterhouse Leather Co. Inc. .................................................800 www.waterhouseleather.com

Becker Orthopedic Appliance Co. ................................... 1819 www.beckerorthopedic.com

Cadence Biomedical ....................... 826 www.cadencebiomedical.com

Bio-Mechanical Composites Inc. 2. 01 www.phatbraces.com BioDESIGNs, INC. ...............................900 www.joinhifi.com BioQuest Prosthetics LLC ............1133 www.bioquestpros.com BioSculptor Corp. .......................... 1037 www.biosculptor.com

Board of Certification/ Accreditation, Int’l (BOC) ............1842 www.bocusa.org

O&P Almanac SEPTEMBER 2012

Boston Brace International Inc. ......................... 525 www.bostonbrace.com Brainer Custom Molding............. 828 www.branier.com

Bledsoe Brace Systems ......................820 www.bledsoebrace.com

58

Bort-Swiss Orthopedic Supply ................................................1033 www.bort-swissortho.com

Cailor Fleming Insurance. .........1034 www.cailorfleming.com CARIS Innovation Inc. .........................1035 www.carisinnovation.com Cascade Dafo Inc. ............................919 www.cascadedafo.com Cascade Orthopedic Supply Inc. .........................................1017 www.cascade-usa.com Center for Orthotics Design— A Fillauer Company ........................219 www.centerfororthoticsdesign.com

Patent Pending

Patent Pending 1

Be sure to stop by the Friddle’s and O and P booths at AOPA to see Spyder Technologies in action!

Spyder Technologies will be having a braider workshop on Thursday, September 6th from 1PM - 5PM (2nd floor Republic A Room). Spyder Technologies will also host daily mini-workshops in the exhibit hall on the following days: THURSDAY @ 6PM and 7:15PM FRIDAY @ 9AM, 12:30PM, 2PM, and 6PM SATURDAY @ 9AM, 12:30PM, and 2PM SUNDAY @ 10AM

Patent Pending

www.oanp1.com Ph: 800.408.3598 Fx: 800.408.3595

PROUDLY FABRICATING “GOSS” Friddle’s is pleased to announce that we are fabricating the custom orthoses for “GOSS” (Gomez Orthotic Spine System).

BEFORE

AFTER

Dr. Gomez dedicated much of his career

42 degrees

19 degrees

to scoliosis research after learning that his 9 month old daughter was diagnosed with infantile idiopathic scolosis, His dedication to this cause has resulted in an industry innovation that will change the lives of thousands of patients.

The next GOSS workshop will be on Thursday, September 6th at AOPA in Boston. www.friddles.com

Ph: 800.528.9339 Fx: 800.582-3646

Don’t want to be limited to 4 months a year when your certification exam is offered?

we CARE.

“We offer year-

round testing so you can take your test on a date that works for you.”

Michelle Yoon, Certification/External Relations Coordinator

877.776.2200

www.bocusa.org

2012 exhibit directory

Centri—A Fillauer Company...219 www.centri.se

Drew Shoe Corp. .................................... 1903 www.drewshoe.com

CIR Systems .......................................1518 www.gaitrite.com

Emotis—A Fillauer Company .... 219 www.e-motis.com

CJ Socket Technologies ................308 www.cjsocket.com

EMR Stat .......................................... 1627C www.myemrstat.com

College Park Industries Inc. .....1805 www.college-park.com

Endolite ........................................105 www.endolite.com

Comfort Products Inc. ............... 1004 www.comfortoandp.com

ESP, LLC ...........................................................1127 www.wearesp.com

Complete Business Solutions ... 935 www.oandp-solutions.com

Euro International Inc. .............. 605 www.eurointl.com

Corflex Inc. .................................................1111 www.corflex.com

Euro International, Inc/ Sporlastic Orthopaedics .............301 www.eurointl.com

Coyote Design .......................................1627F www.coyotedesign.com CSUS LLC by Allard...........................901 www.allardusa.com

Evolution Industries Inc. ................1522 www.evoii.com Fabtech Systems LLC .....................1025 www.fabtechsystems.com

CyberKINETICS ................................ 1400 www.cyberkinetics.us.com

Fillauer Companies Inc. ............219 www.fillauercompanies.com

DAW Industries Inc. ........................213 www.daw-usa.com

Fillauer LLC—A Fillauer Company..............................................219 www.fillauer.com

Delcam ......................................907 & 908 www.delcam-healthcare.com

Florida Brace Corp. ....................... 1010 www.flabrace.com

DeRoyal Industries Inc. ............... 1128 www.deroyal.com

FLO-TECH® Orthotic & Prosthetic Systems Inc. ............... 737 www.1800flo-tech.com

DJO Global .........................................808 www.djoglobal.com DR - HO’S ..............................................1514 www.drhonow.com Dr. Comfort ...................................... 805 www.DrComfort.com

Placee!

