September 2018 O&P Almanac

SPECIAL SECTION: 2018 AOPA NATIONAL ASSEMBLY EXHIBITOR PREVIEW P.48

The Magazine for the Orthotics & Prosthetics Profession

S E P T E M B E R 2018

E! QU IZ M

Get To Know the SDR Article and Other Policy Changes

EARN

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BUSINESS CE

CREDITS P.24

P.20

Award-Winning Researchers Talk Microprocessor Ankles and Cranial Orthoses P.40

Leading the Movement Toward Evidence-Based Practice P.62

C

Closer onnections

GRASSROOTS EFFORTS NATIONWIDE PUSH FOR MORE FAVORABLE LAWS AND POLICIES P.30

WWW.AOPANET.ORG

This Just In: CMS Proposes Two New Issues for RAC Audits P.26

YOUR CONNECTION TO

EVERYTHING O&P

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

ION

T STRA REGI

OPEN

PASSPORT

INNOVATION

Vancouver is easy to explore during your time at the downtown Vancouver Convention Centre as there are many nearby top attractions.

• • • • • •

Capilano Suspension Bridge Vancouver Aquarium Forbidden Vancouver Stanley Park Horse-Drawn Tours Harbour Cruises & Events Flyover Canada

• Vancouver Lookout • Dr. Sun Yat-Sen Classical Chinese Garden • Vancouver Art Gallery • Science World • Grouse Mountain

Experience Beyond Vancouver’s unbeatable location makes it the perfect gateway to the rest of British Columbia and beyond, providing you with outstanding opportunities for pre- and post-conference travel.

• Whistler • Okanagan Valley • Jasper • Victoria • Banff • Cruise to Alaska

AOPAnet.org

#AOPA2018

Experience all the AOPA National Assembly has to offer while visiting Vancouver.

contents

SE PTE M B E R 2018 | VOL. 67, NO. 9

2

COVER STORY

FEATURES

30 | Closer Connections O&P advocates are getting more involved at the state and local levels, working to influence area lawmakers and push forward legislation to improve the lives of O&P patients and protect the O&P profession. Initiatives in several states focus on insurance fairness laws, O&P licensure, and more equitable reimbursement, among other priorities.

By Christine Umbrell

26 | This Just In

CMS Proposes Two New Issues for RAC Audits Two issues have been proposed for review by Performant Recovery. Changes to RAC reviews of custom-fabricated knee orthoses described

by L1844 and L1846 and services delivered to Medicare beneficiaries during a hospice benefit period could impact the delivery of O&P care.

SEPTEMBER 2018 | O&P ALMANAC

40 | Thought Leaders Attendees at the AOPA National Assembly in Vancouver will witness the presentation of the 2018 Thranhardt and Hamontree Awards.

This year’s honorees will present the latest findings on microprocessor and energy-storing prosthetic ankles, cranial remolding orthoses, and a variety of best business practices.

By Deborah Conn

Moments in Time

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contents

SPECIAL SECTION 2018 AOPA National Assembly

DEPARTMENTS Views From AOPA Leadership......... 6 Tips on social engagement from Traci Dralle, CFM

48 | Passport to the Exhibit Hall

AOPA Contacts.......................................... 8

Find out what’s new on the trade show floor in 2018 and meet the title sponsors of this year’s event.

Numbers...................................................... 10

How to reach staff

At-a-glance statistics and data

54 | Exhibit Hall Map

Happenings................................................12

Plan your route on this two-page aerial view of the trade show floor.

Research, updates, and industry news

54 | Exhibitor Directory See the full list of international companies exhibiting at the 2018 AOPA National Assembly.

PRINCIPAL INVESTIGATOR Shane R. Wurdeman, PhD, CP, FAAOP...................................................... 62

P.12

Meet the director of clinical research for Hanger Clinic, who oversees research activities within the facility’s network, designs new research protocols, and implements outcome measures and patient registries.

People & Places........................................18 Transitions in the profession

AOPA News............................................... 72 AOPA meetings, announcements, member benefits, and more

COLUMNS

PAC Update............................................... 73

Reimbursement Page........................ 20

Welcome New Members................... 74

Critical information from the Local Coverage Articles

Careers......................................................... 76

Pausing for Policy Changes

Professional opportunities

Marketplace.............................................. 78

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

P.20

CREDITS

Upcoming meetings and events

Member Spotlight.................................68 n n

Kinetic Research

Ad Index..................................................... 82

Western Reserve Orthotics & Prosthetics Center

Ask AOPA.................................................. 84 P.68

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SEPTEMBER 2018 | O&P ALMANAC

Calendar..................................................... 80

P.70

Out-of-pocket payments, HIPAA notices, and more

We’re Moving Forward. Join Us. BCP Group is an innovative company of medical professionals looking for orthotic and prosthetic professionals across the country. We work with revolutionary technologies and dynamic medical professionals to improve quality of life for people around the U.S. Be part of a team that is changing lives - join us today.

C ON TAC T U S TODAY: CAR E E R S @ B C P G ROU P. N ET

C H E C K O U R W E B S I T E F O R M O R E D E TA I L S AT B C P G R O U P . N E T

VIEWS FROM AOPA LEADERSHIP

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

How Do I Get Engaged?

M

OST O&P CLINICS ARE NOT engaged on social media. Yes, they may have several hundred “likes.” Some even have 1,000 likes, but only five or 10 people actually like or share their posts. In my unscientific poll of 20 O&P clinics across the United States, less than 5 percent are engaged—and only 1 percent are happily married.

So how do you know if you are engaged? Take the number of likes, comments, and shares of your last post and divide that number by the number of followers on your page. The same is true for your social media presence.

The next question is, “How do I get engaged?”

Start with a plan. Look at your top five most popular posts.

What do they have in common?

That tells you what your current audience likes to see. At Fillauer, videos of amputees and kids and pictures of the Fillauer family generate the biggest engagement.

Next, look at other O&P clinics or manufacturers to see the types of posts that have the most engagement. Then, come up with a plan to share those types of posts at least three times a week. Consistent posting is key.

The next step to engagement is enlisting help with sharing your message. That is why tagging, and including hashtags, is so important. Tagging allows social media users to engage an individual, business, or organization with a social profile when they mention them in a post or comment. Hashtags are used to mark a keyword or words (with spaces removed) using the pound symbol, “#,” followed by the keyword(s). Hashtags can be used on Twitter, Instagram, Facebook, and other social media platforms.

When sharing patient videos or photos, tag the manufacturers of the devices your patient is wearing. Hashtag your city and state. Tag or hashtag your referral source for the patient, including his or her therapist and physician practice. Tag the payor. (Most people tag payors because they are mad at them. Maybe your next claim will be paid in 12 weeks instead of 20.) All these people are invested in your patient, and they will engage with you by liking and sharing. Your engagement rate will soar, and your business will grow.

And, the final tip to being engaged is “tracking” … not to be confused with trolling.

So, how do you track all the #hashtags related to your business? There are many tracking apps, like Mention, that allow you to receive an email or app alert each time your business name is mentioned anywhere on the Internet. This way, if a patient ends up being interviewed by a local news station or shares what an awesome practitioner he or she has on a Facebook page, you will know and will be able to engage with them.

Remember, social media is not just about how many people like you. It also is about engagement—because that really is a true test of your potential reach.

Traci Dralle, CFM, is a member of AOPA’s Board of Directors.

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Board of Directors OFFICERS President Jim Weber, MBA Prosthetic & Orthotic Care Inc., St. Louis, MO President-Elect Chris Nolan Ottobock, Austin, TX Vice President Jeffrey Lutz, CPO Hanger Clinic, Lafayette, LA Immediate Past President Michael Oros, CPO, FAAOP Scheck and Siress O&P Inc., Oakbrook Terrace, IL Treasurer Jeff Collins, CPA Cascade Orthopedic Supply Inc., Chico, CA Executive Director/Secretary Thomas F. Fise, JD AOPA, Alexandria, VA DIRECTORS David A. Boone, MPH, PhD, BSPO Orthocare Innovations LLC, Edmonds, WA Jeffrey M. Brandt, CPO Ability Prosthetics & Orthotics Inc., Exton, PA Mitchell Dobson, CPO, FAAOP Hanger Clinic, Grain Valley, MO Traci Dralle, CFM Fillauer Companies, Chattanooga, TN Teri Kuffel, JD Arise Orthotics & Prosthetics Inc., Blaine, MN Dave McGill Össur Americas, Foothill Ranch, CA Rick Riley Thuasne USA, Bakersfield, CA Brad Ruhl Ottobock, Austin, TX

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AOPA CONTACTS

American Orthotic & Prosthetic Association (AOPA) 330 John Carlyle St., Ste. 200, Alexandria, VA 22314 AOPA Main Number: 571/431-0876 AOPA Fax: 571/431-0899 www.AOPAnet.org

Publisher Thomas F. Fise, JD Editorial Management Content Communicators LLC Advertising Sales RH Media LLC

Our Mission Statement Through advocacy, research and education, AOPA improves patient access to quality orthotic and prosthetic care.

Printing Sheridan

EXECUTIVE OFFICES

REIMBURSEMENT SERVICES

SUBSCRIBE O&P Almanac (ISSN: 1061-4621) is published monthly by the American Orthotic & Prosthetic Association, 330 John Carlyle St., Ste. 200, Alexandria, VA 22314. To subscribe, contact 571/431-0876, fax 571/431-0899, or email ymazur@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.

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

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

ADDRESS CHANGES POSTMASTER: Send address changes to: O&P Almanac, 330 John Carlyle St., Ste. 200, Alexandria, VA 22314.

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

Copyright © 2018 American Orthotic and Prosthetic Association. All rights reserved. This publication may not be copied in part or in whole without written permission from the publisher. The opinions expressed by authors do not necessarily reflect the official views of AOPA, nor does the association necessarily endorse products shown in the O&P Almanac. The O&P Almanac is not responsible for returning any unsolicited materials.

All letters, press releases, announcements, and articles submitted to the O&P Almanac may be edited for space and content. The magazine is meant to provide accurate, authoritative information about the subject matter covered. It is provided and disseminated with the understanding that the publisher is not engaged in rendering legal or other professional services. If legal advice and/or expert assistance is required, a competent professional should be consulted.

Our Core Objectives AOPA has three core objectives—Protect, Promote, and Provide.

These core objectives establish the foundation of the strategic business plan. AOPA encourages members to participate with our efforts to ensure these objectives are met.

Tina Carlson, CMP, chief operating officer, 571/431-0808, tcarlson@AOPAnet.org Don DeBolt, chief financial officer, 571/431-0814, ddebolt@AOPAnet.org MEMBERSHIP & MEETINGS Kelly O’Neill, CEM, manager of membership and meetings, 571/431-0852, kelly.oneill@AOPAnet.org Betty Leppin, manager of member services and operations, 571/431-0810, bleppin@AOPAnet.org

SPECIAL PROJECTS Ashlie White, MA, manager of advocacy, outreach, and special projects 571/431-0812, awhite@AOPAnet.org O&P ALMANAC

Yelena Mazur, communications specialist, 571/431-0835, ymazur@AOPAnet.org

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

Ryan Gleeson, CMP, assistant manager of meetings, 571/431-0836, rgleeson@AOPAnet.org

Josephine Rossi, editor, 703/662-5828, jrossi@contentcommunicators.com

Kristen Bean, membership and meetings coordinator, 571/431-0876, kbean@AOPAnet.org AOPA Bookstore: 571/431-0876

Catherine Marinoff, art director, 786/252-1667, catherine@marinoffdesign.com Bob Heiman, director of sales, 856/673-4000, bob.rhmedia@comcast.net

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

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Design & Production Marinoff Design LLC

SEPTEMBER 2018 | O&P ALMANAC

Christine Umbrell, editorial/production associate and contributing writer, 703/6625828, cumbrell@contentcommunicators.com

Advertise With Us! Reach out to AOPA’s membership and more than 11,800 subscribers.

Engage the profession today. Contact Bob Heiman at 856/673-4000 or email bob.rhmedia@comcast.net.

Visit bit.ly/almanac18 for advertising options!

NUMBERS

Mapping O&P Legislation What laws are in effect in your home state?

O&P laws regarding two separate but important issues—licensure of certified orthotists and prosthetists, and insurance fairness laws for amputees— are in effect in some states, but absent in others. The following maps provide a visual overview of the types of laws in effect in each state.

O&P INSURANCE FAIRNESS LEGISLATION

21 29 2

States with an insurance parity law in effect

States without an insurance parity law

States where insurance fairness legislation has been recently introduced: Michigan and New York

SOURCE: Amputee Coalition

O&P LICENSURE LAWS WA ND

MN

PA

IA

OH

IL

KY OK

TN

AR MS

AL

GA

TX FL

RI NJ

15 2 1

States with an O&P licensure law in effect

States that have certification requirements but do not issue licenses for orthotics or prosthetics

State where a licensure law has been repealed: Rhode Island

SOURCE: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, https://www.abcop.org/State-Licensure/Pages/state-licensure.aspx

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Happenings RESEARCH ROUNDUP

UCSF Researchers Examine Trauma-Induced Upper-Extremity Amputations performed were amputations through the humerus (35 percent), forearm (30 percent), and hand (14 percent). Patients typically spent 17 days in the hospital, and 31 percent of patients underwent at least one “re-operation.” The rate of re-operation was higher at university-associated hospitals, compared to nonteaching or community hospitals, according to the data.

The UCSF researchers, Elizabeth Inkellis, MD, Eric Edison Low, MPH, Christopher Langhammer, MD, PhD, and Saam Morshed, MD, PhD, also investigated mechanisms of injury and found that one third of the upper-extremity amputations had been caused by motor vehicle trauma, 21 percent by a machinery accident, and 7 percent by a motorcycle accident. In addition, more than three quarters of the patients (76 percent) were male, with an average age at amputation of 42 years. The study was published in the June 28 issue of the Journal of Bone and Joint Surgery.

IMAGE: Getty Images

Researchers from the University of California—San Francisco (UCSF) have released the findings of a study examining the disease burden of trauma-related upper-extremity amputation in the United States.

Noting that no such research had been conducted in the previous decade, the researchers sought to provide updated information on the incidence and characteristics of severe upper-extremity trauma in the civilian population as reflected in the National Trauma Data Bank.

Studying the data of 1,386 patients who had undergone a major upper-extremity amputation secondary to a traumarelated injury between 2009 and 2012, the researchers found that the most frequent definitive procedures

‘E-Dermis’ Enables Prostheses To Register Touch

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SEPTEMBER 2018 | O&P ALMANAC

the Biomedical Instrumentation and Neuroengineering Laboratory at Johns Hopkins. “For the first time, a prosthesis can provide a range of perceptions, from fine touch to noxious, to an amputee, making it more like a human hand,” said Thakor, who served as senior author on an article on this topic in the June 20 issue of Science Robotics.

The sensors are designed to be placed over the fingertips of a prosthetic hand and act in a manner similar to biological skin, according to Luke Osborn, a graduate student in biomedical engineering and a member of the research team. The team used a prosthetic hand that is already on the market and fit it with the e-dermis that “can tell the wearer

A prosthetic hand equipped with the experimental e-dermis

whether he or she is picking up something that is round or whether it has sharp points,” Osborn explained.

The e-dermis has been tested on an amputee who volunteered in the Johns Hopkins Neuroengineering Lab over the course of a year, as well as with four additional amputee volunteers who have provided information on sensory feedback.

PHOTO: Larry Canner/JHU

A team of engineers at Johns Hopkins University has created an electronic skin that, when layered on top of prosthetic hands, is designed to bring a sense of touch through the fingertips. The “e-dermis” is composed of fabric and rubber laced with sensors that mimic nerve endings.

This allows for users to experience a sense of touch as well as pain by sensing stimuli and relaying the impulses back to the peripheral nerves, according to the research team.

The e-dermis conveys information and sensation to the amputee by stimulating peripheral nerves in the arm in a “noninvasive way,” according to Nitish Thakor, a professor of biomedical engineering and director of

HAPPENINGS

MIT Engineers Design Customizable Low-Cost Prosthetic Foot

PHOTO: Courtesy of Amos Winter, Kathyrn Olesnavage, MIT

MIT engineers have developed a simple, low-cost, passive prosthetic foot that they can tailor to an individual.

Engineers at the Massachusetts Institute of Technology (MIT) have reportedly developed a simple, passive prosthetic foot designed to be tailored to the user. The device’s design framework provides a quantitative way to predict a user’s biomechanical performance.

Taking into account the user’s body weight and size, the researchers can tune the shape and stiffness of the prosthetic foot to ensure the user’s gait is similar to able-bodied gait.

Researchers began development of the foot after representatives from Jaipur Foot in India approached Amos Winter, PhD, associate professor of mechanical engineering at MIT, which manufactures a passive prosthetic foot for amputees in developing countries. The organization asked Winter to design an improved and lighter foot that could be mass produced at low cost. Winter assembled a research team, led by former graduate student Kathryn Olesnavage, and began developing a foot that would produce lower-leg motions similar to those of an able-bodied person as they walk, rather than replicating the movements of able-bodied feet and ankles. This focus allowed them to change the foot dramatically, as long as they were able to ensure the lower leg could function appropriately in terms of kinematics and loading, according to Winter.

