Simply the Best

THREE OUTSTANDING RESEARCHERS SHARE DETAILS OF THE WORK THAT EARNED THEM ONE OF THE MOST DISTINGUISHED HONORS IN THE O&P PROFESSION

ORIGINALLY PRESENTED IN 1996,

in memory of O&P education pioneer Howard R. Thranhardt, the annual Thranhardt Awards have become synonymous with exceptional educational information and the highest caliber research advancing the O&P field. This year also marked a milestone for the award and lecture series—25 years of honoring the best and brightest minds in the profession.

During the celebratory event, held during the AOPA National Assembly in Boston, the three 2021 winners presented their work to attendees in person and virtually. Andreas Hahn, MSc, PhD, discussed his project, “The Effect of Microprocessor-Controlled Exo-Prosthetic Knees on Limited Community Ambulators: Systemic Review and Meta-Analysis,” and Chrysta Irolla, MS, MSPO, CPO, and Emily Nelson, MSE, MSOP, CP, expounded on their study, “Treatment Parameters for the UCSF Pectus Carinatum Orthosis: A Pilot Study.”

O&P Almanac recently spoke to all three honorees about their research and what it means for the future of O&P patient care.

MEET THE 2021 WINNERS

Andreas Hahn, MSc, PhD, holds the global corporate responsibility for Otto Bock’s clinical research activities. He was trained as a physicist at Oxford University, and he currently co-chairs the ISPO Industry Advisory Group’s outcome measurements working group. He previously received the Thranhardt Award in 2014 and 2019.

Chrysta Irolla, MS, MSPO, CPO, explored her interest in patient rehabilitation while obtaining her Master of Science in engineering design from Northwestern University, and she subsequently decided to focus on patient care and earn her MSPO from The Georgia Institute of Technology. Irolla is now the clinical manager and residency mentor at the University of California, San Francisco (UCSF).

Emily Nelson, MSE, MSOP, CP, pursued a master’s degree in biomedical engineering from the University of Michigan with hopes to design prosthetic components. After a career stint in process engineering in the consumer healthcare manufacturing industry, the desire to work with patients led her back to the MSOP program at Eastern Michigan University. Nelson is now a certified prosthetist and completed her orthotics residency at UCSF.

Dr. Hahn, what compelled you to investigate the benefit of MPKs for limited ambulators?

Andreas Hahn: This topic had been in my focus for a long time. People with disabilities are treated very differently in different social security systems. In Germany, people with limb loss are entitled to receive state-of-the-art technology to compensate their disability. It was recognized very early on that, specifically, amputees with limited community ambulation capabilities over-proportionally benefit from advanced safety features. In 2014, I was able to present—also at the Thranhardt lecture series—that mobility grade rating has very little predictive value when it comes to the utilization of the benefits of microprocessor-controlled prosthetic knee components. Still, it was argued that the scientific evidence was not sufficient to mirror what could so clearly be experienced in clinical practice.

Briefly explain your study design/methods used.

Hahn: We updated a systematic review (published by my colleague Andreas Kannenberg et al. in 2014), and as an innovative element, I included a meta-analysis to reduce ambiguities found earlier. We chose to use the AAOP State-of-the-Science Conference’s validity assessment system as it allowed us to assess a wide range of study designs and validity indicators relevant to our field. Our aim was to make the meta-analysis as robust as possible. We understand that research in our field is characterized by heterogeneous study designs and not all aspects may be controlled as well as those in pharmaceutical trials, for example. Therefore, we chose Hedges’ g as an effect size estimator and drew conclusions from a random effects model only.

What were the main findings of your research?

Hahn: First of all, we were most delighted to see how active this field of research had become. The number of high-quality studies increased significantly since 2014. Fifteen documents relating to 13 research projects could be identified. It is also quite telling that, in all those studies, not a single outcome was identified that favored the use of non-microprocessor-controlled knee components in this population. The meta-analysis revealed a clear reduction of the number of falls, the fear of falling, the risk of falling, but also an increase of the mobility grade rating itself. Furthermore, the self-selected walking speed increased. For the first time, we could now detect the effects related to subjects’ perception as measured by the prosthetics evaluation questionnaire (PEQ) ambulation and utility subscales.

Which outcomes were most profoundly affected by use of MPKs?

Hahn: The results on the reduction number of falls were investigated in seven research projects. Fear of falling, the change of mobility grade, and self-selected walking speed were reported in six studies, respectively. The ambulation and utility PEQ subscales were investigated in a smaller number of studies but still showed relevant and significant effects.

Andreas Hahn, MSc, PhD

Did you encounter any limitations?

Hahn: In research projects with exo-prosthetic components, the blinding of studies is a huge challenge. However, many researchers address the underlying problem by applying a multiple crossover design. I think this is an elegant and appropriate way to also account for learning effects. It may be worthwhile to remember that the Oxford Centre of Evidence Based Medicine Classification ranks multiple crossover designs within evidence class 1.

We were also overwhelmed by the number of different outcomes being used in the studies and, in some cases, by the variety of reporting standards. We commend any effort in providing a larger harmonization of outcomes and reporting standards. Unfortunately, the difference in presenting some of the investigated items did not allow for full utilization of all data provided. This is regrettable, as we can see from the publications that those data would have helped to further reduce ambiguity. Did your work reveal anything you did not anticipate?

Hahn: Next to the number of highquality studies currently published and given the heterogeneity of the trial designs, we were astonished by the homogeneity of the results. A lot of the ambiguity we may have had earlier was resolved, and we feel the argument that a lack of scientific evidence may justify withholding this therapeutic option from an entire class of amputees is no longer sustainable.

How will your findings be used?

Hahn: We hope we’ve made a recognizable contribution to the scientific community and helped reduce the ambiguity related to the clinical effectiveness of microprocessor-controlled prosthetic knees in limited community ambulators. We believe this work can help inform healthcare providers and supports the choice of the most appropriate prosthetic fitting. The Ascent K2 study, a landmark trial initiated by the Hanger Institute for Clinical Research and Education and Ottobock, will in addition assess the long-term effects in the real-life environment of prosthetic clinics. This important research is designed to help ensure people living with limb loss and limb difference have coverage for medically necessary and clinically appropriate technology, which will, in turn, enable them to participate more fully in their communities and enjoy a higher quality of life.

Chrysta Irolla, MS, MSPO, CPO Emily Nelson, MSE, MSOP, CP

Chrysta and Emily, what is pectus carinatum and how has it been treated in the past?