To B

Futura International Inc. ...........937 www.futuraintl.com Grace Prosthetic Fabrication Inc. ...723 www.gpfinc.com HOPE Orthopedic .............................804 www.hopeortho.com Hosmer Dorrance Corp.— A Fillauer Company ........................219 www.hosmer.com Infinite Biomedical Technologies .................................. 1510 www.i-biomed.com Innovative Neurotronics Inc. .. 1501 www.WalkAide.com

Cybertech Medical ........................1205 www.cybertechmedical.com DANCO Medical Inc. ........................ 1129 www.dancomedicalinc.com

The

Freedom Innovations LLC ........... 1705 www.freedom-innovations.com Friddle’s Orthopedic Appliances Inc. ..............................1627J www.friddles.com

Insightful Products ................... 1640 www.insightful-products.com iWalk Inc. .............................................117 www.iwalk.com Joint Active Systems .......................... 1126 www.jointactivesystems.com Juzo ................................................................ 832 www.juzousa.com Kinetic Research Inc./Bader Prosthetics & Orthotics............. 1012 www.kineticr.com KISS Technologies LLC. ................... 917 www.kiss-suspension.com KLM Labs Inc. ............................................1100 www.klmlabs.com

SEPTEMBER 2012 O&P Almanac

61

2012 exhibit directory

Motion Control Inc.— A Fillauer Company ........................219 www.UtahArm.com

Orten ..................................................1512 www.orten.fr

National Assn for the Advancement of O&P (NAAOP) ....1638 www.naaop.org Orthocare Innovations .............. 625 www.orthocareinnovations.com

Knit-Rite Inc. ................................... 1627I www.knitrite.com

National Commission on Orthotic & Prosthetic Education (NCOPE) ..........................1530 www.ncope.org

LADON Systems of Lawton Brace & Limb Co Inc. .........................108 www.ladonsys.com

NE Chapter Academy of Orthotists & Prosthetists ......... 332 www.neaaop.com

Orthomerica Products Inc. ........................1813 & 1713 www.orthomerica.com

Levy & Rappel .....................................729 www.LevyandRappel.com

Nearly Me Technologies LLC ........912 www.nearlyme.org

Liberating Technologies Inc. ..... 1627B www.liberatingtechnologies.com

New Options Sports .......................114 www.newoptionssports.com

Orthotic & Prosthetic Activities Foundation—OPAF & The First Clinics ................................................ 1740 www.opafonline.org

Life Like Laboratory LLC .............. 1301 www.lifelikelab.com

Nora Systems USA, Shoe Components ......................................707 www.nora-shoe.com

Orthofeet ........................................ 1124 www.orthofeet.com

Orthotic and Prosthetic Equipment Corp./Prosthetics Laboratories Inc.................................. 1602 www.optable.com

Linkia-A Hanger Orthopedic Group Company ...............................1132 www.linkia.com

North Sea Plastics ................................104 www.northseaplastics.com

M. J. Markell Shoe Co. Inc. ...........1036 www.markellshoe.com

O&P 1 Central Fabrication ........1627D www.oandp1.com

MD Orthopaedics .............................735 www.mdorthopaedics.com

O&P Business News/SLACK Inc. ... 1115 www.healio.com/oandp

Med Spec (ASO) ...................................812 www.medspec.com

O&P EDGE/Western Media LLC .... 1000 www.oandp.com/edge

Össur Americas Inc. ....................... 1517 www.ossur.com

Medex International Inc. .............801 www.medexinternational.com

OP Marketing ....................................102 www.opmarketing.com

OTS Corp.—A Fillauer Company .............................................219 www.ots-corp.com

Medi USA .............................................. 611 www.mediusa.com

OPED LLC .............................................. 842 www.OPEDusa.com

Medicare Contractors ...................... 1130 www.NGSMedicare.com www.MedicareNHIC.com www.CGSMedicare.com www.Noridianmedicare.com www.palmettogba.com/palmetto/palmetto. nsf/DocsCat/Home

OPIE SOFTWARE/oandp.com .............711 www.oandp.com

62

O&P Almanac SEPTEMBER 2012

OPTEC USA, INC ..................................1505 www.optecusa.com Orfit Industries America ............ 905 www.orfit.com

Orthotic & Prosthetic Group of America (OPGA) ........... 1627C www.opga.com

HEAT ADJUSTABLE

COST SAVINGS. PATIENT CONVENIENCE. 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 unique and innovative designs have been tested and refined in high volume orthotic centers.

The resulting high-quality custom AFOs, synthetic and leather gauntlets offer optimal fit and are less expensive in today’s ultra cost-conscious environment — without compromising comfort or function.

Orthomerica’s experienced custom fabrication team of certified orthotists, technicians and customer service representatives deliver prompt and exceptional service at highly competitive prices.

www.orthomerica.com/spectrum 877-737-8444

Experience Our Commitment

SPS Booth: 317

New Pediatric System

Increased LOCOMOTION is fundamental to your patient’s DEVELOPMENT. The Kid-friendly FES The new Pediatric WalkAide® features several advantages not found in other FES systems: - Pediatric cuff DESIGNED to fit small children - Peds programing options: Amplitude, Frequency, Pulse Duration settings for sensitive cases are well tolerated - Freedom in Footwear: Allows kids to have more freedom in shoe styles including none at all - Self-contained System: Single unit system with no extra pieces, ideal for playful kids

Service Fax

Independence The active muscle contraction produced with the Pediatric WalkAide System will result in a more efficient, controlled and balanced walking pattern.