The team developed a mathematical model of a simple, passive, prosthetic

foot that describes the stiffness, possible motion, and shape of the foot.

They ultimately tuned the stiffness and geometry of the simulated prosthetic foot to produce a lower-leg trajectory that mimics an able-bodied swing.

To determine the shape for a singlepart prosthetic foot, the team studied different foot shapes and lower leg trajectories and designed a shape that is “similar to the side-view of a toboggan,” according to the researchers. The prosthesis is one big structure, without an ankle or metatarsal joint, because “all we care about is how the lower leg is moving through space,” explained Winter.

Early versions of the foot were made from machined nylon, and a covering is being developed by a company that manufactures rubber outsoles. The researchers plan to test the prosthesis and coverings on volunteers in India. The low cost of the new design will allow the foot to be used in developing countries.

FAST FACT

CMT Patients Gain Stability and Balance From AFO Usage Individuals with Charcot-Marie-Tooth (CMT) disease who wear orthoses often experience improvements in gait and balance, but many patients do not follow orthotic use recommendations, according to a new study. Researchers from Russia conducted a meta-analysis of 412 scientific papers and concluded that using orthoses appropriately can prevent the progression of deformities and provide stability to the skeletal system in patients to improve their quality of life.

After reviewing the literature, the authors found that ankle-foot orthoses (AFOs) can help reduce foot drop and reduce proximal compensatory movements while walking by people with CMT. Several studies found that

orthotic use was associated with an improvement across various domains, including walking balance and performance, preventing the foot from falling, reducing the frequency of tripping, and aiding in restoring bone-joint interactions. Other studies found that the use of orthoses was associated with an increase in gait velocity.

The researchers concluded that orthoses are “an indispensable method of habilitation of patients with [CMT].”

They recommended a multidisciplinary approach to patient care to ensure patients understand how to use orthoses and follow through with compliance. The full study was published in the July issue of the Journal of Biosciences and Medicine.

Approximately 85 percent of lower-limb amputations are preceded by a foot ulcer.

Source: “Limb Loss in the USA,” Amputee Coalition

O&P ALMANAC | SEPTEMBER 2018

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HAPPENINGS

RESEARCH ROUNDUP

Lower-Limb Amputees With Comorbidities Shown To Benefit From Prosthetic Intervention Researchers at Hanger Inc. have concluded the second part of their Mobility Analysis of Amputees (MAAT II) study on lower-limb amputees. The study investigated the impact of those comorbidities comprising the Functional Comorbidities Index (FCI) and other notable comorbidities, and their influence on mobility among people living with lower limb loss.

MAAT II findings demonstrated a person’s overall comorbid health has little impact on mobility with a lower-limb prosthesis, as patients with multiple comorbidities benefit from a prosthesis that provides meaningful mobility, according to the researchers. “The continued rise in lower-limb amputations is creating a need for improved means of identifying patients who will benefit from prosthetic rehabilitation and technology,” explained James

Campbell, PhD, CO, FAAOP, chief clinical officer, Hanger Clinic. “In the absence of strong research support to guide prosthetic rehabilitation, decision makers have been restricted in their options for identifying prosthetic candidates. Historically, comorbid health has been among the factors utilized, despite a lack of strong evidence to support this application, which necessitated further research.”

Campbell, along with Shane R. Wurdeman, PhD, CP, FAAOP, and Phil M. Stevens, MEd, CPO, FAAOP, performed a retrospective review of outcomes data collected within multiple clinics, analyzing the data of nearly 600 adult lower-limb prosthesis users. The primary endpoint included within the analysis was the Prosthetic Limb Users Survey of Mobility (PLUS-M).

The researchers found only four

factors to be significant predictors of mobility: age, history of stroke, presence of peripheral vascular disease (PVD), and anxiety/panic disorders. With compounding comorbid health conditions, mobility declines; however, after adjusting for age, history of stroke, PVD, and anxiety/panic disorders, there was no significant impact of comorbid health on mobility. The MAAT II study concluded the presence of comorbidities does not preclude meaningful mobility. The researchers advise clinicians to consider age, history of stroke, PVD, and anxiety/ panic disorders in formulating their plan of care to maximize patient mobility.

The outcomes from the MAAT II study will be published in an upcoming print edition of American Journal of Physical Medicine and Rehabilitation, and are available via early release online.

AMPUTEE ATHLETICS

Service Members Compete in Warrior Games More than 300 active-duty military service members and veterans took part in the 2018 Department of Defense Warrior Games, hosted this year by the Air Force Academy in Colorado. Representatives from all branches of the U.S. military, as well as competitors from the United Kingdom, Canada, and Australia, participated in the June event.

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SEPTEMBER 2018 | O&P ALMANAC

PHOTO: Scheck & Siress

Tim Russo, CPO, LPO, a Scheck & Siress practitioner, assists a competitor at a repair station during the 2018 Warrior Games.

Athletes competed over a nine-day period in June in 11 Paralympic-style sporting events, including track and field, sitting volleyball, wheelchair basketball, swimming, shooting, archery, powerlifting, and indoor rowing. Designed to introduce wounded, ill, and injured service members to adaptive sports, the Games featured several participants using prostheses or orthoses.

Scheck & Siress participated in the event as a sponsor and provided a prosthetic and orthotic repair station, featuring a team of clinicians and a mobile lab equipped with machinery and computer-aided design technology. The repair team completed tasks such as overhauling prosthetic running legs, troubleshooting and repairing O&P equipment, resolving comfort and fit issues, and performing modifications and adaptations to optimize various sporting equipment.

“After struggling to walk with paralysis in the back of my leg for over two years, I spoke with the people working at the Scheck & Siress stand at Warrior Games. They set me up with a small orthotic that compensates for the weakness in my calf and they had me walking normally in five minutes,” said Breton Carroll, a retired Canadian Army signals officer.

Next year’s Warrior Games will take place in Tampa, Florida, June 21-30, and will be hosted by the U.S. Special Operations Command.

The clinically proven pocket-sized 3D image capturing system.

The Apple® iPhone® and the Prosthetic Module are the latest additions to the SmartSoc 3D Capturing System from Orthomerica. Clinicians now have the freedom to choose where they send their prosthetic scans for manufacturing including Orthomerica, custom fabrication facilities, or their own labs.

SmartCam™ for fast, safe, and accurate video scans • Samsung® Galaxy S7® with Android™ OS -orApple iPhone 7 with iOS®* • User friendly—requires minimal training to use • Accurate to 0.1% • Generic model on the device display shows real-time SmartScan™ progress • Scanning halo turns green, indicating optimal stand-off distance • Allows patient movement during a SmartScan • Portable—easily taken to clinics and satellite offices CurveCapture™ App converts 2D video images to a 3D model • Revolutionary technology analyzes 2D video images for optimal 3D conversion in the cloud • HIPAA compliant eBrace® web portal • Allows users to review the 3D Model • Platform for ordering STAR® family of cranial remolding orthoses from Orthomerica and sending prosthetic scans to third-party fabricators Product offerings • • • •

Prosthetics STAR family of cranial remolding orthoses Custom protective helmets More modules to come!

2018 AOPA • September 26-29 • Vancouver, BC, Canada

Stop by O r thomerica b ooth #41 2 to se e the l atest updates and new features of the Smar tSoc System.

877-737-8444 | www.orthomerica.com *Apple/iOS prosthetics module available December 2018. Android is a trademark of Google LLC. © 2018 Orthomerica Products, Inc. All Rights Reserved.

U.S. Patent: 14/062,994 & Patents Pending

HAPPENINGS

VETERANS’ VIEWPOINT

Congressional Roundtable Addresses Provider Choice, Medical Necessity for Veterans AOPA was among several entities represented at a July 25 Congressional Roundtable discussion conducted by the House Veterans Affairs Health Subcommittee. Subcommittee Chair Rep. Neal Dunn, MD (R-Florida), and Rep. Julia Brownley (D-California), the ranking minority member, presided over the roundtable, with Rep. Annie Custer (D-New Hampshire) also in attendance for a portion of the session.

Roundtables are informal discussions with no sworn testimony and no recording of statements, to encourage a free exchange of ideas and information.

The primary topic for the session was U.S. Department of Veterans Affairs (VA) prosthetic care, with a focus on the VA’s proposed rule of Oct. 16, 2017, including controversial provisions that would make VA the sole determinant of where a veteran could receive O&P care (private sector versus a VA clinic). This provision would limit the longstanding choice of provider afforded to many veterans.

Participants also discussed a provision that would tighten the definition of medical necessity, among other talking points.

Dunn and Brownley offered statements opposing the provisions limiting

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SEPTEMBER 2018 | O&P ALMANAC

Seated: Sen. Tammy Duckworth (D-Illinois) and Nicole ver Kuilen; standing: AOPA Executive Director Thomas F. Fise, JD, and AOPA Legislative Counsel Colin Roske provider choice and tightening the definition of medical necessity, and asked, “Why now? And what is broken that needs fixing?” Dunn specifically mentioned the need to ensure training funds to aid in the education of new prosthetists for future generations of veterans; he cited the workforce

study supported by the National Commission on Orthotic and Prosthetic Education and AOPA that targeted the need for a 60 percent increase in the number of prosthetists to keep pace with retirements and the expanding patient population. AOPA’s lead advocate on this issue, Catriona Macdonald, was present for the session.

AOPA representatives emphasized that VA care should be focused on achieving both choice and quality of providers. Participants discussed the valuable clinical guidelines developed and implemented by VA and the possible expansion of patient outcomes efforts. In addition, the VA Office of the Inspector General (OIG) representatives provided commentary on purported excessive referrals to private-sector contractors for diabetic shoes and compression footwear in Southern Nevada. There also was a brief mention of an upcoming OIG report of VA coding practices and a discussion supporting H.R. 2322, the Amputee Veterans Bill of Rights.

In addition to the VA Roundtable, representatives from AOPA, including Executive Director Thomas F. Fise, JD, and Legislative Counsel Colin Roskey, along with Nicole ver Kuilen, an intern advocate from the National Association for the Advancement of Orthotics and Prosthetics, met with Sen. Tammy Duckworth (D-Illinois). The AOPA representatives provided a briefing, update, and request for support, and discussed the implementation of the prosthetist/orthotist notes provision; the latest status of the CMS July 2015 draft Local Coverage of Determination (LCD) and the Dear Physician letter (both now withdrawn, though deliberations on LCD-related issues remain active and volatile); the remaining sections of S. 1191, including the section on reinforcing the “minimal self-adjustment” definition that distinguishes off-the-shelf orthotics from custom-fitted and customfabricated orthotics; VA matters; and a report on orthotics from the Medicare Payment Advisory Committee.

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Coronal View (Anterior)

Transverse views showing derotational forces and void areas

Our SCT 3DSM Modification System combined with our two decades of CAD/CAM experience allows us to lead the way in using next generation technology for custom fit and fabrication.

Lumbar Derotation

Transverse Top View

Thoracic Derotation

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PEOPLE & PLACES PROFESSIONALS ANNOUNCEMENTS AND TRANSITIONS

American Prosthetics & Orthotics (APO), which has patient-care facilities throughout Iowa, has announced two promotions. Malena Billups, CPO, LPO, was named director of education, and Matt Husnik, CPO, LPO, ATC, was named Malena Billups, assistant manager of the Iowa City office.

CPO, LPO Billups, an employee of APO since 2007, sees patients at all three of APO’s Iowa City offices.

A graduate of the University of Iowa with a degree in athletic training, Billups completed orthotic and prosthetic studies at Northwestern University. She is certified to fit the C-leg, Matt Husnik, CPO, the RHEO KNEE, and the i-limb hand, and LPO, ATC is a member of the Iowa Prosthetic Orthotic Pedorthic Association (IPOPA).

Husnik studied physiology at the University of Iowa and has a background in athletic training. He began his career at APO in 2009 as an orthotic resident, earning his certification in orthotics in 2011 and prosthetics in 2013 from Northwestern University’s Prosthetic-Orthotic Center. Husnik is the resident mentor for the Iowa City offices and a member of IPOPA. He is i-limb/i-digits and C-leg certified.

SPS has awarded three 2018 SPS O&P student scholarships.

Paco Galvan (University of Washington), Brian White (Georgia Institute of Technology), and Sean Dineen (Northwestern University) have each been awarded a $2,500 scholarship for their outstanding leadership, community service, and academic achievements.

THE LIGHTER SIDE

Craig Rooney is the New England district manager for Allard USA. With more than 20 years’ experience in the O&P industry, Rooney previously worked with businesses such as Fillauer Companies Inc., Century 22, and BHI. He has a bachelor’s degree from the University of Massachusetts, Isenberg School of Management. He resides in Massachusetts will serve the O&P community in New England and upstate New York.

Christopher Shallal

OPAF intern Christopher Shallal, a rising sophomore at Johns Hopkins University majoring in biomedical engineering, spent the summer as an intern at the Singapore Institute for Neurotechnology at the National University of Singapore. A bilateral lower leg amputee, Shallal plans to focus his prosthetic research at making prostheses more life-like. He works as a research assistant in the Johns Hopkins Neuroengineering and Biomedical Instrumentation Lab. He also recently presented his team’s research at the 40th International Conference for IEEE Engineering in Medicine and Biology in Honolulu, Hawaii.

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REIMBURSEMENT PAGE

By DEVON BERNARD

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Take some time to review the latest updates to documentation requirements and policy articles

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A

S AN O&P PROFESSIONAL, it’s likely you are already aware of the vital information found in the Medicare medical policies (Local Coverage of Determinations and Policy Articles) for orthotics and prosthetics, and how this information ensures coverage and proper payments. But are you aware of the Local Coverage Article that outlines the majority of the documentation requirements for all durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS)? And how often do you review and reread current O&P Medicare medical policies?

This month’s Reimbursement Page examines some of the critical information from the Local Coverage Article and reviews some of the changes made to other O&P policies so far this year.

Standard Documentation Requirements

In the past, each Medicare medical policy contained an individual general documentation requirements section and specific policy-related documentation requirements. This practice changed slightly in late 2017 when all of the standard documentation language was removed. This standard documentation information was then placed into a single Local Coverage Article called the Standard Documentation Requirements (SDR) Article. This change allows the durable medical equipment Medicare

administrative contractors (DME MACs) to update and correct information quicker and more efficiently, rather than having to update multiple Local Coverage Determinations anytime there are changes in policy to standard documentation requirements, such as orders, delivery slips, etc.

The SDR Article not only contains information related to the standard rules and regulations for documentation and documentation retention, it also includes basic guidance regarding the need to properly code items, and the documentation required when submitting claims with miscellaneous codes.

There are three key areas of the SDR. First, for any claim submitted to the DME MACs for payment, the justification for medical need and necessity is established at the time the items are ordered. The information that is used to demonstrate medical necessity must be documented just prior to, or at the time of, the initial prescription. However, any information to establish and show that appropriate policy coverage rules and necessity have been met must be documented prior to the date of service. So, at the time of the initial order for an ankle-foot orthosis (AFO), for example, there would have to be some information showing the need for an AFO, such as the diagnosis, and prior to delivery there would have to be documentation supporting the need for the specific AFO being provided.

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Second, if you are billing for a miscellaneous 99 code, your claim must include specific information: a description of the item, the manufacturer’s name (if available), the product name and number (if available), and the Health-Care Common Procedure Coding System (HCPCS) code of a related item (if applicable).

You also must provide your price for the miscellaneous code. If a claim for a miscellaneous code is submitted without this information, the claim or claim line will be rejected and will have to be resubmitted.

Medicare will not automatically continue coverage for an item provided to the patient and covered by a different payor when that patient finally becomes eligible and begins to receive Medicare benefits.

Third, the SDR also provides guidance on the documentation requirements regarding the instance when a patient receives an item prior to becoming eligible for Medicare. Medicare will not automatically continue coverage for an item provided to the patient and covered by a different payor when that patient finally becomes eligible and begins to receive Medicare benefits. In essence, the first Medicare claim associated with the existing item (i.e., repair, 22

SEPTEMBER 2018 | O&P ALMANAC

adjustment, replacement, transfer, etc.) is considered a new initial Medicare claim; for Medicare to make a payment or provide coverage, the patient and the item must meet all Medicare coverage, coding, and documentation requirements. This includes having a valid proof of delivery (POD) on file.

A POD is required for all items, even those in the beneficiary’s possession provided by another insurer prior to Medicare eligibility, if Medicare is to consider making a future payment. Not all payors have the same requirements as Medicare when it comes to obtaining a POD—so what can you do to ensure compliance?

The POD requirements in these instances are straightforward and require that you document two things: First, create a statement for the patient, or his or her designee, to sign that indicates that you have examined the item in question. Second, document or attest that the item in question meets established Medicare requirements. These two steps allow you to provide repairs, adjustments, and replacements and receive payment from Medicare on items or devices provided to patients prior to them becoming eligible for Medicare.

Therapeutic Shoes for Persons With Diabetes

While not necessarily new information, it’s important for O&P professionals to know the policy on therapeutic shoes and understand the newly created code for diabetic shoe inserts, which has been in mandatory effect since April 1, 2018:

K0903—For diabetics only, multiple-density insert, made by direct carving with CAM technology from a rectified CAD model created from a digitized scan of the patient, total contact with patient’s foot, including arch, base layer minimum of 3/16-inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each.