Emily Nelson: Pectus carinatum is a chest wall deformity that presents as a protrusion of the sternum due to overgrowth of the costal cartilages. It is most commonly diagnosed in adolescent males during a longitudinal growth spurt.

Chrysta Irolla: Historically, pectus carinatum was treated with surgical intervention involving placement of a metal bar along the sternum. Following this procedure, there was an uncomfortable recovery period and a permanent scar. Starting in the 1990s, we saw an increase in use of orthotic interventions to correct pectus carinatum while the chest wall was still flexible, prior to skeletal maturity. There are a wide range of both off-the-shelf and custom orthotic designs that have emerged.

What was the impetus for your study, and how is the UCSF orthosis different from prefabricated orthoses?

Nelson: There has been research regarding orthotic treatment of pectus carinatum over the last 20-30 years; however, there is not consensus regarding the treatment parameters with these different devices. The purpose of our study is to create a detailed protocol by determining which variables have the greatest impact on successful correction of the chest wall deformity. Irolla: From the literature and clinical experience, we found that patients often abandon use of a pectus carinatum orthosis because it is uncomfortable and excessively bulky, does not correct the chest wall deformity at a reasonable pace, does not address prominent inferior costal cartilage, and/or is hard to breathe when using. We developed the UCSF Pectus Carinatum Orthosis (UCSF-PCO) to address these specific concerns. We made a custom design that is contoured as close to the patient's anatomy as possible while allowing appropriate space for ML chest expansion for breathing; includes the ability to add extensions to address the inferior costal cartilage; has a comfortable gel interface against the pectus carinatum; includes shoulder straps for appropriate suspension; and is designed to produce enough force that patients start to see correction in the first month of use.

How was your research conducted? What materials were used in the orthosis?

Nelson: This is a longitudinal prospective clinical research study which collects both qualitative and quantitative metrics to assess success of the UCSF-PCO. We recruited a convenience sample of patients referred mostly through the UCSF chest wall deformity clinic. Inclusion criteria is 7- to 17-years-old, skeletally immature, diagnosed with flexible pectus carinatum, and recommended for conservative treatment with an orthosis.

Irolla: Each subject is provided with a custom UCSF-PCO made from 3/16" polypropylene anterior and posterior shells with 1" wide polypropylene reinforcement struts. A PediFix Visco-gel sheet pad is added to the anterior shell to provide a soft interface against the pectus carinatum. Adjustable 1" Dacron backed lateral straps are used to allow for adjustability of the AP pressure and 1" C-fold shoulder straps are added to help with suspension. A Maxim Integrated Products Thermochron I-Button temperature monitor is installed in the posterior panel to track wear time. The recommended orthotic wear time is at least 18 hours per day, during the corrective phase of treatment. At routine follow-ups, we take new measurements of the pectus carinatum size, download the data from the I-Button sensor, and use TekScan FlexiForce force sensitive resistors to measure the in-orthosis corrective pressure. Once the prominence remains reduced for a 24-hour period outside of the orthosis, the patient can transition to the maintenance phase where they only wear it at night for eight hours per day.

Nelson: Throughout treatment, we administer surveys to better understand the patient’s overall quality of life and feelings about their chest wall shape.

What were the main findings of your research?

Irolla: We hypothesized that subjects who were older and/or had a stiffer pectus carinatum deformity would spend more time in the corrective phase of treatment. Thus far, it does not appear there is a clear predictive relationship between age and pectus carinatum stiffness.

We also discovered that in younger subjects (7- to 13-year-olds), the pectus carinatum corrected at a meaningfully faster rate compared to the older subjects (14- to 17-year-olds).

Nelson: Younger subjects also had a reduction in pressure of treatment from delivery to final follow-up, but this was not true in older subjects.

Overall, all patients were happy with the appearance of their chest at the end of treatment, and there was no negative impact on their quality of life over the course of treatment. How much did social and psychological factors affect patient wear time?

Irolla: We found that subjects in the older age group (14- to 17-year-olds) pushed to transition to maintenance phase of the treatment (eight hours per day of wear) sooner than was clinically recommended and sooner than their younger counterparts. Subjective feedback from subjects is that they did not want to wear the orthosis during high school given the increased social pressures of that environment. This earlier transition results in an increase in the length of the overall treatment time for these subjects.

Did you encounter any limitations to your work?

Nelson: The biggest limitation is that this treatment is conducted over a one- to two-year time frame. A number of subjects were lost to follow-up or self-discontinued their treatment outside of the clinical setting, leading to an incomplete data set. We surveyed those subjects who self-discontinued, and they mostly reported doing so because they were satisfied with the appearance of their chest wall.

Did you discover anything surprising?

Nelson: We expected a clear correlation between age and time to correct the pectus carinatum, and it was surprising that there was no clear trend.

What's next?

Irolla: This is an ongoing study, so we are still actively recruiting patients. Our end goal is to develop a predictive model that allows clinicians to input specific physical metrics collected at an initial evaluation and outputs the transition points in pectus carinatum treatment for that specific patient. This will be a clinical tool that can better guide treatment in the future.

Josephine Rossi is editor of O&P Almanac. Reach her at jrossi@contentcommunicators.com.

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Improving Rehab Outcomes

Physical therapist studies balance, phantom limb pain, injury risk, and more among individuals with amputation

O&P Almanac introduces individuals who have undertaken O&P-focused research projects. Here, you will get to know colleagues and healthcare professionals who have carried out studies and gathered quantitative and/ or qualitative data related to orthotics and prosthetics, and find out what it takes to become an O&P researcher.

CHRISTOPHER KEVIN WONG, PhD, PT, who has published several significant studies regarding physical therapy and the O&P patient population, believes his most important contribution to the O&P field is verifying the Berg Balance Scale as a valid and reliable assessment of balance for people with limb loss across performance ability levels. “Surprisingly, this was the first paper to establish a standard balance assessment for people with limb loss, as none had been established with rigorous psychometric testing prior to 2013,” he explains. Although standing on one leg was used as a balance measure, people with unilateral limb loss get “lots of practice” standing on one leg—“and this activity did not rate in the top three most difficult activities of the Berg Balance Scale,” says Wong. he currently serves several roles at Columbia University Irving Medical Center, including associate director of faculty development for the program in physical therapy; curriculum director of the clinical residency in orthopedic physical therapy; and associate professor of rehabilitation and regenerative medicine.