Social Skills Free from bulky AFOs, the Pediatric WalkAide System can give kids the confidence to engage in social activities they once avoided.

Positive Feedback WalkAide compliments patient driven activities with biofeedback, repetitive sensory motor stimulation and active muscle contraction.

800.767.7776 x3 T 800.69.7776 F

www.SPSCO.com eSTORE.SPSCO.COM

© 2012 SPS. SPS and Experience Our Commitment are trademarks of SPS. All other trademarks are properties of their respective owners. All rights reserved.

The

2012 exhibit directory

PlaBcee!

To

RX Textiles Inc. .................................816 www.rxtextiles.com

TiMED Inc. ........................................... 824 www.ti-med.com

Ottobock ........................................... 305 www.ottobockus.com

Silipos Inc. ......................................... 709 www.silipos.com

Top Shelf Orthopedics ................. 1137 www.topshelforthopedics.com

Pacific Supply Co., Ltd. .......................... 1123 www.p-supply.co.jp/

Soletech Inc. .................................... 302 www.soletech.com

Touch Bionics ................................... 817 www.touchbionics.com

PEL Supply Co. ..................................1005 www.pelsupply.com

Townsend Design .......................... 1827 www.townsenddesign.com

Physiotherapy Associates ......... 1121 www.physiocorp.com

Trulife .............................................717 www.trulife.com

Pilgrim Shoes (Deer Tracks Made in USA) .................................... 1534 www.pilgrimshoes.com Pine Tree Orthopedic Lab Inc. ... 1001 www.pinetreeorthopedic.com Professional Technologies International Inc. ........................1642 www.protech-intl.com Prosthetic Design Inc. ..................209 www.prostheticdesign.com PROTEOR ............................................. 1016 www.orthopaedics.proteor.com ProtoKinetics .................................1520 www.protokineticks.com Provel Inc. ........................................ 1140 www.provel.us Quality Outcomes ....................... 1627E www.qualityoutcomes.org Renia GmbH. Chemische Fabrik .................................................. 705 www.renia.com Restorative Care of America Inc. ..................................... 1134 www.rcai.com Royal Knit Inc. ................................. 822 www.royalknit.com

Spinal Technology Inc. ............121 www.spinaltech.com SpringActive Inc. ............................300 www.springactive.com SPS ......................................................... 317 www.spsco.com

U.S. Paralympics .................................... 1940 www.usparalympics.org VGM Education .............................. 1627C www.vgmu.com VGM Financial ............................... 1627C www.vgmfs.com

Spyder Technologies..................1627G ST&G USA Corp. ................................... 811 www.stngco.com SteeperUSA .......................................1907 www.steeperusa.com SureStep ...........................................1529 www.surestep.net Symmetry Prosthetics .................. 110 www.symmetryprosthetics.com

VGM Forbin ..................................... 1627C www.forbin.com VGM Insurance ............................. 1627C www.vgminsurance.com Vibrant Commercial Technologies Inc. ........................... 823 www.vibrantcommerce.com Vorum Research Corporation ..................................... 835 www.vorum.com

Tamarack Habilitation Technologies Inc. ......................... 1800 www.tamarackhti.com

VQ OrthoCare ........................................ 1200 www.vqorthocare.com

TECHMED 3d ....................................... 1401 www.techmed3d.com

WBC Industries Inc. ......................1500 www.wbcindustries.com

Tekscan Inc. ...............................................1119 www.tekscan.com The BARR Foundation .........................1736 www.oandp.com/barr The Pedorthic Foundation .............1532 www.pedorthicfoundation.org

WillowWood .............................. 505 www.willowwoodco.com XBack Bracing Services Inc................830 www.xbackbrace.com a

SEPTEMBER 2012 O&P Almanac

65

Marketplace Friddle’s is now offering the FC2 Flexion Control Ankle Joint

High-Performance Seattle Triumph Foot from PEL Supply

FC2 Flexion Control Ankle Joint features: • Patented, spherical-axis FC2 Ankle • FC2 provides up to 70 degrees of anterior-posterior range of motion using plantar-/ dorsiflexion-stop set screws • Unique design made of high-quality, heat-treated stainless steel • Allows for adjustments to be made while patient is wearing orthosis • FC2 pre-contoured design saves fabrication time while facilitating a low-profile finish • Availability of self-squaring molding dummy to reduce fabrication time.

Contact Friddle’s today at 864/369-2328, fax 864/3691149, or visit www.friddles.com.

Trulife’s newest high-performance foot—the Seattle Triumph—is available from PEL at a great low price. Designed of carbon composite, the Seattle Triumph provides dynamic performance while adding features to save practitioners time and money.

The Seattle Triumph combines a split keel and S-shaped shank to create a multiaxial ankle-foot system with vertical shock absorption, smooth rollover, and controlled plantar flexion. Complete with integrated heel wedge, titanium pyramid, and Spectra sock, the Seattle Triumph comes preassembled in a removable foot shell, making it ready to fit directly out of the box. In addition, you get FREE SHIPPING with the PEL Higher Activity Shipping (H.A.S.) program.