The policy and subsequent coding bulletins require that inserts described

by K0903 be reviewed, cleared, and listed on the Pricing Data Analysis Coding (PDAC) contractor’s product classification list. The PDAC coding redetermination project was initially announced in August of 2017 and scheduled to be completed by June 1, 2018; however, it was extended to Aug. 1, 2018, to allow all manufacturers and central fabricators additional time to submit applications for their respective products.

As a result, all custom diabetic inserts billed to Medicare using the existing A5513 or recently introduced K0903 must be listed on the PDAC product classification list no later than Aug. 1, 2018. Inserts that are not included on the PDAC list by Aug. 1, 2018, must be coded as A9270 and will be considered noncovered by Medicare. Verify the proper coding of the inserts you are providing against the PDAC product classification list (www.dmepdac.com/ dmecsapp/ProductClassification/Search), and if the insert is not listed, use A9270.

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If the custom inserts (A5513 or K0903) are fabricated in-house and provided directly to your patients, you don’t need to have your inserts reviewed and placed on the PDAC product classification list. However, you must be able to provide information regarding fabrication methods and materials used, if requested.

Spinal Policy

So far this year, there have only been minimal changes to the Spinal Orthoses: Lumbosacral Orthoses (LSOs) and Thoracolumbosacral Orthoses (TLSOs) Policy. It has been updated to provide coverage and coding guidance for maternity support garments. Policy now clearly states that garments that are used to support the abdomen during pregnancy do not meet the definition of a brace and are considered noncovered—so they must be coded as A9270.

In addition, the Spinal Policy was updated to place two codes on the custom-fabricated list, which would require any product described by one of the two codes (L0622 and L0624) to be listed on the PDAC product classification list: L0622—Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated.

L0624—Sacroiliac orthosis, flexible, provides pelvic-sacral support, with rigid or semirigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated.

As with the custom diabetic inserts, if you are fabricating these braces in-house and delivering them directly to your patients, they don’t need to be listed on the PDAC product classification list. These changes are effective for any claims with a date of service on or after Jan. 1, 2018.

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Lower-Limb Prostheses Policy

Additional Updates

The next two updates to the policy are not new, as they have been previously released as coding bulletins and/ or directives from the PDAC and the DME MACs, but they have now been enshrined in the official policy. First is the explanation that certain base codes inherently include batteries and battery chargers, and these items may not be billed separately, unless they are being billed as replacements. Second, the policy now includes statements on the proper use of both prosthetic skins and covers. As a reminder, prosthetic covers (L5704-L5707) are considered to provide sufficient protection and weatherproofing on their own, and protective covering systems (L5962, L5964, and L5966) are specialized covers intended to be worn over an existing prosthesis to provide additional protection and are not designed for cosmetic purposes or for everyday usage. The L5962, L5964, and L5966 should only be used if the patient is subjected to “unusually harsh environmental situations.”

Devon Bernard is AOPA’s assistant director of coding and reimbursement services, education, and programming. Reach him at dbernard@AOPAnet.org.

The Lower-Limb Prostheses Policy has seen three changes this year. The first update was made to provide coverage and use instructions for the newly created L7700 code, which has been in effect for claims with a date of service on or after Jan. 1, 2018. The L7700 is used to describe a component added to a prosthetic liner to create a sealing feature to aid in the suspension of the prosthesis. The full official descriptor for the L7700 is: “gasket or seal, for use with prosthetic socket insert, any type, each.” The revised Policy Article portion of the policy now clearly states that the L7700 may only be billed as one unit of service since it is designed to be removable, and it may not be used to describe rings that are physically incorporated or attached to liners. Any separate billing of these attached or incorporated rings would be considered unbundling.

Each of the orthotic policies (on AFOs/KAFOs, LSOs/TLSOs, and knee orthoses) now includes a statement or some type of guidance in situations when an existing prefabricated code does not distinguish between whether it is an off-the-shelf brace or a custom-fitted brace. These are braces that could be fit by the patient or require custom fitting by a qualified practitioner at the time of final delivery, and where there is no set of split HCPCS codes that describe similar types of braces.

Previous guidance, not published in policies, indicated that if the code did not directly state custom fitting and it required custom fitting, the brace had to be billed as a 99 or miscellaneous code.

The policies now state that when using one of these unspecified prefabricated codes, regardless of the type of fitting provided at the time of delivery, the unspecified prefabricated code appropriately describes the item and must be used for Medicare billing.

If you provide, for example, an L1930 (AFO, plastic or other material, prefabricated), it could be considered an off-the-shelf brace if it requires minimal self-adjustment—or it could be considered a custom-fit brace. However, no matter how the fitting is accomplished, it would still be billed as an L1930.

The policies are updated on a rolling quarterly basis, so it’s a good idea to routinely review the them and stay up to date on all changes—whether they are small updates or more drastic revisions.

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This Just In

CMS Proposes Two New Issues for RAC Audits Reviews possible for custom-fabricated knee orthoses and services provided during Medicare-covered hospice benefit periods

O

N AUG. 7, 2018, CMS published two new proposed issues for review by Performant Recovery, the recovery audit contractor (RAC) for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS); home health; and hospice claims nationwide. The two issues that have been proposed for RAC review are custom-fabricated knee orthoses described by L1844 and L1846 and DMEPOS services delivered to a Medicare beneficiary during a hospice benefit period.

The proposed RAC review for custom-fabricated knee orthoses is a complex review, meaning that claims will be reviewed to ensure that the knee orthoses delivered were medically necessary and meet the coverage guidelines outlined in the Medicare Local Coverage of Determination (LCD) and Policy Article for knee orthoses. The proposed RAC review will be limited to only two Health-Care Common Procedure Coding System (HCPCS) procedure codes, L1844 and L1846. These codes describe rigid knee orthoses that are custom fabricated, contain either a single upright (L1844) or double upright (L1846), provide medial, lateral, and rotation control,

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and contain adjustable flexion and extension joint(s). The general criteria for coverage of a custom-fabricated knee orthosis instead of a prefabricated knee orthosis as outlined in the knee orthosis LCD are as follows: A custom-fabricated orthosis is covered when there is a documented physical characteristic [that] requires the use of a custom-fabricated orthosis instead of a prefabricated orthosis. Examples of situations [that] meet the criterion for a custom-fabricated orthosis include, but are not limited to: • Deformity of the leg or knee • Size of thigh and calf • Minimal muscle mass upon which to suspend an orthosis.

Although these are examples of potential situations where a custom-fabricated orthosis may be appropriate, suppliers must consider prefabricated alternatives such as pediatric knee orthoses in beneficiaries with small limbs, straps with additional length for large limbs, etc.

In addition to the general criteria for coverage of a custom-fabricated

This Just In

knee orthosis, the LCD also requires the coverage criteria for the prefabricated version of these knee orthoses (L1843, L1845, L1851, and L1852) to be documented in the patient’s medical record. These criteria include the following: 1. The patient must be ambulatory while wearing the orthosis; and 2. The patient must have had a recent injury to or surgical procedure on the knee related to a diagnosis listed in either Group 2 or Group 4 of the LCD; or 3. The patient must have documented knee instability as a result of a diagnosis listed in Group 4 of the LCD. Claims subject to RAC review that do not meet the general criteria for coverage of a custom-fabricated orthosis or the specific coverage criteria for coverage of L1844 and L1846 will most likely result in an overpayment request. Claims that are deemed not medically necessary as

part of a RAC audit may be appealed using the same appeal procedure as regular claims. While RAC reviews are always done on a postpayment basis, you may want to review your documentation procedures for delivery of custom knee orthoses in general to make sure you do not have potential exposure to future RAC reviews.

The second issue that has been proposed for RAC review is an automated review for DMEPOS services that were provided during a Medicarecovered hospice benefit period. As hospice is considered a Medicare Part A benefit, claims submitted to Part B contractors, including the durable medical equipment Medicare administrative contractors (DME MACs), are typically not covered as Medicare Part A provides coverage for all medically necessary care related to the terminal disease that resulted in the hospice election by the patient.

There is a significant exception to this general rule that allows for continued coverage of DMEPOS and

other services that are unrelated to the patient’s terminal disease but remain medically necessary during the hospice election period. In this scenario, providers are required to submit the claim with a GW modifier to indicate that the service is unrelated to the terminal disease for which the hospice election was made. The proposed issue will review DMEPOS claims that were submitted during a Medicare Part A covered hospice benefit period and will issue overpayments for any claims that were not submitted with a GW modifier.

If approved by CMS, the proposed issues for RAC review described above will join two existing O&P issues under RAC review: a complex review of custom-fabricated AFO/KAFO codes and a complex review of custom-fabricated spinal orthoses. CMS is likely to approve both proposed issues as a result of high error rates in claim reviews performed by DMEMACs and comprehensive error rate testing contractors.

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COVER STORY

CONNECTIONS O&P advocates are making a greater push for more favorable laws and regulations at the state level

By CHRISTINE UMBRELL

NEED TO KNOW MM O&P advocates are ramping up participation in grassroots initiatives at the state level, seeking to influence local lawmakers and push for legislation that will improve O&P patient care and protect the O&P profession.

MM Several states are considering new insurance fairness legislation that would ensure access to O&P care. An insurance parity bill was recently signed into law in Connecticut, and similar pushes are underway in Michigan, New York, and Pennsylvania.

MM Other states are considering new licensure laws: In North Carolina, advocates are studying successful licensure laws in Florida and Texas and are hoping to introduce legislation in the coming months.

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MM O&P professionals also are working on efforts to achieve more equitable reimbursement from state payors, engaging in educational initiatives and meeting with representatives of private and state insurers.

MM Given uncertainties at the national level regarding the future of health-care legislation, increased collaboration among O&P professionals and state advocates will be necessary to ensure clinicians are able to provide optimal patient care to those who need it.

COVER STORY

W

ITH UNCERTAINTY IN THE air regarding the future of federal health-care legislation and a renewed focus on the importance of having a voice in regional decision making, O&P advocates are harnessing the power of grassroots initiatives to fight for changes at the state and local levels.

A.J. Filippis, CPO

“It’s clear that things need to get done locally,” says A.J. Filippis, CPO, chief executive officer of Wright & Filippis in Rochester Hills, Michigan.

“Health care is regional.” Filippis notes that O&P advocacy is “not a political issue; it’s a patient-care issue, and a patient access issue.”

In addition to initiatives aimed at passing state licensure laws, O&P stakeholders in many areas are uniting in localized efforts to pursue insurance fairness laws, given the increasingly challenging reimbursement climate and too-frequent denials from payors.

“Why should patients be restricted from getting the components they need because of the health insurance they have?” says Filippis. “Insurance companies tend to look at orthotics and prosthetics in a vacuum. But these products are not a luxury to the patients. The components that patients receive helps return them to the activity level they had prior to the amputation.”

Jeremy Haines, grassroots advocacy coordinator at the Amputee

Coalition, has seen a “larger push into state advocacy efforts.” With the repeal of the Affordable Care Act’s individual mandate, pursuit of state waivers to enact work requirements for Medicaid recipients, and discussion of changes to coverage of Essential Health Benefits (EHBs) at the state level, it becomes increasingly important to understand and have a voice in state-level insurance and health-care regulations and laws, says Haines.

James Kaiser, CP, LP

“It always has been important to have a seat at the table,” explains James Kaiser, CP, LP, who is retired from a 40-year career at Scheck & Siress Prosthetics Inc. and currently serves as chair of the Illinois Society of Orthotists & Prosthetists (ISOP).

Kaiser is a strong advocate of getting involved in communities, civic groups, and local and state governments. “We must listen … and understand that even subtle moving targets in the current health-care system may impact patients’ access to qualified orthotic, prosthetic, and pedorthic (OPP) care.” And Kaiser, who advocated on behalf of the profession in securing the 2000 passage of licensure in Illinois and the 2009 Illinois Parity Act, believes the “OPP story” is “best seen through the eyes of the patient and supported by the O&P professionals.”

O&P ALMANAC | SEPTEMBER 2018

31

COVER STORY

durable medical equipment (DME),” he says. “Now my patients will be entitled to a higher cost benefit,” which may result in their paying lower out-of-pocket expenses to make up the difference between what is covered by insurance and what is not.

David Rooney, CPO

Jeremy Haines

Advocating for measures that will improve the lives of O&P patients and protect the O&P profession is “extremely important,” says Matthew Garibaldi, MS, CPO, president of the California Orthotic and Prosthetic Association (COPA) and associate clinical professor and director of orthotics and prosthetics at the University of California–San Francisco. “We have a responsibility to defend our profession against onerous mandates and changes that limit access to care and/or negatively affect the sustainability of business practices in our field,” he says. “Local advocacy groups can be proactive in nature, by enacting change that will improve the long-term outcome of their profession, ultimately improving the health of a population.”

With a renewed interest in grassroots activities, advocates in several states are embarking on initiatives to ensure the most appropriate patient care is conducted by qualified clinicians and is accessible to all.

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CONNECTICUT: First New Insurance Fairness Law Since 2013

One of the areas where O&P advocacy groups are making inroads at the state level is in pushes for insurance fairness legislation. Connecticut recently passed S.B. 376, An Act Concerning Health Insurance Coverage for Prosthetic Devices, which was signed into law by Gov. Dannel P. Malloy on May 25. This is the first state legislation passed since 2013 related to ensuring access to O&P care, and it signals a return to prioritizing state and grassroots engagement, according to Haines.

The grassroots push to bring the legislation to a vote was driven in large part by the Connecticut Amputee Network, led by amputees Herb Kolodny and Brenda Novak. The legislation earned bipartisan support, with 38 co-sponsors and unanimous passage in both the Connecticut House and Senate.

(See the sidebar on page 36 for details of how Connecticut S.B. 376 became law.)

The insurance fairness law is a huge win for patients in Connecticut, says David Rooney, CPO, owner and president of BioMetrics, which has three locations throughout the state. “It prompts commercial insurers to follow Medicare standards, and it distinguishes O&P from

PHOTO: Herb Kolodny

A group of Connecticut O&P advocates spoke at a Joint Insurance and Real Estate Committee hearing in March to push for S.B. 376, the state's insurance fairness legislation that was later signed into law. Back row: John Redfield, a below-knee amputee and Hanger Clinic marketing representative; Chris Scranton, a below-knee amputee; and Larry Dobitas, a below-knee amputee; front row: Gerry Schoolnick, a below-knee amputee; Herb Kolodny, an above-knee amputee and co-founder of the Connecticut Amputee Network (CAN); State Sen. Ted Kennedy Jr. (D), an above-knee amputee; Brenda Novak, an above-knee amputee and co-founder of CAN; Kimberly Eisen, PhD, a physical therapist; and David Mahler, chief prosthetic officer and former chief executive officer of NEOPS

Rooney says the involvement of O&P consumers played a significant part in persuading legislators to support the bill. “The impetus [for requesting insurance fairness legislation] is the quality of care and getting the care they need” when the “ask” comes from patients, says Rooney.

Rooney also is optimistic about a recent, but unrelated, change to policy impacting O&P clinicians: “The state of Connecticut is now accepting faxed detailed written orders, effective July 1,” he says. Previously, Connecticut was one of only two states that would not accept faxed versions—which meant longer waiting times for patients.

MICHIGAN, NEW YORK, AND MORE: Prime for Insurance Fairness Pushes

So far, 21 states have enacted insurance parity laws—with Connecticut being the most recent. The Amputee Coalition has prioritized an initiative aiming to pass insurance fairness laws nationwide, according to Haines. “We want to get these in all 50 states—to make sure they’re in place at the state level since we don’t know what will happen at the federal level.” The process reflects the goals of the Amputee Coalition’s 50-State initiative, to train and build a nationwide team of advocates to help lead and support state and local legislative and advocacy priorities.

Looking to the immediate future, two states have bills in progress that could be up for a vote in late 2018 or early 2019—one in Michigan and one in New York, says Haines.

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COVER STORY

AOPA Offers Support for State-Level Initiatives AOPA has several programs in place to assist O&P stakeholders with their regional and state-level advocacy initiatives.

• The State Reps Group is a coalition of members representing the interests of their states. Participants meet quarterly via conference call and annually in-person during the AOPA Assembly.

• The AOPA Co-OP (www.aopanet.org/resources/co-op) features state-specific pages noting top concerns and links to various state associations.

• The AOPA Key Contacts Program identifies individuals who may be willing to speak up about issues affecting O&P consumers (while remaining in full compliance with HIPAA regulations).

• A new Webinar Series, produced in conjunction with the Amputee Coalition, is scheduled to roll out soon. AOPA has partnered with the Amputee Coalition to provide live webinars focused on advocacy, with O&P consumers as a target audience.

The ultimate goal of many of these programs is to build stronger relationships with legislators, according to AOPA Executive Director Tom Fise, JD. It will be particularly impactful if patients who reside within states tied to key committee members become more involved in state-level advocacy, according to Fise.