The assessment of the Berg Balance Scale incorporated the use of Rasch rating scale analysis to validate the instrument, “which allowed robust analysis of the full range of balance task difficulty and subject performance ability—from K1 to K4—to be used in determining outcome measure validity and reliability,” Wong says. The Rasch approach provides more clinically useful information than concurrent validity via comparison to other measures, he says, “especially when subjects of only a narrow range of performance ability are used—a common issue in prosthetics research.” For instance, the Rasch analysis identified the most difficult Berg Balance Scale tasks for people with limb loss to perform, which can then be used as goals for rehabilitation as ability improves. The Berg Balance Scale evaluations were found to be reliable for use by physical therapists of various levels of clinical experience, according to Wong.

Beyond Balance

Wong’s work on the balance instrument is just one of his many contributions to the O&P field. An OCS-boardcertified orthopedic clinical specialist, Resisted side steps away from the prosthetic limb develop glute medius muscle strength that supports prosthetic weight bearing.

Gait resisted through the arms demands forceful gluteal and abdominal muscle activation and facilitates prosthetic weight bearing.

For the past few years, Wong has been investigating injuries in people with limb loss. “While falls have been frequently reported, injury had been rarely mentioned prior to our first paper [in 2016],” he says. The prospective study with up to 41-month follow-up found that while falls occur regardless of individual characteristics, women were more than six times more likely to be injured. However, the most important takeaway for the O&P community from this study, according to Wong, is that people with limb loss suffered fall-related injury at rates higher than other at-risk populations such as elderly hospitalized people.

He conducted a larger retrospective study that confirmed the danger for women and also highlighted the high risk for people with vascular disease. “These studies help to raise awareness of the risk of injury for people with limb loss, both for researchers and the public,” he says. He and his team built an open-access web-app—based on their study findings and other research—that features a free injury risk profile screening for people with limb loss, with evidence-based suggestions (visit https://pump.ctl.columbia.edu). “My team recently completed a grant exploring injury of all causes, regardless of falls, in people with limb loss” and plans to publish the results soon.

Phantom limb pain is another area of concentration for Wong. Developing treatments to alleviate phantom limb pain without an associated clinical measure can be difficult because that type of pain is episodic and hard to quantify, so his team identified a reliable clinical measure that correlated with phantom limb pain. “Our paper, published in Pain Medicine in 2017, found that the ability to recognize pictures of feet as left or right—known as limb laterality recognition—was strongly associated with the frequency of phantom limb pain,” he says. While limb laterality recognition scored for either accuracy or speed had been unrelated to phantom limb pain in past research, “we found that simply dividing accuracy by speed produced a reliable measure of cognition linked to phantom limb pain,” he says. His team followed up with a second study, currently in press, that suggests a link between cognition and phantom limb pain that may lead to a better understanding of the phenomenon.

In another key investigation, Wong’s discrete understanding of balance abilities led him to develop an early clinical prediction rule for community-dwelling people with limb loss. “Applying a rigorous prospective longitudinal methodology, we found that two simple balance tasks [reachto-floor and look-over-shoulder] and two self-report scales [ActivitiesSpecific Balance Confidence Scale and Houghton Scale] could accurately predict whether a person post-initial prosthetic rehabilitation would achieve independent community walking ability as defined by scores ≥9 on the Houghton Scale,” Wong explains. “The primary lesson learned from this research was that most people who had not already achieved the independent community walking ability, would not advance without intervention.”

Wong also investigated methodologies to advance ambulation among individuals with limb loss and designed an efficient program accordingly. “Exercise, which can be thought of as practiced movement under various conditions, can only utilize motion that is available at the relevant joints,” he explains. Since people with limb loss are known to have limited range of motion, specifically at the hip, “it stood to reason that this joint motion should be optimized to be fully utilized during exercise,” Wong notes. “The most essential joint motions could be obtained using manual therapy for the lumbar spine, pelvis, and hip joints in a four-session program described briefly in an early pilot study,” though further therapy is beneficial.

The whole approach is described fully in a narrative review addressing elements of complete care, called PANACEA: Passive limitations, Active muscles, Neuromotor planning, Activities

Gait resisted from the prosthetic side front of the hip demands gluteus maximus muscle activation at the critical moment that the sound limb begins to swing forward. Christopher Kevin Wong, PhD, PT, demonstrates a useful patient position for mobilizing the hip and pelvic joints to help reduce hip flexor contractions.

Wong presented research findings at the Columbia University Irving Medical Center Precision Medicine Scholars Day in October 2019.

essential for function, Capacity to perform both cardiac and cognitive, Environmental requirements, and Attitude, he says. “The take-home message, however, is that people with limb loss, beyond their prosthetic concerns, have the same needs of all of us, and addressing them can improve their health status and quality of life.”

Promoting Education

Wong believes strongly in the importance of education—beginning with his own. He earned a master’s degree in physical therapy from Columbia University, followed by a doctorate in health education and research from Touro University International in Los Angeles, California. He gravitated toward O&P while in physical therapy school, under the direction of Joan Edelstein, MA, PT, CPed. “Joan had been the director of New York University’s prosthetics program, taught O&P around the country and world, and published multiple O&P books and papers,” he recalls. “Her vast experience and patient stories fascinated me.”

He has been a New York statelicensed physical therapist since 1993 and an American Board of Physical Therapy Specialists board-certified orthopedic clinical specialist since 2000. Today, Wong makes the most of his roles at Columbia University to influence students in healthcare fields. “In the DPT program, I teach prosthetics and orthotics, soft tissue mobilization, and advanced orthopedics,” he says. Wong integrates advanced physical therapy treatment concepts typically applied to patients with orthopedic conditions such as knee and back pain to the care of people with limb difference. “After all, people with limb difference have essentially the same musculoskeletal impairments, but with the additional challenges of limb loss,” he notes.

Notable Works

Christopher Kevin Wong, PhD, PT, has been involved in dozens of important published studies, including the following:

• Wong, C.K., Chen, C., Welsh, J. “Preliminary

Assessment of Balance With the Berg Balance Scale in Adults Who Have a Leg Amputation and Dwell in the Community: Rasch Rating Scale Analysis.”

Phys Ther, 2013; 93(11): 1520-1529. Epub June 6, 2013. doi: 10.2522/ptj.20130009. PMID: 23744457

• Wong C.K., Young, R.S., Ow-Wing, C., Karimi, P.