For more information on the Triumph foot or any of Trulife’s high-quality, innovative products, call your friendly PEL Supply customer service rep at 800/321-1264, fax your order to 800/222-6176, or email customerservice@pelsupply. com. Registered customers may order online at www. pelsupply.com.

Reformulated KISS® Adhesive: Amazing adhesion The reformulated KISS adhesive features increased flexibility and less time needed for bonding. The adhesive bonds porous and nonporous surfaces, and bonds flexible as well as rigid materials. It is packaged in two separate bottles for increased shelf life.

For more information, call 410/663-KISS (5477) or visit www.kiss-suspension.com.

NEW Online Liner Selection Tool Interested in a way to easily search, filter, and find the liners to suit your patients’ needs?

We’ve heard this wish a few times and took action. WillowWood’s new online liner selection tool allows clinicians to obtain liner size recommendations and part numbers based on the data they provide.

Clinicians may search by amputation style, gel type, fabric type and profile, and more. Liner size may be selected or clinicians may enter distal and proximal measurements of their patient’s residual limb. Results displayed by liner type and by part number, with links to detailed product information.

Give it a try at willowwoodco.com.

66

O&P Almanac SEPTEMBER 2012

NEW Triton LP Foot from Ottobock We’ve added a new low-profile (LP) carbon fiber foot to the popular Triton family! Now patients with lower clearance (2.5 in) can take advantage of the same smooth rollover and robust function as the original Triton. The multi-axial Triton LP provides excellent dynamics and flexibility for above- or below-knee individuals. Ideal for all your active patients, the Triton LP features a titanium adapter for added strength and water resistance, a weight limit up to 330 lbs, and a split toe design for safety, stability, and control.

Contact your sales representative at 800/328-4058.

Marketplace Fabrication Services from Ottobock

Total Knee® by Össur®. Totally versatile.

Whether your fabrication job is simple or complex, you want the broadest range of services available, staffed by knowledgeable, caring people. That’s why Ottobock Fabrication Services is a perfect partner for your business: We offer decades of expertise, exceptional customer service, and an unparalleled reputation for quality.

Our expert services include water transfer, lamination, and pre-preg carbon fiber. You can count on timely turnaround delivering the results you want.

Visit www.ottobockus.com or call 800/795-8846.

With K2, K3 and K4 models to choose from, Total Knee enables a broad range of amputees to walk with a smooth, more natural, energy-efficient gait, enhancing their confidence and stability. Key features include geometric locking for stability, plus mid-swing shortening designed to prevent hip-hiking, and reduce the chances of tripping. Each model fits a wide range of amputees and is lightweight and easy to cosmetically finish.

To learn more about Total Knee by Össur, call 800/ 233-6263 or visit www.ossur.com today. a

SEPTEMBER 2012 O&P Almanac

67

JOBS

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

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

Classified rates Classified advertising rates are calculated by counting complete words. (Telephone and fax numbers, email, and Web addresses are counted as single words.) AOPA member companies receive the member rate.

Member Nonmember Words Rate Rate 50 or fewer words $140 $280 51-75 words $190 $380 76-120 words $260 $520 121 words or more $2.25 per word $5.00 per word Specials: 1/4 page, color

1/2 page, color

Inter-Mountain Clinical Marketing Representative Salt Lake City Seeking a person with excellent communication skills to provide marketing and educational services for myoelectric UL and advanced LE prostheses for prosthetists and other professionals throughout North America and international markets.

Successful candidate will be responsible for: • Developing and presenting educational and marketing programs; • On-site visits to evaluate candidates and assist with upper-extremity and lower-extremity fittings and training with company’s products; and • Extensive contact with customers via a variety of media, including telephone, email, Internet, and multimedia materials, including trade shows, educational seminars, printed materials, etc.

Experience in myoelectric prosthetics is preferred, but not essential; training will be provided.

Benefits include: • An excellent salary/benefit package is offered, and a great working environment.

• Certified Prosthetist (CP or CPO) preferred. Call us or email/fax resume to:

$482 $678 $634 $830

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

No orders or cancellations are taken by phone.

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

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

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

Job board rates Visit the only online job Member Nonmember board in the industry at Rate Rate jobs.AOPAnet.org! $80 $140

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

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

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

Email: humanresources@fillauer.com

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.