Filippis, working with the Michigan Orthotic and Prosthetic Association (MOPA), is heavily involved in the effort to drive insurance fairness legislation in the state. He emphasizes the importance of coordination among O&P stakeholders. After some early miscommunications about the provisions being included in suggested bills, MOPA and the Amputee Coalition are working together to push forward legislation that meets the needs of patients and ensures credentialed practitioners provide O&P care. Two insurance bills have been introduced in Michigan: H.B. 6009 and 34

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H.B. 6085. Either bill would amend Act 218 of the Michigan Insurance Code to require coverage of O&P devices and services. Haines is hopeful that the Michigan legislation will be put up for a vote in the coming months.

In New York, two bills have been introduced advocating for insurance fairness for amputees in both houses of the legislature. A.B. 2212 and S.B. 2080 have been introduced and have received some bipartisan support. They currently are awaiting consideration before their respective chamber’s Insurance Committee.

Similarly, Pennsylvania O&P providers and the Pennsylvania Orthotic Prosthetic Society (POPS) are pursuing insurance fairness/prosthetic and orthotic parity to increase patients’ access to O&P care in the state. Plans are underway to introduce the bill in the fall. POPS is using similar language to New Jersey’s bill, Health Benefits Coverage for Orthotic and Prosthetic Appliances.

Beyond Michigan, New York, and Pennsylvania, the Amputee Coalition has identified 10 additional states where laws could be introduced or come to a vote, possibly in 2019: Alabama, Florida, Kansas, Kentucky, Minnesota, New Mexico, North Carolina, North Dakota, Ohio, and Washington. “We are engaging in a grassroots push to engage more people in these efforts,” says Haines. The goal is to “use stories to explain why we need fair and adequate insurance coverage, and also why licensure is important. … We’re building an army of advocates,” he says.

Jim Weber, MBA

While each state’s insurance fairness law is a little different, the Amputee Coalition focuses on three goals when advocating for these laws: First, the law should ensure that external prosthetic devices are treated and reimbursed in the same manner as internal devices—for example, that prosthetic knees are reimbursed just as internal knee replacements would be covered, says Haines. Second, the law should remove any arbitrary caps or restrictions on prosthetics—for example, remove one-limb-per-lifetime rules, Haines explains. And third, the law should ensure that the people who have the loudest voices about what is needed by a person with limb loss are the people with limb loss and their care providers—not the payors.

COVER STORY

How Patient Advocates Pushed Insurance Fairness Legislation in Connecticut

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Connecticut State Sen. Ted Kennedy Jr. (D), Herb Kolodny, and Brenda Novak that found that prosthetic intervention saves money in the long run and returns O&P patients to work.

While the law, which is slated to take effect January 1, is definitely a “win” for the O&P community in Connecticut, Kolodny says there is still more work to be done. “The question now is, ‘What do we do next?’” he says. He plans to work closely with Novak and others to create materials and schedule in-service visits to make sure new amputees and health-care professionals throughout the state know their rights and understand the new legislation.

PHOTO: Herb Kolodny

PHOTO: Joe Lemieux

Connecticut State Sen. George Logan (R) with Kolodny during an Insurance Committee meeting

Amputee Network (CAN) and help push the initiative forward. Novak is an above-knee amputee and co-founder of GoFireflyGo.com, an online travel platform for women. Their next step was to recruit “champions” in the state legislature. State Sens. George Logan (R) and Ted Kennedy Jr. (D)—an amputee himself—quickly joined the cause.

They soon discovered that an insurance fairness bill had been introduced and passed favorably through committee back in 2009, but it had never come to a vote. They drew from that legislation to push through S.B. 376, Insurance Fairness for Prosthetics, which passed unanimously out of both the House and Senate, and was signed into law on May 25, 2018.

The legislation “tells private insurance companies that have written policies in the state of Connecticut that they must cover prosthetic devices at a rate at least equal to Medicare— including microprocessor knees for above-knee amputees who are at least K-3 ambulators,” says Kolodny. “They also are required to cover repairs and replacement” and cannot institute “one-limb-per-life” rules, he says.

Kolodny attributes his team’s success to their determination; their commitment to spreading their message, in the form of radio and TV interviews and newspaper articles; the zealous and bipartisan support of their champions, Logan and Kennedy; additional advocacy from O&P clinicians, such as David Mahler, CPO, from New England Orthotic and Prosthetic Systems (NEOPS), and John Redfield from Hanger Clinic; and the fact that the legislation promoted “economic value,” he says. They shared with legislators the Dobson-DaVanzo study

PHOTO: Herb Kolodny

The recent victory in Connecticut of a new law promoting insurance fairness for prostheses resulted from a group effort involving O&P consumers, state-level legislators, and O&P clinicians—but it started with a decision to get active in local politics by one man, Herb Kolodny. An above-knee amputee since 2013 due to cancer, Kolodny was formerly an owner of a computer services business but is now retired— and has taken up “a new career as a full-time advocate for the limb loss community of Connecticut,” he says.

In 2017, Kolodny enrolled in “Partners in Policymaking,” a free program designed to teach people with disabilities and family members the power of advocacy to positively change the way people with disabilities are supported, viewed, taught, live, and work. He soon decided his “goal” would be to reintroduce insurance fairness law to the state of Connecticut. “I realized 20 other states had insurance fairness laws, and Connecticut was the only state in New England without insurance fairness,” he says.

Soon after, Brenda Novak partnered with Kolodny to found the Connecticut

Novak and Kolodny

COVER STORY

While patient stories are important, it’s also critical to involve O&P clinicians in these efforts. It’s much easier for states to influence state legislation or regulations when O&P professionals are organized in a state association or similar type of structure, says Jim Weber, MBA, AOPA president. “If you don’t have a state association, it becomes more cumbersome and harder to stay up on the latest topics,” he says.

NORTH CAROLINA: Pursuing Licensure

In North Carolina, O&P advocates are primarily focused on pursuing state licensure, according to Brittany Stresing, CPO, FAAOP, founder of Limbionics of Durham, North Carolina, and president of the North Carolina Chapter of the American Academy of Orthotists and Prosthetists. North Carolina is looking to become the 16th state to have licensure requirements in effect, motivated by a need to prevent encroachment.

Brittany Stresing, CPO, FAAOP

“We are seeing some slight creepover from other professions” within the state, given that parts of North Carolina are saturated with engineering and scientific professions, says Stresing. “So, we’ve started looking more closely at licensure as a way to protect the O&P profession and our patients from unqualified providers providing care.” Stresing and other representatives of the chapter have met with an attorney and are in the process of identifying which legislators to approach to champion the effort.

Stresing says her group has been looking at licensure states as examples, Florida and Texas in particular. They are examining “lessons learned” from some of the earlier efforts, and writing their bill in such a way as to ensure the

North Carolina licensure proposal isn’t overly strict and that licensure will carry over from state to state should a clinician move.

Stresing is hopeful the effort will find a champion in Congress later this year or in early 2019. “We’re trying to get more individuals active in the effort,” she explains. “We have an influx of young, smart practitioners, but they’re slower to get active in committees and organizations. Yet, they’re the ones who will be the most affected by these things since they have most of their careers left.” She encourages more young people to get involved in advocacy efforts—“even if it’s just sitting on a committee and listening.”

ILLINOIS AND CALIFORNIA: Seeking More Equitable Reimbursement

Kaiser and his team at ISOP are working on a number of efforts to secure increased patient access to quality care and more reasonable reimbursement

O&P ALMANAC | SEPTEMBER 2018

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COVER STORY

in Illinois. Currently, Illinois Medicaid, which is administered by nine managed care organizations (MCOs), reimburses at 80 percent of the Medicare level. “MCOs, Medicare, and private insurance continue to restrict more functional options due to cost,” explains Kaiser. “The concept of improved outcomes is hardly a consideration when MCOs clearly state they want the patient to receive a ‘basic’ or ‘regular’ prosthesis in their reason for denial. Denials override the ordering physician’s prescription—that can put patients at risk and increased liability to the provider if the care is not provided.”

On the West Coast, the “primary focus” for COPA is addressing reimbursement rates for state-funded health care in California, according to Garibaldi. “Our data shows that over the last 16 years, Medi-Cal reimbursement for 75 codes has decreased by an average of $50, while 517 codes have remained unchanged in that same period,” he says. “If nothing is done, and this trend is allowed to continue, it will severely impact the long-range sustainability of O&P care facilities in California. This will greatly impact the most vulnerable patient population in California—children and adults with limited income and resources.”

Matthew Garibaldi, MS, CPO Garibaldi notes that it’s particularly important for stakeholders in his state to advocate for important O&P issues.

“California is the largest provider of O&P services in the country, so, as the landscape of O&P changes, our state serves as a good barometer for what’s to come,” he explains. “That said, we have a huge responsibility to stay abreast of pending changes and to engage our lobbyist regularly on behalf of practitioners and their patients.”

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with payors and regulators regarding reimbursement challenges and explain the economic value of O&P intervention. In Michigan, O&P advocates are meeting with insurance companies to address these issues, says Filippis.

Payors “need to look at overall costs that come when O&P patients don’t get the devices they need,” he says. Similar efforts are underway in many states across the country.

ALL 50 STATES: Persistence, Education, and Cooperation

All of these initiatives are being driven at the state level by clinicians and consumers who dedicate their time and energies to advocating on behalf of the profession and O&P patients. For these efforts to be successful, O&P stakeholders must strive to educate “legislators, payors, referral sources, and patients what custom OPP care offers to patients with life-long life-altering events— independence, function, mobility, and self-esteem with achieving new goals,” says Kaiser.

Kaiser also notes that it’s important to keep pushing to ensure patients have access to quality care from qualified providers and fair insurance coverage based on the medical/ surgical plan benefit coverage. He encourages O&P clinicians to overcome “professional OPP apathy” and to work to become “one voice” of the OPP professionals.

Looking to the future, Filippis advocates for more collaboration—for associations and O&P companies to work more closely to focus on what is needed for the patient: “providing a quality product at a reasonable and fair reimbursement.”

Garibaldi also calls for increased cooperation and partnerships. “For state-based associations to survive and continue to be effective, formalized partnerships with national bodies are required,” he says. “State associations serve well to address important local issues, but, due to limited influence and funding, they’re unable to enact important changes that have a national impact. Partnering statebased associations with such groups as the American Medical Association, American Academy of Orthopaedic Surgeons, and, of course, AOPA will be critically important for the sustainability of our profession.”

O&P advocates agree that the most important goal going forward should be to provide optimal patient care.

“My historical philosophy is, ‘If we first do what is best for the patient, it will ultimately also be best for the OPP practitioner, practice, and profession,’” says Kaiser.

The good news is that, despite the challenges to the O&P profession at all levels of government, “my crystal ball shines bright for our OPP profession,” says Kaiser. “The new generation of practitioner, from the diverse master’s program graduates, have more social awareness than ever, more knowledge to utilize social media to tell the OPP story, more energy to challenge injustice in medical policy, and a desire to support the best interest of patients.”

Christine Umbrell is a contributing writer and editorial/production associate for O&P Almanac. Reach her at cumbrell@contentcommunicators.com.

By DEBORAH CONN

Thought

LEADERS

AOPA will recognize award-winning clinical and business presentations during the Thranhardt and Hamontree Award sessions at the 2018 National Assembly

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T

HE AWARD PRESENTATIONS at

the AOPA National Assembly are one of the highlights of the annual conference, recognizing groundbreaking studies by highly regarded O&P professionals. This year, the awards session will feature six presentations—two Thranhardt award winners, recognized for their important research studies, and four Hamontree nominees, selected for their innovative business strategies.

This year’s Thranhardt presentations will offer the latest clinical information, with honorees presenting the results of their in-depth research endeavors—one focusing on lowerlimb prosthetics, and the other on cranial remolding orthoses. And the Hamontree session is full of innovative ideas and “best” business practices—centering around topics to improve facility efficiencies, revamp claims management procedures, boost company culture, and more.

Thranhardt Winners Microprocessorcontrolled prosthetic ankles and of SHOW cranial remolding orthoses are the focus of the presentations recognized with Thranhardt Awards for 2018. During the 8 a.m. Thranhardt Lectures Series session on September 27, Brian Kaluf, BSE, CP, FAAOP, and Tiffany Graham, MSPO, CPO, LPO, will present findings of their separate studies.

Created 23 years ago in honor of Howard R. Thranhardt, CP, the Thranhardt Award recognizes research that advances the O&P profession. This year’s winners focused on clinical studies designed to gain real-world outcomes data in an effort to both improve clinical practice and demonstrate efficacy to insurers. Winners of the Thranhardt recognition receive an award of $500 each.

BEST

NEED TO KNOW • The presentation of Thranhardt and Hamontree Awards during the AOPA National Assembly in Vancouver provides an opportunity for conference attendees to gain exposure to high-level clinical and business presentations.

• The two 2018 honorees of the Thranhardt Award, which was created in honor of Howard R. Thranhardt, CP, and recognizes research that advances the O&P profession, will give their award-winning presentations on Friday, September 27, at 8 a.m.

• Brian Kaluf, BSE, CP, FAAOP, will discuss new research on the benefits associated with microprocessor and energy-storing prosthetic ankles.

• Tiffany Graham, MSPO, CPO, LPO, will share her findings on the factors influencing the effectiveness of cranial remolding orthoses.

• Four O&P professionals have been nominated for the Sam E. Hamontree, CP(E), Business Education Award, and will present papers on Saturday, September 28, at 10 a.m.

• The Hamontree contenders will share best business practices in the areas of contract negotiations, claims management, organizational culture, and the perception of O&P professionals as health-care professionals.

MicroprocessorControlled Ankles: Brian Kaluf, BSE, CP, FAAOP Kaluf and his team members, including Ashley Duncan, EP-C, and William Bridges, PhD, conducted a large-scale assessment of the benefits of advanced prosthetic technology in their study, “Comparative Effectiveness of Microprocessor and Energy-Storing Prosthetic Ankles: Patient-Reported Outcome Measures.”

Brian Kaluf, BSE, CP, FAAOP “We recognized the need to establish evidence for patients and practitioners to make more informed decisions as to which devices benefit patients the most,” says Kaluf. His team, which included several Ability Prosthetics & Orthotics practitioners, enrolled 23 unilateral transtibial amputees in a randomized crossover protocol using two ankle-foot prostheses: the Pacifica LP energy-storing and -returning (ESAR) device, and Kinnex from Freedom Innovations, a microprocessor-controlled ankle-foot prosthesis (MPA).

The goal of the research, according to Kaluf, was a clinically relevant study that could be implemented in ordinary practice locations, rather than in advanced laboratory settings—allowing researchers to recruit nearly double the number of participants of previous studies. “We were able to arrive at some statistically significant findings that smaller studies in laboratory settings struggled to achieve,” he says.

Each participant used the fixed-ankle Pacifica LP ESAR and the Kinnex microprocessor ankle for four weeks in a randomized order before testing.

O&P ALMANAC | SEPTEMBER 2018

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Researchers used patient-reported outcomes, functional tests, and video analysis to assess mobility, balance, and gait quality walking on a 15-degree sloped ramp.

The Kinnex MPA demonstrated higher patient-reported outcomes for mobility and socket comfort, the study found. Knee and ankle angles were more stable while standing on a ramp, and knee angles were more stable walking down a slope. Patients did report negative comments, largely related to the additional weight and battery life of the MPA. “The study will have a large impact on patient access to technology,” says Kaluf. “Currently, most policies exclude microprocessor ankles as experimental, citing low numbers of subjects and study endpoints not relevant to the real world. That was one of our motivations for designing a patient-centric and clinically relevant trial, instead of a more traditional gait lab study.”

Kaluf observes, “Payors are more likely to cover technology with the benefits we saw—improved mobility and greater socket comfort walking on slopes—and that benefits all parties: patient, practitioner, and payor.”

Cranial Remolding Orthoses: Tiffany Graham, MSPO, CPO, LPO Graham’s award-winning study, “Significant Factors Influencing the Effectiveness of Cranial Remolding Orthoses in Infants With Deformational Plagiocephaly,” was inspired by the lack of reimbursement for such devices by Texas Medicaid.

Graham is a clinician and instructor at the University of Texas Southwestern Medical Center in Dallas.

“I have a background in clinical work,” Graham says, “and this study is part of an effort to improve what’s out there and potentially have outcomes

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evidence for insurers. In addition, by understanding how different factors influence treatment outcomes, practitioners can make more informed decisions about who would benefit from cranial remolding orthosis treatment.”

The study began in 2016 with two years of data collection from three Texas offices of Level 4 Prosthetics & Orthotics, Graham’s former employer.

She and several students analyzed outcomes data from 499 infants who were treated for plagiocephaly with remolding helmets, looking at the age of treatment inception, presence or absence of torticollis, and whether the infants were premature.

Tiffany Graham, MSPO, CPO, LPO

Using statistical analysis tools, the researchers found that the age treatment began, the severity of the deformation, and the presence of torticollis were significant factors in evaluating how long treatment should last to achieve a satisfactory outcome.

“Prematurity did not significantly affect treatment duration when we corrected for it,” notes Graham, who subtracted the number of weeks the infant was premature from his or her age.

She and her colleagues found that torticollis did not affect the outcome but did require a longer duration of treatment.

“Based on the results of this study, practitioners can expect infants who are older, with more severe deformity, and/or who have torticollis, to need

a longer duration of treatment with a cranial remolding orthosis,” says Graham. She has already begun the next step in this research, which is to extend the retrospective chart review to 500 subjects to study asymmetrical brachycephaly.