“Determining One-Year Prosthetic Use for Mobility

Prognoses (PUMP) for Community-Dwelling Adults

With Lower-Limb Amputation: Development of a

Clinical Prediction Rule.” Am J Phys Med Rehabil, 2016; 95(5): 339-347. Epub Sept 18, 2015. doi: 10.1097/

PHM.0000000000000383. PMID: 26390393

• Wong, C.K., Varca, M.J., Stevenson, C.E., Maroldi,

N.J., Ersing, J.C., Ehrlich, J.E. “The Impact of a Four-

Session Physical Therapy Program Emphasizing

Manual Therapy and Exercise on the Balance and Prosthetic Walking Ability of People With Lower-Limb Amputation: A Pilot Study.” J Prosthet Orthot, 2016; 28(3): 95-100. doi: 10.1097/JPO.0000000000000099

• Wong, C.K., Sheppard, J.K., Williams, K.L. “Balance and Gait Training to Community-Dwelling

People With Lower-Limb Loss: A Narrative

Review With Clinical Suggestions.” Phys Ther

Rvw, 2018; 23(2): 124-132. Epub April 4, 2018. https://doi.org/10.1080/10833196.2018.1451291

• Wong, C.K., Gibbs, W., Chen, E. “Use of the

Houghton Scale to Classify Community and

Household Walking Ability in People With Lower-

Limb Amputation: Criterion-Related Validity.” Arch

Phys Med Rehabil, 2016; 97(7): 1130-1136. Epub

Feb 10, 2016. pii: S0003-9993(16)00090-3. doi: 10.1016/j.apmr.2016.01.022. PMID: 26874230

Wong also teaches O&P courses, positioning them as advanced applied biomechanics courses. Beyond teaching amputation rehabilitation and the components and biomechanics of prosthetics and orthotics, he focuses on biomechanical and rehabilitation implications for gait as well as other movement such as sit-to-stand, stairs, and slopes, as well as sport, dance, and work activities. “Learning to use prostheses is adapting movement after subtraction of an anatomic segment,” he says, “while learning to use orthoses is adapting movement after addition to an anatomic segment.”

Wong says that the concepts and techniques he teaches have direct applications to all people—including those without limb impairments. “Inactivity and prolonged time spent sitting leads to stiff spines, tight hip muscles, and weakness of the core and hips,” he says. “Through effective joint manipulations, soft tissue releases, and strategic exercises, efficient and durable changes can be achieved for people with and without limb difference.”

Spreading the Manual Therapy Message

Looking to the future, Wong hopes to educate more rehabilitation and O&P professionals about the benefits of soft tissue mobilization. “Manual therapy and soft tissue mobilization in particular are difficult to standardize and therefore research,” he says. “Many physical therapists have the manual therapy skills to achieve rapid improvements in musculoskeletal function, balance, and walking ability for people with limb loss,” pointing to certain “essential” skills: muscle energy technique for the lumbopelvic region, joint mobilization/manipulation for the hip and lumbar spine, and myofascial manipulation for the hip flexor muscles, including the tensor fascia lata.

“Some modifications are required for people without a lower limb, of course, but the biggest barrier may be recognizing that the same skills required for addressing back pain apply to people with limb loss,” he says. To ensure more healthcare workers are aware of the benefits of these manual therapy skills, Wong recently held an in-service with physical therapists at Walter Reed Hospital, and he hopes to provide additional trainings for clinicians working with the limb loss community.

“While manual therapy is more often provided to younger and healthier people, I say: Who is most likely to be stiff and in need of manual therapy— the older or less active person, or the younger or more active person?” he asks. “In my opinion, people with other disadvantages can benefit the most from the manual skills that physical therapists can offer. It can be the difference between being able to get up from a chair independently and needing assistance.”

Demonstrating Support

International manufacturer focuses on orthoses, soft goods, and education for its products

THE ALLARD CO. GROUP dates back to the 1950s, when Camp Scandinavia was founded in Stockholm as a spinoff from another company to manufacture orthopedic corsets. In 1996, Bertil Allard purchased Camp Scandinavia and began to develop products that could be sold outside of Scandinavia. Its first product was the ToeOFF®, a foot drop ankle-foot orthosis (AFO) made of composite materials. AFOs continue to be the company’s flagship product.

Peter Allard, Bertil’s son, took over the company in 2005 and founded Allard International. The company began producing its own materials, including composites, low-temperature plastics, textiles, and plastic corsets. Today, Allard has warehouses and sales offices in Sweden, Norway, Finland, Ireland, and the United States.

Allard’s AFOs comprise three different product lines. “We have been innovating these devices for 20 years, so we offer a variety of AFOs. The rigidity differs among the product lines and also among sizes,” says Diane Beesley, the company’s marketing manager. BlueROCKER® offers more rigid orthotic control, ToeOFF is intended for moderate stability, and Ypsilon® is designed for mild stability.

“While these are considered off-the-shelf AFOs, you have much more success with the lifespan when they are properly customized to your patient,” explains Beesley. “We offer a number of CEU courses, so practitioners can feel sure of the way they fit the AFO to give the best outcome to the patient.” Clinicians can make adjustments to the bottom or the top of the footplate and grind down certain areas on the footplate and anterior shell.

Allard also offers a line of soft goods, such as the Vission Clavicle splint, and thermoplastic materials for making custom splints and casts. “We have some that are precut, preshaped for the final front and back panels, so clinicians can mold them to each patient,” Beesley adds.

In addition to manufacturing, the company launched a new central fabrication service in 2020, which offers straps, chafes, buckles, and other materials needed to build an orthosis.

“Education before sales” is Allard’s mantra. The company offers a full range of continuing education programs, product training, and marketing support. Initially, all courses were held at Allard USA headquarters in New Jersey. “But people had to take two

Peter Allard created the Dralla Foundation to support activities, such as the Adaptive Sports Foundation’s Race4ALL.

COMPANY: Allard USA

OWNER: Peter Allard

LOCATION: International headquarters in Helsingborg, Sweden; U.S. subsidiary in Rockaway, New Jersey

HISTORY: 67 years

PHOTO: Samuel Vickrey Photography full days off to attend, and that was difficult, so we started offering them in the evenings and on weekends,” explains Beesley. “We have eight district managers around the country, and when they can get a group of people together, they will do a live course.” Even before the pandemic, Allard offered online courses, and they continue as a convenient way for participants to gain training and earn CEUs.

Seeking to support the patients he serves, Peter Allard created the Dralla Foundation (Allard spelled backward) in 2011. The foundation awards grants to organizations that hold events for those with disabilities. “The foundation is dear to Peter’s heart,” says Beesley. “Its tagline is, ‘Giving individuals with physical challenges a day to remember.’” Dralla has funded such events as adaptive skiing, biplane adventures, a 100-mile European trek on Camino de Santiago that ended in Spain, adaptive skating, and an outdoor adventure camp.