68

O&P Almanac SEPTEMBER 2012

JOBS

Pacific

Northeast

Certified Prosthetist/Orthotist, Certified Prosthetist, Certified Orthotist 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:

Certified Orthotist 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

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

“ 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: Certified Orthotist Denver, CO Columbia, MO Jacksonville, FL Lancaster, PA Urbana, IL Spartanburg, SC Springfield, IL Waukesha, WI Jackson, MS Certified Prosthetist Chico, CA Overland Park, KS Certified Pedorthist Belleville, IL Portland, ME Certified Prosthetist / Orthotist Stockton, CA Mayfield Heights, OH New London, CT Bartlesville, OK Tamarac, FL Portland, OR Waterville, ME Wilkes Barre, PA Bethesda, MD San Antonio, TX Buffalo, NY Olympia, WA Mooresville, NC Tacoma, WA Akron, OH

1 VISION

12-HGR-10786HangerClinicAdTinaOPAlmanacHalfpageF.indd 1

7/27/12 12:43 PM

SEPTEMBER 2012 O&P Almanac

69

JOBS

Northeast Certified Orthotist, Certified Orthotist and Board-Eligible Prosthetist, or Certified Prosthetist/Orthotist New York State Privately owned and growing multisite ABC-accredited P&O practice in upstate New York is seeking a certified orthotist with a minimum of two years of experience and/or a certified orthotist and board-eligible prosthetist, or certified prosthetist/orthotist. We are looking for individuals with strong orthotic backgrounds, and we may entertain an NCOPE prosthetic residency if needed.

Our offices in the historic and scenic Hudson Valley and Catskill Mountains of New York are located from Saratoga to Poughkeepsie, with immediate openings in Kingston and Poughkeepsie. The ideal candidate must be self-motivated and a team player, possess good communication and technical skills, and be willing to excel for performancebased objectives. Competitive salary and benefits package offered. Submit resume to:

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

Mid-Atlantic Management Opportunity Columbia, Maryland An exciting and rewarding management opportunity in our beautiful Columbia, Maryland, office! We treat infants with plagiocephaly and other head shape abnormalities, utilizing the STARscanner data acquisition system and the STARband cranial remolding orthosis. Our center works closely with the area’s most renowned craniofacial and pediatric neurosurgeons.

Ideal candidates will have management as well as cranial remolding orthosis experience.

Certified orthotists who join our Columbia, Maryland, team will enjoy: • Unique and specialized training opportunities with leading cranial remolding experts • Assistance with relocation expenses • Generous benefits package • Competitive salary • Working in a great location with convenient access to surrounding cities such as Washington, D.C., Annapolis, and Baltimore! Columbia/Ellicott City, Maryland, was ranked #2 for the “Best Places to Live” in 2010 by CNN-Money.

• Rewarding patient treatment outcomes!

Please fax or email your resume in confidence to:

Technician Position Boston Immediate career opportunity in Boston as O&P technician.

Job duties may include: filling, correcting, and modifying casts; draping and blister forming; static alignment of both upper and lower extremities; bending and contouring metal; lamination; fabrication of soft goods; knowledge of componentry. Professional demeanor and appearance, attentiveness to detail, pride in work, all a must. Benefits include health insurance, 401K, paid vacation and holidays, disability.

Forward qualifications to:

United Prosthetics 295 Columbia Road Dorchester, MA 02121 Email: chris@unitedprosthetics.com www.unitedprosthetics.com

70

O&P Almanac SEPTEMBER 2012

Fax: 407/667-8998 Email: HR@starcranialcenter.com

?

Coke or Pepsi

You make choices every day, based upon many factors.

One of those choices is your O&P product supplier. PEL Supply’s Power of One® service accommodates your tastes.

With tens of thousands of the most popular O&P products in stock (most popular for same Larry Moore day shipment) we have a menu • CSR with PEL since 2008 • Veteran’s Administration Specialist to meet your diverse cravings for • International Auditor with UPS for 14 years product, performance, price and • Business Management degree • Loves watching and playing sports, overall value. Sweet! PEL makes family and the outdoors your choices easier.

• “The customers are what make PEL.” Knit-Rite Core-Spun by Therafirm®

Fillauer Element DS™ Foot System

Hosmer E-TWO Electric Elbow

• Ultra stretchy core-spun yarns for a compression sock that is easier to put on and more comfortable to wear • Designed to help promote better circulation, prevent swelling, and relieve tired, achy legs • Moisture wicking fibers • Comfort top is non-restrictive while staying in place • Light 10-15mmHg, Mild 15-20mmHg, Moderate 20-30mmHg, and Firm 30-40mmHg Support Levels • Available in Black, White, Navy and Khaki

• 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 • Rated for patients up to 275 lbs (125 kg) • Low profile design – 6.5 in. build height

• 37.5% increase in lifting power • Exoskeletal or Endoskeletal application • Compatible with wide range of products including NY Prehension Actuator and Centri Myo Hand • Extremely quiet • Lightest weight design available (weight: 439 grams for medium size) • Compatible with the Motion Control hand and ETD Exoskeletal

Endoskeletal

t Gradien ion s s e r p m Co Socks

PEL Supply Co. Orthotic & Prosthetic Components

®

pelsupply.com

4666 Manufacturing Avenue Cleveland, OH 44135-2638 USA

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

®

Experience the Power of One.

CALENDAR

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

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

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

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

UtahArm.com.

■■

■■

2012 ■■ SEPTEMBER 1 ABC: Application Deadline for Certification Exams and Clinical Patient Management (CPM) Exams. Applications must be received by Sept. 1, 2012, for individuals seeking to take the November 2012 ABC certification exams for orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, therapeutic shoe fitters, and orthotic and prosthetic technicians or winter CPM ABC exams for orthotists and prosthetists. Contact 703/8367114, email info@abcop.org, or visit www.abcop.org/ certification.