In addition, Graham just received funding from AOPA to do a repositioning versus remolding trial. Such a study is tricky, she says, because in the United States, treatment may not be denied to create a control group. A non-U.S. randomized, blinded control trial published in the British Journal of Medicine found no difference in end results between repositioning and remolding; however, in Graham’s clinical practice, she reports she has seen far more improvement through remolding than was reported in that trial.

Graham’s study will begin with infants at two months old, when they are too young to receive an orthosis.

“Those with a deformational head shape, as evaluated by a physician, will be started with repositioning.

Infants who still show deformation at four, five, and six months will be given the option to go into a helmet,” she explains. “We’ll analyze results at one year on all the patients, using a 3-D scanner, and those for whom repositioning worked will stay in that group, while others may decide to move to a remolding orthosis.”

Graham expects to have about 100 subjects in the pilot trial and hopes it will serve as a springboard for a larger study, which would allow her to match head shapes to gain further information.

She says she is fortunate to be in a situation that allows her to combine clinical work with research. “As a field, we are getting better at research,” she says, “and I hope to encourage research in the next generation of O&P practitioners.”

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Hamontree Business Education Honorees Chris Field, MBA, Lesleigh Sisson, CFom, Kenneth Gavin, BUSINESS ABSTRACT MEd, CO, and Frank Bostock, CPO, FAAOP, will be recognized during the Sam E. Hamontree, CP(E), Business Education Award session, scheduled to take place on Friday, September 28, at 10 a.m.

Their presentations focus on specific business strategies to build relationships with payors, prevent claim denials, improve company culture, and elevate the role of O&P professionals among health-care professionals.

The Hamontree Award was created as a counterpart to the Thranhardt prize to recognize the best business paper submitted for presentation.

Once the four nominees have given their presentations in Vancouver, conference attendees will be encouraged to vote on the best presentation to be recognized as the award winner.

BEST

Chris Field, MBA

Special Recognition

In addition to the Thranhardt and Hamontree Awards, additional recognitions will take place during the AOPA National Assembly in Vancouver. These awards will be presented during the Membership Meeting on Friday, September 28, from 7:15 to 8 a.m.

Lifetime Achievement Award

C. Michael Schuch, CPO, FAAOP, FISPO

Each year AOPA presents the Lifetime Achievement Award, bestowed on individuals who have made significant contributions to the O&P field. The AOPA Board of Directors has named C. Michael Schuch, CPO, FAAOP, FISPO, as the recipient of the 2018 Lifetime Achievement Award.

Ralph R. “Ronney” Snell, CPO, FAAOP, Legislative Advocacy Award

Denise Hoffmann Pam Lupo, CO

This award recognizes individuals who have made valuable contributions toward advancing the legislative and regulatory goals of the O&P field by motivating members of Congress and other decision makers to take action on behalf of O&P. The 2018 award winners are Denise Hoffmann and Pam Lupo, CO.

Student Poster Awards Contract Negotiations: Chris Field, MBA

Field, who is chief financial officer at Boas Surgical in Bethlehem, Pennsylvania, will speak on “Successful Contract Negotiations.”

His presentation will focus on a process that has been successful for his company in working with insurers.

“The proposition is basically that the insurance company has to recognize the value of what we are doing so that we can be paid fairly for the products and services we offer,” he says.

He emphasizes educating insurers and fostering a nonadversarial relationship. For example, Field explains

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The Edwin and Kathryn Arbogast Award and the Otto and Lucille Becker Award will honor two meritorious scientific papers submitted for presentation as a poster at the 2018 AOPA National Assembly by a student or resident. The purpose of these awards is to encourage students and residents to share their research through outstanding poster presentations. This year’s winner for the Arbogast Award is Katherine Ching of the University of Pittsburgh. The Becker Award will be presented to Peter Zenger of the University of Pittsburgh.

team, management, and owners,” she says, including due dates, claim information, follow-up tasks, appeals tracking, and outcomes.

“It is estimated that 90 percent of denials are preventable, and that two out of three denials are recoverable,” says Sisson. “Business owners and managers in our profession simply need the proper tools to help them succeed financially.”

Organizational Culture and Brand: Kenneth Gavin, MEd, CO

how one invitation to an insurance representative to visit his office and learn more about the value of the company’s offerings resulted in a beneficial contract. Field also notes that laying the groundwork for a positive relationship may not yield immediate results but will contribute to a longterm connection.

“The most important point is that insurance contracting must be a win-win situation,” he says. “Insurance companies have to realize the value we bring to them and their patients and be willing to pay fairly for that.”

Claims Management: Lesleigh Sisson, CFom

Sisson is the founder of the consulting firm O&P Insight and an owner of Prosthetic Center of Excellence, based in Las Vegas. Her paper, “Top 10 Ways To Get and Keep Your Money,” is a summary of best practices in claims management, which she has learned through her experience over the years.

“What I’ve found throughout my travels is that many O&P business owners and managers are so busy taking care of patients that they often miss the necessary steps to ensure their billing processes are efficient,”

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Lesleigh Sisson, CFom she says. “Thorough patient intake and accurate data entry are imperative.

One small error or omission can cause significant issues in getting a claim paid properly.”

Common errors that may seem insignificant—but often cause headaches during the reimbursement process—include misspelled names and lack of verification of patient eligibility at the time of service. Sisson recommends checking for the same or similar device information with the durable medical equipment Medicare administrative contractor or other insurers.

Sisson emphasizes transparency in denials, audits, and appeals. “Whether in your billing software and clearinghouse tools, or on a shared, secured spreadsheet, all activity should be visible to the accounts receivable

Gavin’s paper, “Organizational Mission Possible: Top 10 Developmental Impacts With Increasing Employee Engagement and Lean Strategies,” discusses ways to affect the culture of a practice to improve financial and clinical success. “Leaders can help shape a positive culture of their organization by building their brand—which is who you are and why you matter—and the mission, values, and purpose of the organization and its people,” Gavin says.

“Studies show that leaders who inspire employees are considered great leaders,” he says, “and expressing the values of the organization in a unique style will gain their attention.”

Gavin recommends using such continuous improvement management models as lean business practices, where an organization identifies what truly adds customer value and what should be eliminated, and A3, a process

Kenneth Gavin, MEd, CO

to engage in group-based problem solving. He also notes that effecting successful change requires three major elements: “a burning platform (or a reason why the status quo is untenable), a compelling vision for the future, and a strong and safe bridge connecting the two. Consider these elements before change, and you may avoid transformational disaster.”

Elevating Clinicians as Health-Care Professionals: Frank Bostock, CPO, FAAOP

Bostock, vice president of the Southwest region for Hanger Clinic, will present on, “Certified Orthotists and Prosthetists: Product Supplier or Knowledge-Based Health-Care Professional?” He plans to speak on how to change health care’s perception of O&P professionals.

“From our perspective, O&P certified practitioners are knowledge-based health-care professionals, whose practice requires a master’s degree,

Frank Bostock, CPO, FAAOP residency, and national certification,” he says. “Unfortunately, many referral sources and health-care payors do not see us that way. They view us as product suppliers.”

The reason, Bostock says, is that O&P clinicians are reimbursed using product codes from the Health-Care Common Procedure Coding System (HCPCS codes) rather than current procedural terminology codes (CPT codes) used by other health-care providers for patient-care services.

He suggests educating payors on the value-added patient-care services O&P clinicians provide to their patients, beyond just the products the patients receive.

“We have seen a continual expansion of the scope of practice with other health-care providers, such as podiatrists and physical therapists, that use both CPT and HCPCS codes in the care they provide their patients, but O&P is still defined by the products it provides because it is viewed and paid as a provider of products versus a health-care professional that provides both products and patient-care services,” he says.

Bostock recommends adding curricula to the O&P master’s programs that provide O&P students with additional patient-care skills, such as gait training and wound care management. “This would enable them as orthotists and prosthetists to expand their scope of practices to include value-added patient care services,” he says.

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

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PASSPORT TO THE

EXHIBIT HALL

Everything you need to know about exhibitors, sponsors, and special events planned for the trade show floor during the 2018 AOPA National Assembly

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Assembly Sponsors................

Meet the exhibitors that have signed on as title sponsors for the 2018 AOPA National Assembly

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Exhibit Hall Map.....................

Navigate the show floor using this handy floor plan Exhibitor Directory................

Access a complete, alphabetical listing of the exhibitors and their booth numbers

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2018

AOPA NATIONAL ASSEMBLY

HE EXHIBIT HALL AT the Vancouver Convention Center will serve as your “passport to innovation” as you browse the hundreds of exhibits, demonstrations, and special events scheduled to take place September 26-29. By travelling to this unique destination to celebrate the 2018 AOPA National Assembly, you will be rewarded with many opportunities to acquaint yourself with the latest O&P products and services; network with business owners, managers, clinicians, researchers, and a wide range of key O&P stakeholders; and take part in cuttingedge educational sessions, award presentations, and keynote speeches.

Whether or not you choose to take advantage of the special travel opportunities preceding the Assembly—such as one of the Alaska cruise specials

NATIONAL ASSEMBLY EXHIBIT HALL

offered by AOPA in conjunction with AlaskaBySea—you will kick off your on-site experience with the Welcome to Vancouver Grand Opening Reception, Wednesday, September 26, 5:30 to 7:30 p.m. At this special evert, you will get your first introduction to the cutting-edge exhibits hosted by U.S., Canadian, and international O&P companies. See the latest in O&P innovation and talk with representatives from exhibiting companies to find out how you can leverage the newest products to provide optimal patient care.

Plan to catch up with old friends and forge new partnerships during the special events scheduled to take place on the Exhibit Hall floor throughout the Assembly—including daily coffee breaks and lunches on Thursday and Friday. And don’t miss the ever-popular Exhibitor-Sponsored Happy Hour, scheduled for 5 p.m. on Friday, September 28. Attendees will enjoy refreshments while networking with colleagues and exhibitors.

In between visits to the trade show floor, be sure to take part in additional opportunities to immerse yourself in the O&P ecosphere. Attend the keynote presentations on Thursday and Saturday to find out how two O&P innovators—“Monster” Mike Schultz and Tobie Hatfield—were inspired to introduce new products to market.

Wear your grooviest ’70s threads to celebrate at this year’s “Party With a Purpose,” the annual AOPA Political Action Committee fundraiser. Listen in during the Thranhardt Lecture series, to hear the latest clinical breakthroughs, and the Hamontree Business Education sessions, to vote for your choice of “best” business presentation.

With so many special events planned for the Vancouver Convention Center—and the Exhibit Hall in particular—you will want to plan your itinerary now. Be sure to set aside several hours to browse the aisles, meet with representatives from exhibiting companies, and interact with like-minded O&P professionals from across the world.

Keep these O&P Almanac pages handy to help guide your trip.

DON’T MISS THESE SPECIAL EVENTS IN THE EXHIBIT HALL Welcome to Vancouver Grand Opening Reception, Wednesday, September 26, 5:30 – 7:30 p.m.

Lunch in Exhibit Hall, Thursday and Friday, September 27 and 28, Noon – 1:30 p.m.

Coffee Break in Exhibit Hall, Thursday, Friday, and Saturday, September 27, 28, and 29, 8:30 – 10 a.m.

Exhibitor-Sponsored Happy Hour in Exhibit Hall, Friday, September 28, 5 – 6:30 p.m.

STEP IT UP CHALLENGE Participate in a three-day Step It Up Challenge! Each day attendees can track their steps via phone, separate app, fitness tracker, pedometer, etc. Participants must post a picture of their daily steps by 6:30 p.m. each day in the Activity Feed of the AOPA 365 app or present their data to the Step it Up race headquarters, located right outside the Exhibit Hall. Sign up for your chance to win daily cash prizes and a chance to win the Grand Prize—a Fitbit Ionic! *Exhibitors can participate but do not qualify for prizes.

Sponsored by MD Orthopaedics Booth 1132

O&P ALMANAC | SEPTEMBER 2018

49

AOPA NATIONAL ASSEMBLY

SPONSORS

2018

Sponsors preview their exhibits and share their visions for the future of O&P Download the “AOPA 365” App Use your smartphone to navigate the Assembly. Download the “AOPA 365” App on your iPhone, Android, or iPad: • Easily view the agenda and set up your own personal schedule • Earn extra CE Credits by taking quizzes for Free Paper Sessions • Vote for Hamontree Contenders • Interact with colleagues • Share photos and comments • Search for speakers and specific topics • Navigate the Exhibit Hall • Review speaker bios • Learn about AOPA • Read the O&P Almanac and O&P News • See how membership has its benefits • Get current with hot issues • Learn how Mobility Saves • Visit the AOPA Bookstore • Access the AOPA Membership Directory.

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SEPTEMBER 2018 | O&P ALMANAC

Allard USA

Allard USA’s participation in and sponsorship of the 2018 AOPA National Assembly is driven by a longstanding relationship between the two organizations. Allard USA has been an AOPA member since the company opened its doors in Rockaway, New Jersey, in 2005, says Diane Beesley, marketing manager.

“AOPA has vigorously, aggressively, and successfully continued pursuit of [its] mission ‘to work for favorable treatment of the O&P business in laws, regulation, and services; to help members improve their management and marketing skills; and to raise awareness and understanding of the industry and the association,’” explains Beesley.

Allard USA is excited to be a part of the Vancouver event, where the company will showcase its continued efforts to provide “Support for Better Life,” according to Beesley. She is anticipating a bright future for the O&P community: “As millennials enter the O&P field, they will bring innovation and technology to the industry. This will not only transform the way we communicate, but will impact the way products and services are delivered.”

ALPS South LLC

ALPS’s sponsorship and participation in this year’s AOPA National Assembly in Vancouver is important “because it allows us to support and recognize professionals throughout the world and offers the opportunity to broaden our presence within the industry,” says Shannon Samon, vice president of operations at ALPS. Samon believes that the ongoing advancements of O&P technology and the opportunity to make individual lives better bode well for an exciting future for O&P.

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

The presence of the American Board for Certification in Orthotics, Prosthetics, and Pedorthics (ABC) at the AOPA National Assembly is important “not only for the certified attendees at the event, but to show our

NATIONAL ASSEMBLY SPONSORS

continued support of the work that AOPA does on behalf of the profession,” says Debbie Ayres, ABC director of public relations and marketing.

ABC is excited about the progress the profession has made over the past two decades, according to Ayres.

“The elevation of practitioner educational standards, the increased use of evidence-based practice and validated outcome measures into daily practice, as well as the recognition that facility accreditation is the baseline for assuring quality care points to the continued advancement of the profession,” she says.

Exhibit Hall Hours www.bocusa.org

Thursday, September 27 8:30 a.m. – 5 p.m.

Board of Certification/ Accreditation

Championing the O&P profession has been a priority at the Board of Certification/Accreditation (BOC) for more than 30 years. “Participating in the Assembly is always a highlight of our year,” says Wayne R. Rosen, BOCP, BOCO, FAAOP, BOC board chair.

“As I lead BOC in my role as board chair, I am excited to join with AOPA and our other O&P Alliance co-members, as we work together to unify the O&P community,” says Rosen, who believes the future of O&P will be rooted in collaboration: “We all help one another and our patients by providing meaningful opportunities for education, sharing resources for compliance, and staying committed to our ultimate goal … providing exceptional patient care.”

Cailor Fleming Insurance

As the exclusive insurance program for AOPA, “it's imperative that we have a presence at any events AOPA puts on, so all the members are fully aware

Wednesday, September 26 5:30 – 7:30 p.m.

Friday, September 28 8:30 a.m. – 6:30 p.m.

Saturday, September 29 8:30 a.m. – Noon

of one of AOPA's signature member benefits,” says Donald Foley, principal/ program specialist at Cailor Fleming Insurance. AOPA members qualify for discounted rates—“and in this day and age, pricing is ever so important,” Foley says. “Service and quality are prerequisites, and due to rising costs of running an O&P practice, pricing has never mattered more.” The company also has exclusive endorsements from the American Board for Certification in Orthotics, Prosthetics, and Pedorthics, as well as the Board of Certification, plus many state chapters of the American Academy of Orthotists and Prosthetists, according to Foley, “so Cailor Fleming needs to be there for all our clients, from the practitioner, to the manufacturer, and the central fabs, too.”

The future of O&P will likely include artificial Intelligence (AI) and sensor technology, says Foley. “I truly

believe the sky is the limit with AI, but while this excites me the most [about the future of the profession], it also scares me the most. We have opened up Pandora’s box, and nobody seems to know where this will take us.”

Endolite

Endolite is part of the Blatchford Group, a rehabilitation provider with 125 years of innovation and expertise in lower-limb prosthetic technology.

The staff at Endolite believes it is important for the company to be a sponsor of and participate in the AOPA National Assembly each year. The company will showcase several products in the Exhibit Hall this year.

O&P ALMANAC | SEPTEMBER 2018

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NATIONAL ASSEMBLY SPONSORS

O&P Almanac

O&P Almanac, The Magazine for the Orthotics & Prosthetics Profession, is the official magazine of the AOPA National Assembly. Each month, O&P Almanac features the latest O&P news, hot topics, research roundups, reimbursement information, compliance updates, and in-depth feature articles surrounding the latest trends in the profession. Look for your complimentary copy of the September issue in your attaché bag.