Get Back Up Today is another important segment of Allard. Beth Deloria, a marathon runner whose medical issues left her with foot drop, was able to compete again with the help of the ToeOFF® orthosis. She founded Get Back Up Today to connect and inspire patients with foot drop, and the organization has become a global movement.

Other outreach efforts include advertisements in trade publications and co-promotions with distributors. The company is active on social media, including Facebook, Twitter, Instagram, and LinkedIn. “It’s all part of our goal to educate patients and practitioners,” says Beesley, “so they can achieve the best possible outcomes.”

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

Integrating Nature

North Carolina facility features an outdoor gait lab

IN 1979, BRUCE DOLEN, CP, and his wife, Pippa Dolen, launched Skyland Prosthetics & Orthotics in Fletcher, North Carolina. Nine years later, their son, Shaun, joined the practice, becoming a certified prosthetist in 1996. Bruce died unexpectedly in 1995, but Pippa and Shaun were determined not to sell the business. Their resolve paid off, and Skyland is thriving.

Today, the 6,000-squarefoot company headquarters is still in Fletcher, but the facility has expanded to include satellite locations in Sylva and Asheville—growing the practice’s reach from western North Carolina to upstate South Carolina, east Tennessee, and northeastern Georgia.

Eighteen employees work at the Fletcher office. The site includes a fabrication lab, where devices are made for all three locations. The facility also features a unique outdoor gait lab. “The purpose is to put amputees in real-world dynamic trials,” explains Shaun Dolen. “The lab has grassy and rocky terrains and features a 70-foot ramp with 12 steps on one end and four on the other. Patients can train on stairs and inclines and traverse uneven surfaces, and clinicians are able to identify patients’ prosthetic needs on these terrains. Everyone loves it!”

The satellite office in Sylva, which opened six years ago, is close to the local hospital and staffs three employees onsite. This office serves the nearby Cherokee Indian Reservation. “We’ve had a relationship with the hospital and this unique population for all of our 42 years,” says Dolen. Because Native Americans have high rates of diabetes, Skyland’s services are much needed, and the facility holds weekly clinics at the hospital and provides services in the office.

The Asheville office has been a dream of Dolen’s for years, but it was nearly derailed by the COVID-19 pandemic. Dolen’s idea was to sublease half the office’s 6,000 square feet to a therapy group that would focus on advanced prosthetic rehabilitation. “Technology has advanced so much in recent years, we felt our patients might not be maximizing their potential with the prostheses,” he says. Dolen formed a separate entity with the therapy group and was ready to open the office when everything shut down in March of 2020. The O&P office and the therapeutic division were finally able to open eight months later. Today, says Dolen, “it’s producing really great outcomes for our patients.”

Another advantage of the Asheville office is its location within walking distance of a hospital associated with the U.S. Department of Veterans Affairs (VA). “We’ve had a VA contract since 1979, and now we literally just walk across the street to

Skyland Prosthetics & Orthotics’ main office features an inspirational wall.

Shaun Dolen, CP

FACILITY:

Skyland Prosthetics & Orthotics

OWNERS:

Pippa Dolen and Shaun Dolen, CP

LOCATIONS: Headquarters in Fletcher, North Carolina, plus satellite offices

HISTORY: 42 years

The ribbon-cutting ceremony at the Asheville, North Carolina, office, which opened last year see our patients,” he says. “This is helpful for veterans when coordinating their appointments, reducing travel issues.”

While Skyland has leveraged a wide range of marketing strategies, including billboard advertising, radio spots, television promos, and even advertising in movie theaters, Dolen has found social media to be enormously effective. One staff member regularly updates Skyland’s website and Facebook page, where the practice can share news, patient stories, and education directly with the community. The facility also focuses on increasing Google reviews. “Our own surveys show we have an exceptional 98 percent satisfaction rate, and we want the public to know it, so we want to increase the number of online reviews,” Dolen says.

Among the facility’s community activities, Dolen is particularly proud of its Amputee Appreciation Day, an annual event that brings together Skyland patients and individuals with limb loss from across the region for a day of music, food, and special stations where patients can try specific athletic activities and different components. Skyland’s entire team is on hand for adjustments and questions in what results in a morale booster for both patients and employees.

Dolen attributes the success of his practice to the dedication and teamwork of everyone employed at Skyland. “I’m blessed as an owner because every team member takes their role in this business seriously,” he says. “It’s the clinicians, the techs, the billing and admin staff—every person at Skyland is a cog in the wheel, and they keep us rolling in the right direction.”

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

Webinars

Sign up now for expert guidance on hot topics—and start earning CE credits

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

WEDNESDAY OCT. 13

KO Policy: A Review

Log on for this in-depth review of the Knee Orthosis Local Coverage Determination and Policy Article. Review the documentation required for coverage, which addition codes may be used with each base code, when you must use the KX modifier, which braces require approval by the Pricing, Data Analysis, and Coding contractor, and more.

UPCOMING WEBINAR COMING SOON:

WEDNESDAY NOV. 10

Orthotics Clinician’s Corner

UPCOMING WEBINAR

WEDNESDAY DEC. 8

Year-End Review and What Is Ahead

UPCOMING WEBINAR

Don’t Miss the Virtual Programming From the 2021 AOPA National Assembly

THE IN-PERSON EDUCATION from the AOPA National Assembly in Boston becomes available on the virtual platform for viewing starting September 16 and will be available for 90 days for paid registrants. In addition, don’t miss the bonus education only available on the Virtual Assembly Platform.

Visit AOPA’s website and access the AOPA National Assembly Program for a full list of bonus online education.

Welcome New AOPA Members

Special Thanks to the 2021 PAC Contributors

EARN 100+

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.