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.

■■ September 6-9 AOPA National Assembly & NE Chapter Combined Meeting. Boston. Hynes Convention Center. The 2012 AOPA National Assembly will be held jointly with the NE Chapter Meeting. Plan to join us for this significant event. Exhibitors and sponsorship opportunities available––contact Kelly O’Neill at 571/431-0852 or koneill@AOPAnet.org. To register, please visit www.

AOPAassembly.org or contact Stephen Custer at 571/4310876 or scuster@AOPAnet.org.

September 8 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.

■■

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

■■ September 12 Ultraflex: Pediatric UltraSafeGait™ Continuing Education Course, via WebEx, 5-6 pm ET. Covers assessment of pediatric pathological gait & 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.

■■ September 14 National Pedorthic Services:Therapeutic Show Fitter’s Course. Milwaukee.

Contact Nora Holborow at 414/438-6662, visit www. npsfoot.com, or email nholborow@npsfoot.com.

■■ SEPTEMBER 17 WillowWood: Take the Guesswork Out of Elevated Vacuum Suspension, via WebEx, 1:30 pm ET. Course covers background information and theory on the concept of elevated vacuum. Appropriate clinical applications and components discussed.

Credits: 2.5 ABC/2.5 BOC. To register online, visit www. willowwoodco.com.

■■ SEPTEMBER 18 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.

■■ SEPTEMBER 20 Arizona AFO: The Custom AFO Workshop. Long Beach, CA. This course covers AFO selection, coding, handson casting, and footwear/ modification tips. Fee includes lectures, handouts, and lunch. Approved for 6.5 ABC CE credits. For details, call 877/780-8382 and mention the “workshop” or email education@arizonaafo.com.

■■ September 25 Ultraflex: Adult UltraSafeStep® Continuing Education Course, via WebEx, 12-1pm 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.

SEPTEMBER 2012 O&P Almanac

73

CALENDAR

■■ September 27 Ultraflex: Complex Orthopedic Rehabilitation Continuing Education Course, via WebEx, 12–1 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.

October 2-4 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. To register online, visit www.willowwoodco.com.

877/780-8382 and mention the “workshop” or email education@arizonaafo.com.

■■ October 3 Ultraflex: Pediatric UltraSafeGait™ Continuing Education Course, via WebEx, 8-9 am ET. Covers assessment of pediatric pathological gait & 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.

■■ OCTOBER 5-6 Tennessee Society of Orthotics and Prosthetics (TSOP) Annual Meeting.

Murfreesboro, TN. Embassy Suites. Orthotic, prosthetic, pedorthic, post-mastectomy, and technical programs.

Several product certification courses will be available.

The schedule is being finalized, and opportunities for speakers and vendor booths are still available.

For more information and online registration, visit http:// tennesseesocietyop.org/.

For vendor tables, contact Gary Stokes at gary8916@aol.com.

■■ October 4 Arizona AFO: The Custom AFO Workshop. Houston.

This course covers AFO selection, coding, handson casting, and footwear/ modification tips. Fee includes lectures, handouts, and lunch. Approved for 6.5 ABC CE credits. For details, call

Motion Control

SuperCourse Fall 2012 October 15 - 19, 2012

at Fillauer Headquarters, Chattanooga, TN • In-depth training of Utah Arm / U3+ / Hybrid / ProControl2.

• Hands-on experience with UI-software. Bring your laptop.

• CEUs: 34 (estimated) awarded by ABC.

Overview of: NEW LI-Ion Battery for Utah Arm / U3+ / Hybrid NEW Electric Wrist Rotator NEW TRIAD Preamps Plus an overview of the NEW & EXCITING Motion Foot from Motion Control

The Fall 2012 SuperCourse is a 5-Day Course = $1,350.00 For more information or to register for the SuperCourse email: info@UtahArm.com

Motion Control Inc. 115 N. Wright Brothers Dr. • Salt Lake City UT 84116 Phone: 801/326-3434 • FAX: 801/978-0848 Toll Free: 888.MYO.ARMS • www.UtahArm.com 74

O&P Almanac SEPTEMBER 2012

■■ October 10 AOPAversity Audio Conference–What Every O&P Facility Needs to Know About the FDA. For more information, contact Stephen Custer at 571/431-0876 or scuster@AOPAnet.org.

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

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

■■ October 25 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 is Oct. 4. Contact 877/665-5443 or visit www.willowwoodco.com.

■■ October 26 WillowWood: LimbLogic® VS Applications Technicians Course. Mt. Sterling, OH. Learn all aspects of fabricating LimbLogic VS for various applications: socket materials, controller configurations & care, fob operation, troubleshooting.

Fabricate sockets following recommended techniques for airtight socket designs.

Credits: 9.75 ABC/9.75 BOC. Registration deadline is Oct. 4.

Contact 877/665-5443 or visit www.willowwoodco.com.

■■ NOVEMBER 7-9 New Jersey Academy of Orthotists & Prosthetists 2012 Annual Meeting.

Bally’s Hotel and Casino.