Attendees interested in O&P Almanac subscriptions, editorial, or general information about AOPA publications should stop by the AOPA Booth, #302 in the Exhibit Hall.

Solutions. Touch Bionics by Össur also will be on display, with the i-limb™ and i-digits quantum. Other highlights from Össur include its OA and Injury Solutions bracing line. The Unloader® line of osteoarthritis bracing features the Unloader One® knee brace and the Unloader hip brace. And Össur’s growing line of Rebound® Injury Solutions features the lightweight Rebound DUAL ligament knee brace and the new Rebound Post-Op Knee. In addition, the FormFit® Pro range will be on display, with breathable support technology and precision-engineered 3D knit. Össur is a forward-thinking, innovative company that will advance noninvasive orthopedic products, according to Heather Hoover and Tabi King. The company strives to provide the best patient outcomes and continuously improve its products through innovation. “We are looking forward to helping practitioners provide cutting-edge technology to help their patients live Life Without Limitations®,” says King.

Össur

At this year’s AOPA National Assembly, Össur®, a global manufacturer of noninvasive orthopedics, plans to highlight the Pro-Flex® LP Align, Pro-Flex XC Torsion, and Pro-Flex LP Torsion additions to its Pro-Flex® family of prosthetic feet; the weatherproof RHEO KNEE® and RHEO KNEE XC; and the company’s full line of Low-Activity 52

SEPTEMBER 2018 | O&P ALMANAC

Ottobock

Ottobock approaches the AOPA National Assembly from a supplier member’s perspective, and sees the conference as “the oldest and only

truly authentic annual trade show covering our profession,” according to Brad Ruhl, president of U.S. health care and NA prosthetics for Ottobock HealthCare. “The fact that there is both a scientific and a business educational track offered at this event means that the National Assembly is delivering the most comprehensive education and training program available in one place at one time in North America— regardless of whether it’s being held in Canada or in the U.S.,” he says.

The rapid and continuous development of new technologies into the O&P field is unparalleled in our history, says Ruhl. “The increased use of advanced electronics and hydraulics, active-powered systems, neural control, smart materials, and 3-D printing allows us to fully enter the age of bionics: the true man-machine interface,” he says. “The challenge we face is how to bring these technologies to the market in a way that is both efficient and cost effective so that end users who will benefit most from them will ultimately have access to them.”

RUSH Foot®

RUSH Foot, a PROTEOR Company, “is always proud to be part of the AOPA National Assembly conferences,” says Holly Sanger, director of marketing.

“In our unique industry, we believe it is vital to stay in front of the trends, bring awareness to new innovations, and network with peers and customers, with the end result being to benefit the end users by allowing them to live the life they love—#HumanFirstAlways.”

On the research and development side, the future holds many fascinating and life-altering innovations to improve the life of end users, says Sanger. “We are happy to be one of the attending exhibitors to be leading that charge,” she adds. “No one should be held back by limitations, and we aim to continue development of products to improve quality of life for all.”

NATIONAL ASSEMBLY SPONSORS

Spinal Technology Inc.

Spinal Technology Inc., a leading central fabricator in spinal orthotics since the early 1990s, has “always recognized the importance of sponsoring AOPA and participating in annual National Assemblies,” says Jim Tierney, the company’s president and owner. Representatives of Spinal Technology plan to leverage their time at the Assembly connecting with customers and meeting new practitioners, according to Tierney. This year’s venue, in Vancouver, Canada, “brings together a wider variety of members to advance their knowledge and showcase the latest technologies in our industry,” he says.

Looking to the future, Spinal Technology anticipates “the integration of education, technology, and advanced methodologies to achieve the most beneficial patient outcomes possible,” says Tierney.

the O&P field “an exciting place to be,” with more innovation on the horizon. “We could likely see a rapid advancement in the quality of care we are able to provide to our community, brought about by a confluence of external influences like increased focus on outcomes and evidence-based

research, new product and service technologies, and collaboration with other fields to provide new solutions to existing problems,” says Arbogast.

“There will surely be significant challenges to come as well, but I feel that we have the opportunity to level the playing field like never before.”

2018 SPONSORS Double Diamond Sponsor

Diamond Sponsors

Platinum Sponsors

Gold Sponsors

www.bocusa.org

Silver Sponsors

WillowWood

A long-time contributor to the AOPA education program, WillowWood “is dedicated to helping clinicians be the best they can be in serving their patients,” says Linda Wise, the company’s chief marketing officer. “Each year we take pride in bringing the research we have performed over the past year to the AOPA Assembly in the hope that it will have a global impact in driving the industry forward. Our Diamond sponsorship supports AOPA in bringing a showcase event to beautiful cities such as Vancouver for health-care professionals to learn, explore, and be part of something special.”

Ryan Arbogast, WillowWood owner and chief executive officer, labels

Supporting Sponsors Apis Footwear Co. Aspen Medical Products Becker Orthopedic Appliance Co. Cascade Dafo Cascade Orthopedic Supply Inc. Click Medical Coapt LLC College Park Industries Comfort Products Inc. Fillauer KISS Technologies LLC LegWorks

MD Orthopaedics Inc. Naked Prosthetics OPAI PEL ProsFit Technologies JSC Pro-Tech Orthopedics Protosthetics SPS Surestep Tamarack Habilitation Technologies Inc. Townsend Design/Thuasne USA

O&P ALMANAC | SEPTEMBER 2018

53

2018

AOPA NATIONAL ASSEMBLY

EXHIBITOR DIRECTORY

O

N THE FOLLOWING PAGES is an advance look at the companies that will be exhibiting at the 2018 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!

Slap Shot Hockey Game BROADBAY/ STREIFENEDER ORTHO.PRODUCTION

Cailor Fleming Massage & Relaxation Station

indicates the exhibitor is a Supplier Plus Partner with AOPA. indicates new exhibitor for 2018.

Exhibitors as of Sept. 5, 2018.

American Academy of Orthotists & Prosthetists (AAOP) ................. 544 www.oandp.org American Board for Certification in Orthotics, Prosthetics, & Pedorthics (ABC) ...................... 538 www.abcop.org

ACOR Orthopaedic Inc. .............. 1221 www.acor.com Allard USA Inc. .......................... 518 www.allardusa.com

American Central Fabrication ... 1206

American Orthotic & Prosthetic Association (AOPA) ...................... 302 www.aopanet.org Alps South LLC .............................. 702 www.easyliner.com

Alternative Prosthetic Services Inc. ................................... 1138 www.alternativeprosthetics.com 54

SEPTEMBER 2018 | O&P ALMANAC

American Prosthetic Components LLC ........................... 632 www.apcomponents.com AMFIT Inc. ....................................... 714 www.amfit.com

PRIVATE MEETING ROOMS

Bold listings indicate the exhibitor is a member with the American Orthotic & Prosthetic Association (AOPA).

LIM INNOVATIONS

MARTIN BIONICS

EXHIBITOR HALL MAP 2018

VANCOUVER CONVENTION CENTER EXHIBIT HALL 2018 FLOOR PLAN

TECH FAB CONTEST

STANDARD CYBORG

ÖSSUR AMERICAS INC.

OPIE SOFTWARE

HALL B

822 BECKER ORTHOPEDIC

NABTESCO & PROTEOR/ RUSH FOOT

ALPS SOUTH LLC

2018 PROSTHETIC EDUCATION SPONSOR

DAW INDUSTRIES INC.

O&P ALMANAC | SEPTEMBER 2018

55

EXHIBITOR DIRECTORY 2018

College Park Industries ................ 402 www.college-park.com Comfort Products Inc. ................... 917 www.comfortoandp.com Coyote Design & Mfg. Inc. .......... 1022 www.coyotedesign.com Cranial Technologies Inc........... 646 www.cranialtech.com Create O&P ................................... 1202 www.createoandp.com Cypress Adaptive LLC .................. 334 www.cypressadaptive.com DAW Industries Inc. .................... 1302 www.daw-usa.com

Amputee Coalition ...................... 1306 www.amputee-coalition.org

Boston O&P .................................... 841 www.bostonoandp.com

Amputee Coalition of BC Society (ACBC) ............................................. 545 www.amputees.ca

Broadbay/Streifneder Ortho Production ...................................... 338 www.broad-bay.com

Anodyne .......................................... 737 www.anodyneshoes.com

Bulldog Tools Inc. ........................ 1024 www.bulldogtools.com

Aon Affinity ...................................... 429 www.insurance4op.com Apis Footwear Co. ......................... 529 www.bignwideshoes.com

Becker Orthopedic Appliance Co. ................................. 1118 www.beckerorthopedic.com

Cascade Dafo Inc. ..................... 837 www.cascadedafo.com

BI Medical....................................... 745 www.bimedical.org

Cascade Orthopedic Supply Inc. ...................................... 626 www.cascade-usa.com

BLUEWAVE Technologies.............822 www.bluewave.tech Board of Certification/ Accreditation (BOC) ................... 1218 www.bocusa.org

www.bocusa.org

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SEPTEMBER 2018 | O&P ALMANAC

Drew Shoe Corp. .............................. 838 www.drewshoe.com E-Life .......................................... 1238 www.e-lifebracing.com Endolite ........................................... 602 www.endolite.com

Cailor Fleming Insurance ............. 323 www.cailorfleming.com

Aspen Medical Products .............. 629 www.aspenmp.com

BioSculptor Corp. .......................... 438 www.biosculptor.com

DJO ................................................... 638 www.djoglobal.com

Engineered Silicone Products (ESP) LLC....................... 1243 www.wearesp.com Epica Applied Technologies ........ 432 www.epicatech.com Fabtech Systems LLC .................... 634 www.fabtechsystems.com

Charcot-Marie-Tooth Association (CMTA) ............................................ 422 www.cmtausa.org

Farabloc Development Corp. .............................................. 639 www.farabloc.com

Charleston Bending Brace ........... 944 www.cbb.org

Fillauer ........................................ 502 www.fillauer.com

Click Medical .................................. 310 clickmedical.co

FIOR & GENTZ GmbH ............ 1133 www.fior-gentz.us

Coapt LLC ....................................... 738 www.coaptengineering.com

Freedom Innovations LLC ............ 808 www.freedom-innovations.com

949/645-4401 ● 800/854-3479 ● www.kingsleymfg.com

EXHIBITOR DIRECTORY 2018

Friddle’s Orthopedic Appliances Inc. ............................... 938 www.friddles.com Generix Medical LLC .................. 1241 www.generixmedical.com Glaze Prosthetics ......................... 424 www.glazeprosthetics.com iFit Prosthetics LLC ..................... 1230 www.ifitprosthetics.com Infinite Biomedical Technologies ................................... 939 www.i-biomed.com Integrum Inc. ................................. 1212 www.integrum.set International Institute of Orthotics and Prosthetics ............. 1208 www.iiofoandp.org

Makstride Prosthetics .................. 820 www.makstrideprosthetics.com

O&P EDGE/Western Media LLC... 941 www.oandp.com/edge

Martin Bionics Innovations ......... 210 martinbionics.com

OHI (Apex, AZ AFO, Langer, PedAlign, SafeStep, The Orthotic Group)..................... 1014 www.ohi.net

MD Orthopaedics Inc. ................. 1132 www.mdorthopaedics.com Medi USA ........................................ 818 www.mediusa.com MediYeti........................................1232 www.mediyeti.com Mile High Orthotics Lab Inc. ..... 1220 www.mholabs.com Mobility Saves .................................302 www.mobilitysaves.com

OPAF & The First Clinics ............. 1234 www.opfund.org OPAI.................................................. 326 www.opai.org.in OPIE Software ................................ 824 www.oandp.com OPTEC USA Inc. ............................. 612 www.optecusa.com Orfit Industries America .............. 532 www.orfit.com Orthomerica Products Inc. ........... 412 www.orthomerica.com

ISPO Canada ................................ 1311 www.ispo.ca Kinetic Research Inc. .................... 1119 www.KineticResearch.com

Monetek LLC ................................. 1122 www.monetek.com

Orthotic & Prosthetic Group of America (OPGA) .......... 918 www.opga.com

KISS Technologies LLC ................. 530 www.kiss-suspension.com

Myrdal Orthopedic Technologies Inc............................... 840 www.myrdalorthopedics.com

Orthotic Prosthetic Canada (OPC) ................................ 1142 www.opcanada.com

Myomo ............................................ 1313 www.myomo.com

Osseointegration Group of Australia ........................................ 1305 www.osseointegrationaustralia.com.au

KLM Laboratories ......................... 1310 klmlabs.com Knit-Rite Inc. .................................. 728 www.knitrite.com Landis International ................... 1037 www.landisusa.com LaunchPad .................................. 328 www.LaunchPad-op.com LegWorks ......................................... 531 www.LegWorks.com LIM Innovations .............................. 218 www.liminnovations.com Limbs for Life Foundation .......... 1239 www.limbsforlife.org Lumbrella.......................................330 www.lumbrella-os.com Lunatik Athletiks ........................ 1240 www.lunatikathletiks.com Lustampa—Gins S.R. L................ 409 www.lustampa.it

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SEPTEMBER 2018 | O&P ALMANAC

Nabtesco & Proteor in USA ......... 418 www.proteor.com Naked Prosthetics ................... 1307 www.npdevices.com National Commission on O&P Education (NCOPE) ...................... 540 www.ncope.org nora systems Inc. ......................... 1040 www.nora-shoe.com

Össur Americas Inc. ....................... 718 www.ossur.com

Ottobock ....................................... 1002 www.ottobockus.com

NormaTec Medical.......................1140 www.normatecmedical.com Nymbl Systems ............................. 1018 www.nymbl.systems.com

Paceline ............................................ 521 www.paceline.com

O&P Almanac................................. 440 www.aopanet.org

PEL .................................................... 926 www.pelsupply.com Phits/RS Print................................... 431 www.phitsinsoles.com

Regain a Flexible Future with the

ALPS FLEX SLEEVE

Features new kni�ed construc�on with a 30° pre-flexion

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EXHIBITOR DIRECTORY 2018

Procosil SRL .................................. 314 www.procosil.com

Taika3D......................................... 1045 www.taika3d.com

ProsFit Technologies JSC............ 1204 www.prosfit.com

Tamarack Habilitation Technologies Inc. ........................... 1117 www.tamarackhti.com

Pro-Tech Orthopedics ................. 1222 www.protech-intl.com

PLAY THE

SLAP SHOT HOCKEY GAME

As you attend educational sessions, be sure to get your tokens for the slap shot game located in the Exhibit Hall.

Test your luck and play your tokens to win fun prizes from exhibitors and AOPA. AOPA will be giving away 200 PRIZES, VALUED AT $10 – $100.

ProtoKinetics Gait Analysis Walkways ........................................ 1114 www.protokinetics.com

TheraTogs Inc. ........................... 324 www.theratogs.com

Protosthetics ................................... 411 protosthetics.com

Thermo-Ply Inc. ............................ 1231 www.thermoplygel.com

Rapid TPC..................................... 1141 www.rapidtpc.com

Tillges Technologies ..................... 1123 www.tcopinc.com

Renia GmbH ................................. 1038 www.renia.com

Top Shelf Orthopedics .................. 546 www.pacmedical.com

Rodin4D .......................................... 734 www.rodin4d.com

Townsend Design/Thuasne USA ................................................. 1126 www.townsenddesign.com

Royal Knit Inc. ................................ 537 www.royalknit.com RUSH Foot, a PROTEOR Company ......................................... 418 www.rushfoot.com

SPONSORED BY ALPS South LLC Booth 702

PRIZE SPONSORS: Allard USA American Board for Certification in Orthotics, Prosthetics, and Pedorthics AOPA Aspen Medical Products Cascade Dafo Inc. Cascade Orthopedic Supply Inc. College Park Industries Comfort Products Fillauer KISS Technologies LLC LIM Innovations Limbs for Life Foundation Naked Prosthetics NCOPE OPAF & The First Clinics Spinal Technology Inc.

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SEPTEMBER 2018 | O&P ALMANAC

TechMed 3D Inc. ........................... 1137 www.techmed3d.com

TRS Inc. (Therapeutic Recreation Systems Inc.) ................................ 1309 www.trsprosthetics.com Turbomed Orthotics ..................... 525 turbomedorthotics.com University of Hartford—MSPO....539 www.hartford.edu/mspo

Sensor Medica USA.................... 1242 www.sensormedicausa.com

Value and Trust Co. Ltd ............... 430 www.vntc.me

Spinal Technology Inc. .................. 932 www.spinaltech.com

Vorum .............................................. 832 www.vorum.com Voxelcare Online CAD/CAM Systems...............................................845 www.voxelcare.com

Springer Aktiv Ag ....................... 1042 www.springer-berline.de SPS ............................................... 802 www.spsco.com

WillowWood ............................. 524 www.willowwoodco.com

ST&G USA Corp. ............................ 423 www.stngco.com Standard Cyborg .......................... 1030 www.standardcyborg.com SteeperUSA ..................................... 318 www.steeperusa.com Surestep .......................................... 618 www.surestep.net

Xi’an HSD Rehabilitation Appliance Co. Ltd. ........................... 426 www.haosida.net 9 26-2 R E B EM SEPT

2018

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PRINCIPAL INVESTIGATOR

Inspired by Invention Shane R. Wurdeman, PhD, CP, FAAOP, studies outcome measures and more in his new role as Hanger Clinic’s director of clinical research

For 2018, O&P Almanac is introducing individuals who have undertaken O&P-focused research projects.