CE Credits

Davidson Prosthetics & Orthotics / dba Renew Prosthetics & Orthotics 146 Medical Park Road, Ste. 102 Mooresville, NC 28117 704/765-9837 Martha Matthews, CPO www.renewpo.com Patient-Care Facility Integrity Orthotics & Prosthetics 221 State Hwy. 165, Ste. F Placitas, NM 87043 505/437-3900 Jacque Newman, CO http://integrityoandp.com Patient-Care Facility

NETWORKING

AOPA would like to thank the following individuals for their contributions in 2021 to the O&P PAC: Gerald Bernar, CP Curt Bertram, CPO George Breece Joy Burwell Maynard Carkhuff Tina Carlson, CMP Thomas Costin Michael Fenner, CP, LPO Scott Hebert, CPO Denise Hoffmann Shelly Hogan Steven Hoover Teri Kuffel, JD Eve Lee, MBA, CAE William Leimkuehler, CPO James Lewallen, CO James Liston, CP Melanie Liston Mahesh Mansukhani Brad Mattear, CPA, LO, CFo David McGill Martin McNab, CPO Joe McTernan Wendy Miller, BOCO, LO, CDME Michael Oros, CPO Sara Peterson, PhD, CPO, FAAOP Jeff Quelet, CPO Rick Riley John Roberts, CPO Peter Rogerson, COA Lesleigh Sisson, CFm Mike Sotak Frank Snell, CPO, FAAOP Jack Steele, CO, FAAOP Jason Tanner, CP Bernie Veldman, CO Greg Wahl James Weber, MBA Paul Werner, LPO Ashlie White James Young, CP, FAAOP

The purpose of the O&P PAC is to advocate for legislative or political interests at the federal level that have an impact on the orthotic and prosthetic community. The O&P PAC achieves this goal by working closely with members of the EDUCATIONNETWORKINGEXHIBITS House and Senate and other officials running for office to educate them about the issues, and helping elect those individuals who support the orthotic and prosthetic community. EDUCATION

To participate in, support, and receive additional information about the O&P PAC, federal law mandates that eligible individuals must first sign an authorization form, which may be completed online: bit.ly/aopapac. * Due to publishing deadlines this list was created on Sept. 8, 2021. Any donations or contributions made or received on or after Sept. 8, 2021, will be published in a future issue of O&P Almanac.

ToeOFF® 2 ½ & BlueROCKER® 2 ½ Available!

Now offering more Allard AFOs with ½ the heel height. All 2 ½ models include the 2.0 features you love: Choice of wrap-around or D-ring straps, shorter wings, and a Starter SoftKIT™ included.

It is easier to adapt ToeOFF® 2 ½ and BlueROCKER® 2 ½ to shoes with lower heel heights because if there is a lower forefoot curvature, there is more space in the shoe toe box.

ToeOFF® 2 ½ Addition models available in camouflage, birch, and black for your fashion-conscious patients.

Call 888/678-6548 or email info@allardusa.com to receive your FREE Product Selection Guide.

ALPS Flex Sleeve (SFX)

ALPS Flex Sleeve (SFX) is a prosthetic suspension sleeve made with seamless knitted construction in high-density gel to provide maximum comfort and control for active amputees. With 30-degree preflexion, the SFX effectively allows for ease of bending and reduces bunching behind the knee. The SFX is available in one length and thickness that accommodates most users. Plus, you can choose from two sleek color options—black or beige. For more information, visit www.easyliner.com or call us today at 800/574-5426.

Apis

Apis custom programs offer practitioners best options and services for patient compliance. All products are covered under risk-free guaranteed-fit promise. We stand firmly behind our words.

Call us at 1-888/937-2747.

Small Adult Triple Action®

The new Small Adult Triple Action offers true independent adjustment of alignment, range of motion, and stiffness to promote natural, dynamic motion control throughout the gait cycle.

Indications: • Stroke • Multiple sclerosis • Cerebral palsy.

For additional information, please contact our customer service department at 800/521-2192 or visit BeckerOrthopedic.com.

The Original Preflexed Suspension Sleeve

ESP created the Flexi family of suspension sleeves as a comfortable, durable, and cost-effective alternative to traditional suspension sleeves. Preflexed at 43 degrees for maximum comfort and natural unrestricted movement.

For more information, call ESP LLC at 888/932-7377 or visit www.wearesp.com.

Your Everyday Ambulator

Coyote’s new Dynamic Strut AFO is designed to flex and move with the patient, creating a more natural gait and providing energy response while offloading the foot and ankle with a custom thermoformed orthosis. • Designed to flex • Moves with patient • Natural gait • Works great with thermoformed braces • Provides energy response.

Our unique varying thickness creates a comfortable natural gait. For more information, call Coyote at 208/429-0026 or visit www.coyote.us.

TASKA HandGen2

After bringing the first waterproof myoelectric hand to its users, TASKA is once more leading the way in innovation, introducing the new industry-compatible dual-button release Quick Disconnect Wrist System—a game-changer in the industry and a life-changer for users. The latest model of the TASKA HandGen2 featuring the new Quick Disconnect Wrist System can be paired with the MC Seal Ring from TASKA and the Fillauer Motion Control End Cap to create a totally waterproof wrist connection. Interested in a demo? Contact us at 801/326-3434 for information.

Learn more: www.fillauer.com/taska-hand/.

LEAP Balance Brace

Hersco’s Lower-Extremity Ankle Protection (LEAP) brace is designed to aid stability and proprioception for patients at risk for trips and falls. The LEAP is a short, semirigid ankle-foot orthosis that is functionally balanced to support the foot and ankle complex. It is fully lined with a lightweight and cushioning Velcloth interface, and is easily secured and removed with two Velcro straps and a padded tongue.

For more information, call 800/301-8275 or visit www.hersco.com.

Naked Prosthetics

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

Orthomerica EZ-ON™

The EZ-ON™ is specifically designed for easy donning and doffing. This custom ankle gauntlet features a single Dacron® strap to simplify the opening and closing process. The posterior plastic trim is designed to allow a semi-living hinge with greater flexibility. This allows the gauntlet to easily pass over the ankle bones and relax securely into place. The single strap can then be secured with one hand and allows tighter closure for effective ankle stabilization and support. For more information, please visit www.orthomerica.com.

RUSH ROGUE® 2

The newly redesigned, PDAC-verified RUSH ROGUE® 2 provides the most realistic and dynamic foot and ankle motion available. The Vertical Shock & Rotation (VSR) vertical shock offers relief up to 4.24 mm while offering +/- 15 degree torsion, allowing the user to push the foot and themselves to the limits. The RUSH ROGUE 2 is made of our advanced fiberglass composite, which is three times more flexible than conventional prosthetic feet. The roll-through characteristics of the foot provide exceptional energy return with no “dead spot.” The RUSH ROGUE 2 is also available in the PDACverified EVAQ8 elevated vacuum and H2O models.

For more information, visit shop.proteorusa.com.