Atlantic City. For details, contact Lisa Lindenberg at 973/609-2263 or visit www. njaaop.com.

■■ NOVEMBER 12-17 ABC: Certification Exams.

ABC certification exams will be administered for orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, therapeutic shoe fitters, and orthotic and prosthetic technicians. The application deadline for these exams is Sept. 1, 2012. Contact 703/836-7114, email info@ abcop.org, or visit www.abcop. org/certification.

HYNES CO NVENTI O N CENT ER , B O S T O N

Mark your calendar to attend the country’s largest, oldest, and essential meeting for orthotic, prosthetic, and pedorthic professionals.

S AV E T H E D AT E For information about the show, scan the QR code above with a code reader on your smartphone or simply visit www.AOPAnet.org.

The

e c a l P e!

To B

*

SEPTEMBER

6-9, 2012

Join us at the AOPA 2012 National Assembly and NE Chapter combined meeting at the Hynes Convention Center in Boston. The Place to Be for learning, networking, and exhibits.

• • • • • •

Superior Clinical Education featuring the best speakers from around the world

• • •

Largest Display of O&P exhibits in the United States

Advanced Business Programs to ensure your success during uncertain economic times Practical Learning and live demonstrations Networking with an elite and influential group of O&P professionals Preparation for the massive changes that health care reform is sure to bring Learn the latest rules, regulations, and Medicare billing changes needed to serve your patients Earn more than 34 CE Credits Ideal Location in the heart of one of America’s most historic cities.

Four miles from Logan Airport and blocks from the financial district, Charles River, trendy Newbury Street, and Fenway Park.

Earn more than 34 CE credits!

Visit www.AOPAnet.org for updates on events and education.

S P E A K E R S • E D U C AT I O N • E X H I B I T S • S P O N S O R S • N E T W O R K I N G

ate ★

e the D ★ Sav

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

O&P Business Management: This unique leadership learning experience will provide business owners, managers and practitioners an opportunity to experience fresh insights, new tools and proven techniques as a pathway for developing better business practices, while creating ongoing returns for your company.

■ REFRESH YOUR KNOWLEDGE ■ DEVELOP BETTER BUSINESS PRACTICES ■ ADVANCE YOUR CAREER ■ CREATE ONGOING RETURNS FOR YOUR COMPANY

Earn Your Certificate in

O&P BUSINESS MANAGEMENT

Through a joint partnership between AOPA and the University of Virginia School of Continuing and Professional Studies

How to get started: 1.

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

2.

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

A NEW AOPAversity OPPORTUNITY! Another addition to the valuable education, products and services offered by AOPA that you need to succeed.

3.

Complete a Module specific quiz for each program.

4.

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

CALENDAR

■■ NOVEMBER 14 AOPAversity Audio Conference–Medicare Enrollment Procedures. For more information, contact Stephen Custer at 571/4310876 or scuster@AOPAnet.org.

■■ DECEMBER 1 ABC: Certification Exam Application Deadline.

Applications must be received

by December 1 for individuals seeking to take the winter 2013 ABC certification exams for orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, therapeutic shoe fitters, and orthotic and prosthetic technicians. Contact 703/836-7114, email info@ abcop.org, or visit www.abcop. org/certification.

■■ DECEMBER 6-8 Rehabilitation Institute of Chicago: Pediatric Gait Analysis: Segmental Kinematic Approach to Orthotic Management.

Chicago. Featuring Elaine Owen. 21.25 ABC credits.

Contact Melissa Kolski at 312/238-7731 or visit www.ric. org/education.

■■ DECEMBER 7-8 ABC: Prosthetic Clinical Patient Management (CPM) Exam. The application deadline for this exam is Sept.

1, 2012. Contact 703/836-7114, email info@abcop.org, or visit www.abcop.org/certification.

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

2013 JANUARY 4-5 ABC: Prosthetic Clinical Patient Management (CPM) Exam. The application deadline for this exam is Sept.

1, 2012. Contact 703/836-7114, email info@abcop.org, or visit www.abcop.org/certification.

■■

February 20-23 39th Academy Annual Meeting & Scientific Symposium. Orlando. Caribe Royale Orlando. Contact Diane Ragusa at 202/380-3663, x208, or dragusa@oandp.org.

■■

■■ MARCH 15-16 PrimeFare West Regional Scientific Symposium 2013.

Denver Marriott City Center, Denver. Contact: Jane Edwards at 888/388-5243 or visit www.primecareop.com.

■■ MARCH 21-23 2013 Annual Meeting of the International AfricanAmerican Prosthetic Orthotic Coalition. Georgia Tech Hotel and Conference Center.

Atlanta. Contact Tony Thaxton Jr. at 404/875-0066 or email thaxton.jr@comcast.net.

Visit www.iaapoc.org for more information.