Here, you will get to know colleagues and health-care 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.

Shane R. Wurdeman, PhD, CP, FAAOP, presents at the 2018 Hanger Education Fair with Hanger Clinic patient Amanda Flores, whose mobility has improved after tracking her outcomes.

SEPTEMBER 2018 | O&P ALMANAC

Clinic, having recently been named director of clinical research. He says he was bitten by the research “bug” while attending Georgia Tech’s Master of Science in Prosthetics & Orthotics (MSPO) program, which placed a great emphasis on consuming research. But his original decision to pursue the O&P profession was inspired by a TV show.

“I was initially drawn to O&P while watching a television special on prosthetic device inventor Van Phillips, who has a below-knee amputation himself,” recalls Wurdeman.

“I was fascinated by the tenacity and drive an individual could have to better their ability to walk.” Given his natural inclination toward health care and working with his hands, he knew immediately that O&P was the perfect career path. “I cannot think of a better profession than one in which the individuals we serve are such great inspirations every day,” he says.

Pursuing his chosen career, Wurdeman earned a bachelor’s degree in physics from Creighton University before heading to Georgia Tech, where he earned his MSPO in 2006. He initially held positions at O&P clinical facilities and was soon motivated to pursue his doctorate.

“Not long after I started providing patient care, I found myself getting the far-too-common response of, ‘It’s just how we have always done it,’ from other clinicians referencing patient-care decisions,” he explains.

“That was enough to motivate me to go back for a doctorate to learn how to design and conduct research that could be used to make more informed clinical decisions.”

PHOTO: Hanger Clinic

62

S

HANE R. WURDEMAN, PhD, CP, FAAOP, serves a key role at Hanger

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Visit www.aopanetonline.org/aopaversity.

PRINCIPAL INVESTIGATOR

He gained admittance to the PhD program at the University of Nebraska and was hired as a graduate research assistant there, a position he held from 2009 to 2013. After earning his doctorate in 2013, he took on dual roles as a research scientist and lecturer at the University of Nebraska—Omaha and a certified prosthetist/research scientist at Advanced Prosthetics Center in Omaha, which became a division of Hanger Clinic the next year. He has been with Hanger Clinic ever since.

In 2015, under the purview of Chief Clinical Officer James Campbell, PhD, CO, FAAOP, Hanger Clinic launched its Department of Clinical and Scientific Affairs with the goal of improving evidence-based care within O&P. Wurdeman was named senior research scientist within the department in 2017, and in May 2018 was appointed director of clinical research. “As part of my role within the department, my duties include overseeing research activities within Hanger Clinic’s network of approximately 800 patient-care facilities across the United States, designing new research protocols, implementing outcome measures and patient registries, and publishing our research findings,” Wurdeman explains.

PHOTO: Hanger Clinic

Importance of Outcome Measures Wurdeman currently resides in Houston, and, when he is not engulfed in research and clinical care, he spends time with his wife and their two children, often at the swimming pool. “I think our kids are growing gills,” he says. But the majority of his working hours are devoted to research—on varied topics related to orthotics and prosthetics.

Because Wurdeman’s background is in biomechanics, many of his earlier published studies were from an instrumented gait laboratory. “However, as the winds of change have blown across the profession, I have felt the need to evolve into outcome measures, both physical performance and patient-reported outcomes,” he says.

The work he is doing now centers on outcomes being collected within Hanger Clinic’s network of patient-care facilities. Hanger recently embarked on a publication series, labelled the “Mobility

Shane R. Wurdeman, PhD, CP, FAAOP Analysis of AmpuTees,” or MAAT series, which had its first two manuscripts published. “The first study established a relationship between our lower-limb prosthetic users’ mobility and more holistic measures of quality of life and satisfaction among 500-plus lower-limb prosthesis users,” he says. The second study, or MAAT 2, investigated the impact of co-morbidities and overall co-morbid health on lower-limb prosthesis users’ mobility. “Contrary to some of the widely held beliefs out there, only age, history of vascular disease (not diabetes), history of stroke, and anxiety/panic disorders were significant predictors of mobility,” says Wurdeman of the findings. “Furthermore, once the impact of these variables was removed, there was no effect of worsening co-morbid health on prosthetic users’ mobility. This was found through examining nearly 600 prosthesis users.”

The subsequent MAAT studies, Wurdeman explains, investigate the impact of microprocessor knees on mobility and demonstrate which prosthetic feet yield greatest mobility.

“We are hoping to be able to get to a point of implementing predictive analytics and incorporating this into the decision process,” he says.

In addition to the MAAT studies, Wurdeman and the Clinical and Scientific Affairs team are working to synthesize and disseminate clinical practice guidelines. “These can assist clinicians with knowing what the available evidence has provided as a guideline, as well as helping to guide future research efforts by noting gaps,” he says. Their most recent clinical practice guidelines cover prosthetic foot selection and prosthetic knee selection.

Currently, Wurdeman is involved with projects that continue to investigate outcomes in the patient-care environment. “This includes analyzing a growing database of patient outcomes to determine the most effective devices for different patient demographics,” he says.

Additionally, he and his colleagues are involved with several projects working to effectively provide a means for clinicians to determine the appropriate outcome measures for their patients.

While Wurdeman’s primary research focus over the years has been on lowerlimb prosthetics, more recently his work has grown to include multiple areas of O&P care, now including examining efficacy and impact of multiarticulating hands, and efficacy and dosing in cranial remolding orthoses. “I believe the research I am involved with will help to identify the best methods to care for our patients, eliminating the previous standard of ‘trial and error,’” he says.

Seeing the Bigger Picture

From his unique vantage point, Wurdeman believes research and data will be key to O&P’s proper recognition as a respected health-care field. “O&P needs to establish its place within the larger holistic care of patients,” he says.

“For years, students have been taught the value of gait, strengthening, avoiding contractures, or treatment levels of body function and body structure, as noted

by Whyte et. al. This has placed us in a vulnerable position as we assumed that policymakers and payors had an understanding of how these outcomes ultimately lend themselves to improved ‘higher-level’ outcomes, such as activity and social participation.”

In today’s health-care climate, the push toward a value-based emphasis “will require new systems for managing and analyzing health-care data,” and will require that payors and policymakers look to increase coverage for the arenas of care that have provided evidence for a higher level of outcomes, according to Wurdeman. “In this context, the most pressing issue for O&P research is to show its value in helping patients obtain improvement in higher-level outcomes [in terms of activity and participation], and how these feed to what I believe O&P ALMANAC | SEPTEMBER 2018

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PRINCIPAL INVESTIGATOR

may be the ultimate outcome in quality of life. There will be value in also showing that O&P care can reach these levels at a cost—time, effort, and financial—that is less compared to other arenas of care.”

Fortunately, the work being done at Hanger Clinic and by other O&P researchers is moving the profession in the right direction. “The rapid establishment and development of our outcomes databases is allowing analyses that are revealing information about patient outcomes that many clinicians always believed to be the case,” Wurdeman explains. “Now, we are assembling the hard data to support these claims. If I can quote a study of several hundred patients that shows improved functional mobility within the patients’ own environments, this is a very different conversation with payors than a discussion that often relies upon anecdotal cases. Armed with that evidence, we believe we can show patients how they are doing and allow payors to see how their investments result in a better quality of life for O&P patients.”

Mentors and Partnerships

Throughout his career, Wurdeman has been involved in some “amazing collaborations” and has worked with extremely helpful mentors. His first major research collaborator was his doctoral advisor, Nick Stergiou, PhD. “I learned much of being a scientist from him,” Wurdeman says. “He taught me proper study design, manuscript preparation, effective grant submissions, and the proper way to review other scientists’ manuscripts.

He is still a close friend and confidant.”

Wurdeman also worked closely with two vascular surgeon scientists, Iraklis Pipinos, MD, PhD, and Jason Johanning, MD. “These two individuals furthered my understanding of vascular disease and the science of peripheral arterial disease,” says Wurdeman. More recently, Wurdeman has partnered with O&P research experts Campbell and Phil Stevens, MEd, CPO, FAAOP, “which has been beneficial both in my professional and in my personal growth,” he says.

Additionally, his work has led him to fruitful collaborations with institutions such as the University of Nebraska, the University of Washington, the University of Colorado, the U.S. Department of Veterans Affairs (VA), and several private institutions. “All of them positively impact my thought process and approach every day in different ways.”

Wurdeman also notes the importance of funding assistance from a variety of entities. “At Hanger Clinic, we have been fortunate to get support from AOPA and the Department of Defense,” he says. “I have previously been supported through funding from the National Institutes of Health, the VA, and the Orthotic and Prosthetic Education and Research Foundation.”

Involving Others

One of the most pressing issues to ensure proper research going forward is the recruitment of subjects to participate in studies, according to Wurdeman. “Our profession’s research has been hindered by the difficulty of

Notable Works

Shane R. Wurdeman, PhD, CP, FAAOP, has been involved in the publication of many important articles, papers, and clinical practice guidelines over the course of his education and career. Some of his most impactful articles include the following: • Wurdeman S.R., Stevens P.M., Campbell J.H. “Mobility Analysis of AmpuTees (MAAT I): Quality of Life and Satisfaction Are Strongly Related to Mobility for Patients With a Lower-Limb Prosthesis.”

Prosthetics & Orthotics International 2017. Epub ahead of print.

• Wurdeman S.R., Stevens P.M., Campbell J.H. “Mobility Analysis of AmpuTees (MAAT II): Co-morbidities and Mobility in Lower-Limb Prosthesis Users.”

American Journal of Physical Medicine & Rehabilitation 2018. Epub ahead of print.

• Stevens P.M., Rheinstein J., Wurdeman S.R. “Prosthetic Foot Selection for Individuals with Lower-Limb Amputation: A Clinical Practice Guideline.” Journal of Prosthetics and Orthotics 2018 [Accepted].

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SEPTEMBER 2018 | O&P ALMANAC

recruiting subjects. It takes more than just posting a flyer in the lobby. Rather, take the time to understand the research being conducted, and then relay this to your patients when you are working with them. This will serve the best to advance the evidence of O&P care.”

Wurdeman believes it’s essential to make the effort to inspire young clinicians to become involved in research. Until recently, he served as the residency director for Hanger Clinic in Houston and did his best to emphasize the importance of the scientific aspects of O&P. “In the past, we held journal clubs, where the purpose was to dissect a single article within O&P. This seemed to benefit many of the residents. Now, we are seeing a growing network of clinicians who wish to continue their formal education as a researcher and obtain their doctorate,” he says. In his current role, Wurdeman tries to make himself available to serve on dissertation committees, typically as a nonvoting member.

“I think the most critical thing I can do as an O&P clinician with a PhD is make myself available as a mentor to any individual who may be contemplating pursuing their doctorate,” he says. “When I went through my PhD, as is the case still, there were a limited number of individuals who could provide guidance from that perspective, so I think it’s extremely important to make myself as available as possible.”

By taking this approach, Wurdeman hopes to inspire young prosthetists and orthotists, just as he was inspired by seeing Van Phillips on TV and by collaborating with his doctoral advisor.

“The discovery of the unknown is a fascinating thing,” he says. “When I get to the conclusion of data collection, and we move into the data analysis portion of a study, there is high anticipation as the results are to be revealed. As data is organized for analysis, investigators are eager to find out whether their hypothesis will be supported, or what other findings may arise from the data. This excitement becomes even more intense when there is an awareness that the results could have a strong impact on the day-to-day care of thousands of individuals.”

Realize the facts. O&P care improves quality of life and is cost effective! Learn more at MobilitySaves.org.

The Study that Started MobilitySaves.org A major study, comparing patients using prosthetics versus patients without prosthetics had these findings: • They will have lower or comparable Medicare costs than patients who need, but do not receive, these services.

Reasons to visit MobilitySaves.org Find supporting data to get your device paid for

Learn about the study proving orthotic and prosthetic care saves money

• They will experience greater independence.

• They can increase their physical therapy and become less bed-bound.

• They will have fewer emergency room admissions and acute care hospital admissions.

Share this significant news by using the educational tools provided at MobilitySaves.org. Mobility Saves Lives And Money!

See how amputees rallied when their prosthetic care was threatened

The Results Lower Limb Prosthetics Prosthetic patients experienced better quality of life and increased independence compared to patients who did not receive the prosthesis at essentially no additional cost to Medicare (or other payers).

O&P CARE IS A SAVER, NOT AN EXPENSE TO INSURERS! Visit MobilitySaves.org.

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MEMBER SPOTLIGHT

Kinetic Research

By DEBORAH CONN

Familial Influence O&P manufacturer followed his brother’s lead to become a clinician before launching his company

W

ADE BADER WAS A

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Wade Bader, CPO, at his facility in Tampa, Florida

COMPANY: Kinetic Research OWNER: Wade Bader, CPO LOCATION: Tampa, Florida HISTORY: 23 years

A fisherman wears one of the facility's ankle-foot orthoses.

Wade Bader, CPO

O&P, with the idea that Wade would take over the facility once he gained certification.

Wade began working with composite materials early on because he found plastics unsatisfactory. “I was fitting devices that were textbook and watching them come back six months later with changes caused by body heat and pressure. The material just wasn’t holding up,” he says.

In the course of his research, he patented several types of processes that used composites efficiently to maximize their effects. “We found composite materials gave us resilience that, if used correctly, could be an incredibly powerful tool,” he says.

Wade began to offer his innovations to friends in the industry and then on the national market. He launched Kinetic Research in 1995, and by 1996 he started showing his products at all national O&P meetings.

Today, Kinetic Research provides products and services to clinics and practitioners in

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

PHOTOS: Kinetic Research

young computer systems entrepreneur when he took a trip that would change his career path. While on an assignment in St. Thomas, Virgin Islands, in 1982, Bader noticed a number of amputees and wondered to his client where they went for care.

Told they had to fly to Puerto Rico to access prosthetic services, Bader alerted his brother, Evan, a certified prosthetist/orthotist back in the States.

Evan Bader began making monthly trips to the island, fitting residents with prostheses and orthoses that he fabricated in his stateside facility between visits.

Demand for his services grew, but Evan had plans to attend medical school, and he couldn’t see juggling his family and his education with more frequent visits south.

He enlisted help from Wade, who learned casting techniques and other skills to pitch in.

“At one event in St. Thomas,” Wade recalls, “my brother was fitting a double amputee with his very first pair of prosthetic legs. The patient’s whole family was there, and they were all crying and cheering—it was a powerfully touching moment for me. I certainly never got that kind of reaction in my computer business! The outcome was that I went back to school to get an O&P degree.”

The brothers opened a facility, Bader Prosthetics and Orthotics, in Tampa, while Evan attended medical school at University of South Florida and Wade went to Florida International University to earn his bachelor’s degree in

all 50 states and numerous countries around the world.

The company’s flagship device is the Noodle ankle-foot orthosis (AFO). So named because it resembles a noodle at one stage of production, the device is an ultralight dynamic AFO. “What makes it special are its dynamic properties,” says Wade. “A savvy practitioner can use footplate positioning to take advantage of the carbon-fiber energy-storing and -releasing properties to do magic for a wide spectrum of patients. They can really achieve things that would not be possible with another device.”

Other offerings include custom AFOs, knee-ankle-foot orthoses (KAFOs), and knee orthoses, as well as the Max Force partial foot prosthesis, a custom singlecomponent footplate/strut device.

While Bader P&O is slated to close this year, Kinetic Research also operates a boutique, cash-only clinic that works with patients both from the local area and elsewhere in the country, often referred because their cases are complicated.

Wade takes great satisfaction in the number of lives he has affected through his work. He notes one patient in particular— his brother, Evan, who developed multiple sclerosis and retired from his second career as a physician.

“He wears one of my KAFOs,” says Wade.

Looking ahead, Wade has high hopes for the O&P industry as it takes advantage of new materials and technology, and for his company in particular. He says, “Our focus is to add value for our practitioner clients by allowing them to integrate high-performance composites in a seamless and cost-effective way.”

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MEMBER SPOTLIGHT

Western Reserve Orthotics & Prosthetics Center

Jump-Starting Rehabilitation Ohio facility assists patients in setting and achieving mobility-focused goals

I

N 1975, 21-YEAR-OLD RICHARD

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Richard Grope, CPO, LPO, works with a physical therapy student.

FACILITY: Western Reserve Orthotics & Prosthetics Center OWNERS: Richard Grope, CPO, LPO, and Kim Grope LOCATION: Youngstown, Ohio HISTORY: 17 years

their goals. One such patient, Stacey Kozel, was paralyzed from the waist down as the result of a car accident and lupus. Western Reserve fitted her with Ottobock’s C-Brace, a computer-controlled knee-ankle-foot orthosis (KAFO), and she embarked on a mission to walk all 2,200 miles of the Appalachian Trail.

The facility also has treated teenager Darrius Simmons, who was born with three fingers on one hand and only a thumb on the other, in addition to lacking bones below both knees.

Determined to play the piano, Simmons uses prosthetic legs to manage the pedals, and recently debuted at Carnegie Hall.