Ottobock C-Leg 4

Your patients trust you to deliver the best care. You commit to their quality of life every time you trust the C-Leg 4. As the original MPK, C-Leg redefined the standard of care for above-knee amputees. Featuring technology to keep your patients safe with real-time adaptation across terrains and speed, this knee has an unmatched, industry-leading track record. After 21 years of innovation, the microprocessor technology of the C-Leg continues to raise the bar for an industry that demands innovation to achieve one primary goal: give amputees the mobility they deserve.

For more information, call 800/328-4058 or visit professionals.ottobockus.com.

Ottobock Kintrol

Give your lower-mobility patients the comfort and control they need with the K2 hydraulic Kintrol prosthetic foot.

Kintrol is the only K2 hydraulic foot with above-the-footshell, independent DF/PF adjustability, allowing for easy and precise adjustments. Additionally, the active dorsi-assist spring aids in toe clearance during swing phase to help prevent toe stubbing and tripping. The full-length, unbolted fiberglass keel provides optimal flexibility and comfort, resulting in a smooth rollover.

Kintrol provides your K2 patients the flexibility, stability, and confidence to be more mobile and independent.

For more information, call 800/328-4058 or visit professionals.ottobockus.com.

The Xtern Foot Drop AFO by Turbomed Orthotics

Think outside the shoe! This one-of-a-kind orthosis (AFO) is a game changer for foot drop patients: The Xtern is totally affixed outside the shoe to maximize comfort, and prevent skin breakdown and rubbing injuries. Its flexibility promotes maximal ankle range of motion and calf muscle strength. The Xtern allows running, walking, and even mountain hiking as long and as far as you want without any restrictions, and moves from sandals to boots flawlessly.

Turbomed’s innovative products are designed in Quebec, Canada, sold in over 26 countries, and distributed by Cascade in the United States. Visit turbomedusa.com to get your life back!

Opportunities for O&P Professionals

Job Location Key:

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

Hire employees and promote services by placing your classified ad in the O&P Almanac. Include your company logo with your listing free of charge.

Refer to www.AOPAnet.org for content deadlines. Ads can be posted and updated any time online on the O&P Job Board at jobs.AOPAnet.org. No orders or cancellations are taken by phone. Send classified ad and payment to: O&P Almanac, Calendar, P.O. Box 34711, Alexandria, VA 22334-0711 or email jburwell@AOPAnet.org along with VISA or MasterCard number, cardholder name, and expiration date. Make checks payable in U.S. currency to AOPA. Note: AOPA reserves the right to edit calendar listings for space and style considerations.

O&P Almanac Careers Rates

Color Ad Special Member

1/4 Page ad 1/2 Page ad $482 $634

Nonmember

$678 $830

Listing Word Count Member

50 or less $140

51-75 $190

76-120 $260

Nonmember

$280 $380 $520

121+ $2.25 per word $5 per word

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

Job Board

50 or less

Member

$85

Nonmember

$280

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

SUBSCRIBE

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

Northeast

ABC or BOC Certified Practitioner Immediate Opening

New Hampshire/Massachusetts FDR Center for Prosthetics & Orthotics is seeking a full-time practitioner, CPO, CP, or CO, to join us in our Southern New Hampshire and Massachusetts offices. We have a supportive team with on-site fabrication, cooperative support and mentoring, competitive salary and benefits, with no weekend calls!

We are looking for a certified practitioner who’s selfdriven and energetic and has strong clinical, technical, and communication skills with a willingness to travel locally. If you enjoy working as an integral part of a team and are passionate about providing the best quality care to patients, this is the position for you.

Come join our amazing team!

For further inquiries or to submit a résumé for consideration, direct email to cindy.minich@fdrcenter.com. All inquiries will be kept confidential.

Email: cindy.minich@fdrcenter.com FDR Center for Prosthetics & Orthotics is an Equal Opportunity/ Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, or veteran status.

WANTED!

A few good businesses for sale.

Lloyds Capital Inc. has sold over 150 practices in the last 26 years.

If you want to sell your business or just need to know its worth, please contact me in confidence.

Barry Smith Telephone: (O) 323/722-4880 • (C) 213/379-2397 Email: loyds@ix.netcom.com

2021

October 1

ABC: Application Deadline for December Certification Exams. Applications must be received by October 1 for individuals seeking to take the December Written and Simulation certification exams. Contact 703/836-7114, email certification@ABCop.org, or visit ABCop.org/individual-certification.

October 1

ABC: Application Deadline for ABC/OPERF Student Award for Academic Achievement. Ten exceptional students will be selected to win $1,000 to cover educational expenses. For more info or to apply, go to operf.org.

October 1–9

ABC: Written and Simulation Certification Exams. ABC certification exams will be administered for orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, therapeutic shoe fitters, orthotic and prosthetic assistants, and technicians in 350 locations nationwide. Contact 703/836-7114, email certification@ABCop.org, or visit ABCop.org/individual-certification.

October 6–9

ABC: Orthotic Clinical Patient Management (CPM) Exam. ABC Testing Center, Tampa, FL. Contact 703/836-7114, email certification@ABCop.org, or visit ABCop.org/individual-certification.

WEBINAR October 13

KO Policy—A Review. 1 PM ET. For more information, visit www.AOPAnet.org.

October 16

One-Day Pedorthic, Orthotic, and Prosthetic Program. POMAC is pleased to announce a one-day pedorthic, orthotic, and prosthetic program to take place at The Marriott New York LaGuardia Airport Hotel (across from LaGuardia airport in East Elmhurst, New York). Contact Drew Shreter at 800/ 946-9170, ext. 101, or dshreter@pomac.com for more details.

October 20–23

ABC: Prosthetic Clinical Patient Management (CPM) Exam. ABC Testing Center, Tampa, FL. Contact 703/836-7114, email certification@ABCop.org, or visit ABCop.org/individual-certification.

October 29–December 11

Pediatric Gait Analysis and Orthotic Management: An Optimal Segment Kinematics and Alignment Approach to Rehabilitation (OSKAR). Shirley Ryan AbilityLab, Elaine Owen. Online (on-demand and live), 31.5 ABC credits. Contact Melissa Kolski at 312/238-7731 or visit www.sralab.org/PedsGait.

November 1–4

ISPO 18th World Congress. Now virtual. For more information, contact the ISPO World Congress team at info@ispo-congress.com or call +49/341-678-8237.

WEBINAR

WEBINAR

www.AOPAnet.org.

November 10

Orthotics Clinician’s Corner. 1 PM ET. For more information, visit www.AOPAnet.org.

December 8

Year-End Review and What Is Ahead. 1 PM ET. For more information, visit

Calendar Rates

Let us share your next event!