■■ 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. a

SEPTEMBER 2012 O&P Almanac

77

AD INDEX

Company

Page

Phone

Website

Ability Dynamics

7

855/450-7300

www.abilitydynamics.com

Advanced O&P Solutions

77

866/914 AOPS

www.aopsolutions.com

ALPS

13, 51

800/574-5426

www.easyliner.com

American Board for Certification in Orthotics, Prosthetics & Pedorthics

30

703/836-7114

www.abcop.org

Arizona AFO

33

877/780-8382

www.arizonaafo.com

ARTech Laboratory

54

888/775-5501

www.artechlab-prosthetics.com

Becker Orthopedic

53

800/521-2192

www.beckerorthopedic.com

BOC International

60

877/776-2200

www.bocinternational.org

The Bremer Group Company

11

800/428-2304

www.bremergroup.com

Cailor Fleming Insurance

79

800/796-8495

www.cailorfleming.com

Cascade Dafo

21

800/848-7332

www.cascadedafo.com

College Park Industries Inc.

47

800/728-7950

www.college-park.com

DAW Industries

1, 71

800/252-2828

www.daw-usa.com

DeRoyal Industries Inc.

39

888/938-7828

www.deroyal.com

Dr. Comfort

5, C3

800/556-5572

www.drcomfortdpm.com

Ferrier Coupler Inc.

67

800/437-8597

www.ferrier.coupler.com

Fillauer

2

800/251-6398

www.fillauercompanies.com

Friddle’s Orthopedic Appliances

59

800/369-2328

www.friddles.com

Hanger Clinic

23

Hersco Ortho Labs

27

800/301-8275

www.hersco.com

KISS Technologies LLC

19, 55

410/663-5477

www.kiss-suspension.com

Med Spec

37

800/582-4040

www.medspec.com

Motion Control

49

888/696-2767

www.utaharm.com

OPTEC

16, 17, 44, 45

888/982-8181

www.optecusa.com

Orthocare Innovations, LLC

41

800/672-1710

www.orthocareinnovations.com

Orthomerica Products

15, 63

800/446-6770

www.orthomerica.com

Orthotic and Prosthetic Study and Review Guide

54

www.oandpstudyguide.com

Össur® Americas Inc.

C4

800/233-6263

www.ossur.com

Otto Bock HealthCare

C2

800/328-4058

www.ottobockus.com

PEL Supply

72

800/321-1264

www.pelsupply.com

SPS

64

800/767-7776 Ext. 3

www.spsco.com

Texas Assistive Devices LLC

9

800/532-6840

www.n-abler.org

FIND out more of AOPA’s advertising opportunities today.

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

78

O&P Almanac SEPTEMBER 2012

AOPA Answers

Hospital Hit-or-Miss

Answers to your questions regarding O&P care during inpatient stays

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.

Do rehab hospitals follow the same rules as acute care hospitals and other types of hospitals?

A.

Yes. Even though rehab hospitals are paid under a separate Prospective Payment System than acute hospitals, the rules regarding the rehab hospital’s responsibility to provide or pay for medically necessary care remain exactly the same as the rules for acute care hospitals.

From the O&P provider perspective, the same payment rules that apply to acute care hospitals also apply to rehab hospitals.

Q.

Q.

If a doctor orders an orthosis or prosthesis during an inpatient stay and I provide it, can the facility refuse to pay me, even if the patient is a long-time patient of mine?

A.

Unfortunately, yes. Since the hospital has the responsibility to provide all necessary care during a Medicare Part A covered stay, the facility may choose the vendor that provides the care, and the patient usually is required to sign a form at admittance agreeing to this arrangement. So, if a physician gives you an order and you provide the item without authorization from the facility, the facility may not be obligated to pay you because of a contractual issue.

If an item is provided to a patient prior to an inpatient Medicare Part A hospital stay, who should be billed?

A.

The answer depends on when the medical necessity of the item is established. For example, if a doctor orders a spinal brace for a patient because he is having back surgery, and the doctor wants the patient to wear the brace to help stabilize the spine for surgery, then you would bill Medicare.

On the other hand, if the doctor wants the patient to bring the brace with him to the hospital and have it to wear immediately following surgery, then the hospital is responsible for payment because the need for the brace arose in the hospital (result of the surgery).

80

O&P Almanac SEPTEMBER 2012

Ultimately, since the hospital is responsible for providing the care, that facility may decide which practitioner provides a device. The facility may have a contract with a single O&P provider or may provide a purchase order on a patient-bypatient basis. a

Our Comfort Is Preferred

By Your Patients!

Beautiful Design, Details and Construction Lead To Increased Patient Compliance.

Our Shape To Fit Line of Compression Wear NOW Includes Thigh Highs and Panty Hose.

Merry Jane Comfort Collection

From A Family of Comfort. Š2012 Dr. Comfort All Rights Reserved

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. * studies available at www.ossur.com/unloader

SmartDosing™ now available.

Smar tDosing, powered by the BOA ® Closure System, provides patients with a simplif ied single-hand dosing dial for on-the-f ly adjustability and repeatable unloading, helping them better manage their unicompartmental OA knee pain.

Barely there.

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

Fit the Unloader One for any patient.

If they are not happy with it for whatever reason, they can return it within 30 days for a full refund.

TO LEARN MORE. USA (800) 233-6263 CANADA (800) 663-5982 WEB OSSUR.COM © 2012 Össur

FOLLOW ÖSSUR ON