Phone numbers, email addresses, and websites are counted as single words. Refer to www.AOPAnet.org for content deadlines. Send announcement and payment to: O&P Almanac, Calendar, P.O. Box 34711, Alexandria, VA 22334-0711 or email jburwell@ AOPAnet.org along with VISA or MasterCard number, cardholder name, and expiration date. Make checks payable in U.S. currency to AOPA. Note: AOPA reserves the right to edit calendar listings for space and style considerations. For information on continuing education credits, contact the sponsor.

Words/Rate Member Nonmember

25 or less $40 $50 26-50 $50 $60 51+ $2.25/word $5.00/word

Color Ad Special

1/4 page Ad $482 $678 1/2 page Ad $634 $830 Questions? Email info@AOPAnet.org.

2022

January 9–11

U.S. ISPO Pacific Rim Conference. Waikoloa, Hawaii (Big Island). For more information, visit www.usispo.org.

January 30–February 3

Hanger Live. Dallas, TX.

March 2–5

AAOP. Atlanta. For more information, visit www.oandp.org/events/event_list.asp?DGPCrSrt=&DGPCrPg=2.

May 10–13

OT World. Leipzig, Germany. For more information, visit www.ot-world.com/index-en.html

May 18–20

New York State Chapter of American Academy of Orthotists and Prosthetists (NYSAAOP) Meeting. Rivers Casino & Resort. Schenectady, NY. For more information, visit nysaaop.org/meeting.

AD INDEX May 20–21

Orthotic & Prosthetic Innovate Technologies Conference. Minneapolis. For more information, go to http://cecpo.com/documents/OrthoAndProstheticTech_2022_1up.pdf.

September 28–October 1

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

Advertisers Index

Company Allard USA Inc. ALPS South LLC Amfit Apis Footwear Company Becker Orthopedic Appliance Co. Board of Certification/Accreditation Cailor Fleming Insurance College Park Industries ComfortFit Orthotic Labs Inc. Coyote Prosthetics & Orthotics ESP LLC Ferrier Coupler Inc. Fillauer Hanger Hersco Naked Prosthetics Orthomerica Ottobock PROTEOR USA TurboMed Orthotics Inc. Page Phone Website

35 866/678-6548 3 800/574-5426 43 800/356-3668 19 888/937-2747 15 800/521-2192 41 877/776-2200 45 800/796-8495 17 800/728-7950 31 888/523-1600 27 800/819-5980

www.allardusa.com www.easyliner.com www.amfit.com www.apisfootwear.com www.beckerorthopedic.com www.bocusa.org www.cailorfleming.com www.college-park.com www.comfortfitlabs.com www.coyote.us 5 888/WEAR-ESP www.wearesp.com 29 810/688-4292 www.ferrier.coupler.com

9 800/251-6398 www.fillauer.com

51 877/442-6437 www.hangerclinic.com

1 800/301-8275 www.hersco.com

25 888/977-6693 www.npdevices.com

37 800/446-6770 www.orthmerica.com

C4 800/328-4058 www.professionals.ottobockus.com

13 855/450-7300 www.proteorusa.com

Questioning Cuts

Updates from Colorado, New York, Oklahoma, and Utah

Become an AOPA State Rep. If you are interested in participating in the AOPA State Reps network, email awhite@AOPAnet.org.

Each month, State by State features news from O&P professionals about the most important state and local issues affecting their businesses and the patients they serve. This section includes information about medical policy updates, fee schedule adjustments, state association announcements, and more.

These reports are accurate at press time, but constantly evolve. For up-to-date information about what is happening in your state, visit the Co-OP at www.AOPAnet.org/ resources/co-op.

NEW MEMBER RESOURCE ALERT

AOPA has invested in a new resource that allows us to track legislative and regulatory activity related to O&P in every state. We will be updating the state pages on the AOPA Co-OP with alerts as they arise.

Colorado

In response to the advocacy of providers in the state, the Colorado Department of Health Care Policy and Financing issued a statement on September 8 announcing that the rate would be reverted to the original rate prior to the July 1, 2021, reduction. The department also announced that a rate-setting project is being completed to determine the appropriate rate for cranial remolding orthoses. To view the statement and the latest updates, please visit the Colorado page of the AOPA Co-OP.

New York

A coalition of O&P providers in New York continues to push for a budget resolution to increase the Medicaid fee schedule and protect patient access to O&P care in the state. The efforts of the group have gained momentum, supported by the introduction of bicameral legislation (S 7023/A 7892) that, if passed, would direct the New York commissioner of health to conduct a study on rate adequacy for orthotics and prosthetics.

Oklahoma

The governor of Oklahoma signed into law a sunset extension, through July 2024, for the Advisory Committee on Orthotics and Prosthetics, which consists of members appointed by the Board of Medical Licensure and Supervision.

Utah

AOPA members have reported the removal of more than 50 A and L codes from the Utah Medicaid fee schedule. These codes include cervical, spinal, and upper-limb orthoses, as well as external power for upper-limb and terminal devices. AOPA is looking into this member-reported issue. For additional information, visit the Utah page on the AOPA Co-OP.

Submit Your State News To submit an update for publication in the State by State department of O&P Almanac, email awhite@AOPAnet.org.

CEs

Coding and Billing Got You Confused?

Attend the Mastering Medicare: Essential Coding and Billing Techniques Seminar in Las Vegas, on November 8-9, 2021.

But don’t take our word for it. Attendees have said:

I’ve learned more in the past few days than I’ve learned in the past year. All practitioners should attend this conference so they can learn to document the correct way and ensure compliance. The speakers are very knowledgeable and helpful. This is my second time at a seminar and I’m still learning so much.

For more than 20 years, our faculty have helped thousands of attendees get claims paid, survive audits, collect interest from Medicare, fi le successful appeals and code miscellaneous items.

Each Seminar is updated based on the latest developments, feedback from previous attendees, and needs of the profession. It is two days full of valuable instruction on topics O&P providers face daily, like prior authorization, competitive bidding, Medicare documentation requirements, and new codes. Additionally, 14 CE credits can be earned. Tropicana Las Vegas—a DoubleTree by Hilton Hotel & Resort Las Vegas, NV

HOTEL: Attendees are responsible for making their own hotel reservations at the Tropicana Las Vegas—a DoubleTree by Hilton Hotel & Resort. Hotel rooms are $59/ night plus a daily resort fee of $25 and tax. Book your room online to receive the group rate. Reserve by October 18.

November 8-9, 2021