The facility also is active in amputee athletics, and is sponsoring amputee Barry Schroeder of Team USA’s Para Bobsled and Skeleton Team.

Schroeder, who lost part of his leg in a motorcycle accident in 2012, returned to his work as a paramedic and in 2015 was named to the Paralympic team.

Western Reserve O&P faces stiff competition from other O&P companies but is holding its own, according to Lenzi. “We’re really proud of what we do, considering we are an office of eight people,” he says. The company markets itself through its website and on social media, in addition to going door to door, introducing themselves to nursing homes, physicians, and therapists, as well as attending local health fairs.

In April, during Limb Loss Awareness Month, Western Reserve held its First Annual Amputee Empowerment Workshop, where doctors, therapists, and medical vendors were on hand to answer questions.

Fifty people attended the free event, which featured food, prizes, and music. The facility is already planning for the 2019 workshop.

Western Reserve O&P prides itself on the high quality of its patient care. “We will treat patients wherever they are,” says Lenzi. “Our range extends to all of northeast Ohio, western Pennsylvania, and northern West Virginia. We even once sent clinicians to Maine to repair a device.” The facility hopes to add a mobile van to extend its reach and enable same-day repairs.

Education is important to Western Reserve as well, which will soon welcome an intern, who will take part in a residency at the facility once he completes his master’s degree.

The facility also is completing paperwork to offer continuing education credits to occupational and physical therapists.

Underlying all of Western Reserve’s efforts is the joy of helping others, Lenzi says. “When you see the expression on a person’s face the first time they walk on their own, it’s priceless.”

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

PHOTOS: Western Reserve Orthotics & Prosthetics Center

Grope had his sights set on baseball, and he was soon to try out for the Texas Rangers.

Instead, a 3,000-pound piece of steel fell on his foot while he was working in a large machine shop.

After six surgeries, doctors finally amputated his limb.

Within months, he says, he was playing baseball again and focused on living a normal life. Five years later, he decided to become an O&P clinician, and in 2001, he and his wife, Kim, opened Western Reserve Orthotics & Prosthetics Center in Austintown, Ohio.

The facility employs three clinicians and four administrative staff members. Grope, who is president of the company, is joined by Stephen Pollack, CPO, LPO, and Robert Paul, LPed, CPOA, in offering clinical care.

Kim Grope is head of public relations and customer service.

The facility is about 8,000 square feet with an upstairs fabrication lab. An outside group of physical therapists occupies an 800-square-foot space on the first floor, where they can work with Western Reserve patients on site.

Most of the facility’s patients are older—between 50 and 80—and about half have diabetes, says Jason Lenzi, financial manager at Western Reserve O&P. Nevertheless, the facility offers a full range of prosthetic and orthotic services, including upper-extremity devices.

Clinicians at the facility have helped countless patients achieve

By DEBORAH CONN

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AOPA NEWS

AOPAversity Webinars OCTOBER 10

NOVEMBER 14

Evaluating Your Compliance Plan & Procedures: How To Audit Your Practice

Year-End Review: How To Wrap Up & Get Ready for the New Year

Proper preparation prevents poor performance—make sure your facility is fully prepared with an appropriate compliance plan. Participate in the November 14 webinar:

Don’t wait until December to start closing out the calendar year! Start preparing now by taking part in the October 10 webinar and hearing from AOPA experts on the following topics:

• Review the elements of a compliance plan.

• Learn how to test and evaluate the elements of a compliance plan.

• Find out how to take action when compliance deficiencies are discovered.

• Determine how and when to perform self-audits.

• Learn how to create an in-house or self-audit.

• Updating Medicare participation status • Providing gifts to referral sources and patients • Checking the activity of Provider Transaction Access Numbers • Submitting information on breaches in compliance with the Health Insurance Portability and Accountability Act • Updating Medicare information.

Your source for advanced learning EARN CE CREDITS 72

SEPTEMBER 2018 | O&P ALMANAC

AOPA members pay $99 (nonmembers pay $199), and any number of employees may participate on a given line. Attendees earn 1.5 continuing education credits by returning the provided quiz within 30 days and scoring at least 80 percent. Register at bit.ly/2018webinars. Contact Ryan Gleeson at rgleeson@AOPAnet.org or 571/431-0836 with questions.

Sign up for the entire series and get two webinars free. All webinars that you missed will be sent as a recording. Register at bit.ly/2018webinars.

O&P PAC UPDATE

WE CORD IA LLY IN V ITE Y OU TO ATTEN D

T

HE O&P PAC UPDATE provides

information on the activities of the O&P PAC, including the names of individuals who have made recent donations to the O&P PAC and the names of candidates the O&P PAC has recently supported. The O&P PAC would like to thank the following AOPA members for their recent contributions to the PAC: • • • • • •

Ryan Arbogast Traci Dralle, CFM Michael Fillauer Eddy Gosschalk, CPO Sheri Hassler Jason Wening, CPO, 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 U.S. House of Representatives and Senate and other officials running for office to educate them about the issues, and help elect those individuals who support the orthotic and prosthetic community.

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/pacauth.

Enjoy a night of ’70s soulful tunes, dinner, a silent auction, a disco dance off, and much more. Be there or be square.

You are not required to wear your best ’70s threads, but we hope you will!

6:30-9:30 PM

September 27

2018

That Seventies Bar a.k.a. Convention Center Level 3-Summit

This is a special event and will require a separate registration fee.

Certain rules and restrictions may apply. For additional information about Party With A Purpose or to register, visit AOPA Booth #302.

www.AOPAnet.org

If you plan on attending the 2018 AOPA National Assembly, September 26-29 in Vancouver, be sure to attend the Party With a Purpose. Be there or be square and wear your grooviest threads!

Please visit AOPA Booth #302 for more information on the event or contact Devon Bernard at dbernard@AOPAnet.org.

O&P ALMANAC | SEPTEMBER 2018

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NEW MEMBERS

T

HE OFFICERS AND DIRECTORS of

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

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.

Adaptive Technologies Inc. 20-320 41 Street S. Lethbridge, AB Canada, T1J 5B3 403/381-9501 International Member Ryan Cochrane, CPO Anew Life Prosthetics & Orthotics 6438 Woodward Avenue Detroit, MI 48202 313/870-9610 Patient-Care Facility Chris Casteel Children’s O&P Services Inc. 60 Park Lane, Ste. 1 Highland, NY 12528 845/883-3038 Patient-Care Facility Brendan Rooney Daily Medical 1289 N. Air Depot Blvd.

Midwest City, OK 73110 405/741-5666 Supplier Level 1 Marrisa Shaw

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Kenney Orthopedics of Carmel 755 W. Carmel Drive, Ste. 105 Carmel, IN 46060 317/993-3667 Patient-Care Affiliate

Kenney Orthopedics of Paducah 22 Berger Road Paducah, KY 42003 270/366-0003 Patient-Care Affiliate Lifestyles O&P 15418 W. Center Road Omaha, NE 68144-1500 402/393-2354 Patient-Care Facility Thomas Kalina Oertel Orthopedics Inc. 2095 U.S. Highway 22 W. Union, NJ 07083 908/688-1818 Patient-Care Facility Eric Oertel

PrimeCare Orthotics & Prosthetics 1401 S. Don Roser, Ste. E2 Las Cruces, NM 88011 575/523-2273 Patient-Care Facility Eddie Zepeda Synergy Prosthetics 5466 Complex Street, Ste. 207 San Diego, CA 92123 510/770-9010 Patient-Care Facility Gary Stutz Xtreme Prosthetics LLC 1005 W. Columbia Street, Ste. B Somerset, KY 42503 606/451-0668 Patient-Care Facility William Bray

Kenney Orthopedics of Danville 520 S. 3rd Street Danville, KY 40422 859/209-4156 Patient-Care Affiliate Kenney Orthopedics of Greenwood 33 E. County Line Road, Ste. E Greenwood, IN 46143 317/300-0814 Patient-Care Affiliate Kenney Orthopedics of Louisville 2809 N. Hurstbourne Parkway Louisville, KY 40223 502/882-9300 Patient-Care Affiliate Kenney Orthopedics of Monroe 1420 Ellen Street Monroe, NC 28112 704/635-7029 Patient-Care Affiliate

SEPTEMBER 2018 | O&P ALMANAC

DOWNLOAD the

“AOPA 365” App on your iPhone, Android or iPad

Download the

Mobile App! Download the app by either scanning the QR code or by searching the keyword AOPA365 in the Apple or Google stores.

AOPA Celebrates Health-Care Compliance & Ethics Week

HE SAVE T

November 4-10, 2018

DATE

10

NOV. 4-

2018

FOLLOW US @AmericanOandP

Save the Date!

Health-Care Compliance & Ethics Week Make plans to join your AOPA member colleagues in celebrating Health-Care Compliance and Ethics Week (HCEW), November 4-10.

In its first year celebrating HCEW, AOPA energized more than 500 members of our community to participate in seminars, educate staff, and share their focus on ethical behavior with their patients and community.

AOPA is organizing resources, education, prizes, and more to help your organization participate. With a week-long celebration of compliance and ethics, you have a great opportunity to introduce and reinforce your chosen themes. Your plans will rely in part on your organization’s specific needs, but some basic goals may include:

AWARENESS of the Code of Conduct,

relevant laws/regulations, and other reporting methods, the organization’s compliance and ethics staff, etc.

RECOGNITION of training completion,

compliance and ethics successes, etc.

REINFORCEMENT of a culture of compliance for which your organization strives.

AOPA has developed several free tools and resources to assist you. Visit our dedicated web page for tools, resources and more:

bit.ly/AOPAEthics

AOPA NEWS

CAREERS

Opportunities for O&P Professionals

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

Hire employees and promote services by placing your classified ad in the O&P Almanac. When placing a blind ad, the advertiser may request that responses be sent to an ad number, to be assigned by AOPA. Responses to O&P box numbers are forwarded free of charge.

Include your company logo with your listing free of charge.

Deadline: Advertisements and payments need to be received one month prior to publication date in order to be printed in the magazine. 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. Submit ads by email to ymazur@AOPAnet.org or fax to 571/431-0899, along with VISA or MasterCard number, cardholder name, and expiration date. Mail typed advertisements and checks in U.S. currency (made out to AOPA) to P.O. Box 34711, Alexandria, VA 22334-0711. Note: AOPA reserves the right to edit Job listings for space and style considerations.

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

Member $482 $634

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

Member Nonmember $140 $280 $190 $380 $260 $520 $2.25 per word $5 per word

Member Nonmember $85 $150

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, apply for an eSubscription by subscribing at bit.ly/AlmanacEsubscribe, or visit issuu.com/americanoandp to view your trusted source of everything O&P.

SEPTEMBER 2018 | O&P ALMANAC

Pittsburgh, Pennsylvania De La Torre Orthotics and Prosthetics is seeking certified clinicians to join our ever-growing practice in southwestern Pennsylvania. The qualified candidate will see patients in our local clinical offices, various physical therapy departments, and rehab facilities in the greater Pittsburgh area.

Requirements: • ABC-certified is preferred • A minimum of two years of recent, successful patient-based experience • Must work well in a team environment • Excellent oral communication skills with patients and referral sources • Ability to learn and use an EMR system is necessary.

De La Torre O&P offers competitive compensation and benefit packages, including 401(k), medical, disability policies, and certification reimbursement, and is an AAP employer.

Nonmember $678 $830

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

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Certified Prosthetist/Orthotist (CPO) Certified Prosthetist (CP) Certified Orthotist (CO) Certified Pedorthist (CPed)

Job location key:

Job Board

Mid-Atlantic

Email résumé to: drew@delatorreop.com Subject line: job opportunity

Inter-Mountain CO, CPO, LPO/Resident CPO

New Braunfels and Central Texas Growing practice, well-established, privately owned, multi-office, ABC-accredited, providing services in New Braunfels and Central Texas, is seeking experienced CPO/ CO/LPO/Resident CPO. Candidates must be motivated; patient-oriented; possessing strong clinical, technical and interpersonal skills; and desire a long-term career with a growing company. Salary DOE, 401(k) profit sharing, health insurance, generous PTO. Email résumé to info@gotlimb.com.

Ritchie Limb & Brace LLC Email: info@gotlimb.com

CAREERS Inter-Mountain

O&P Services

Certified Prosthetic/Orthotic Clinicians

Prudential Billing and Consulting

Albuquerque and Santa Fe, New Mexico Advanced Prosthetics and Orthotics is currently seeking skilled, dedicated, and hard-working ABC-certified prosthetic/ orthotic clinicians for our Albuquerque and Santa Fe offices.

CPOs and COs must possess a strong clinical background as well as provide quality and compassionate care. We offer competitive salary; medical, dental, vision, and retirement options are available.

Email: rocket4464@gmail.com

North Central

CPO

Chicago, Illinois The Ann & Robert H. Lurie Children’s Hospital of Chicago is committed to providing the highest level of patient care and has an open position for a CPO with pediatric experience.

This environment includes in-patient and out-patient care for the greater Chicago area. At Lurie Children’s we take a team approach to orthotic/prosthetic care and work closely with other members of the medical team. To access information about benefits and resumé submission, visit www.luriechildrens.org and go to the jobs link at the bottom of the page.

Ann & Robert H. Lurie Children’s Hospital of Chicago Email: bmalas@luriechildrens.org Website: www.luriechildrens.org

North Central Certified Prosthetist & Orthotist or Certified Prosthetist

Indiana SRT Prosthetics & Orthotics, a progressive prosthetic and orthotic company in the Midwest, is seeking an ABC-board certified prosthetist or certified prosthetist and orthotist for its growing markets in various areas of Indiana. The ideal candidate must be able to excel in a fast-paced, team environment. Résumés can be sent to: Shawn Brown, CPO, LPO, President Email: shawn@srtpo.com EOE

An Orthotics and Prosthetics Billing Company A full-service billing company providing initial insurance verification through final payment posting, including any denial management or appeals necessary.

Consultants committed to providing the service you need to be successful!

Contact: www.prudentialbilling.org Phone: 888/862-9377 Email: info@prudentialbilling.org

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 e-mail: loyds@ix.netcom.com

2018 AOPA Coding Products Get your facility up to speed, fast, on all of the O&P Health-Care Common Procedure Coding System (HCPCS) code changes with an array of 2018 AOPA coding products.

Ensure each member of your staff has a 2018 Quick Coder, a durable, easy-to-store desk reference of all of the O&P HCPCS codes and descriptors.

• 2018 Coding Suite (includes CodingPro single user, Illustrated Guide, and Quick Coder): $350 AOPA members, $895 nonmembers Order at www.AOPAnet.org or call AOPA at 571/431-0876.

O&P ALMANAC | SEPTEMBER 2018

77

MARKETPLACE

Feature your product or service in Marketplace.

Contact Bob Heiman at 856/673-4000 or email bob.rhmedia@comcast.net.

Visit bit.ly/almanac18 for advertising options.

ALPS Flex Sleeve ALPS Flex Sleeve (SFX) has a seamless knitted construction with a 30-degree pre-flexion, which allows for ease of bending and reduces bunching behind the knee. It features our HD Gel, which has a relatively firm nature and provides maximum comfort.

For more information, visit us at www.easyliner. com.

Coyote® Design Prosthetic Locks

Formula Foot The Formula foot is the ideal balance of flexibility and power. A first of its kind, the Pediatric Formula is a high-performance, customizable, pediatric foot that grows with the child. The long, lightweight carbon pylon provides critical energy return through the posterior attachment, while the compact shape of the ankle simplifies cosmetic finishing without hindering performance. The Standard and Custom Pediatric Formula feet are transforming pediatric prosthetics for kids who require exceptional performance and flexibility. Let them be little. Let them play big!

For more information, contact Fillauer at www.Fillauer.com.

LEAP Balance Brace

All of Coyote Design’s prosthetic locks are sand, mud, and water resistant to give your patients the freedom to take on whatever life brings their way.

For more information, contact Coyote Design at 208/4290026 or visit www.coyotedesign.com.

Make More Possible With the New 2018 ‘Crossover’ Knee The world’s first hybrid prosthetic knee that is user adaptable for walking, running, or sports.

• Walking knee transforms into an activity knee • Mimics natural muscle function • Adjustable tendon durometers • Adjustable flexion range requiring no tools • Adjustable dampening and rebound • 275 lbs K2-K4+ activity • Use in any environment • Light and strong • Hybrid design.

Call us about our evaluation program! Call 800/322-8324 or visit www.fabtechsystems.com.

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SEPTEMBER 2018 | O&P ALMANAC

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.

CLAW Feature for OWLS WHO and Shark-o Orthoses Diabetic and nondiabetic Charcot joint neuropathy presents the need for orthotic designs to accommodate, correct, unload, and/or alter specific gait dynamics. The CLAW™ technology was developed to enhance the OWLS® WHO™ and shark-o™ designs by improving orthotic fit and increasing patient function. Triplanar adjustments allow quick and easy alignment changes to optimize each patient’s walking characteristics. The CLAW allows for progressive adjustments to accommodate these many variables, and are all performed in the patient fitting room.

For more informtion, contact Orthomerica at 877/737-8444 or visit www.orthomerica.com/owls.

MARKETPLACE Pro-Flex®—Less Load, More Dynamics™ Introducing Pro-Flex LP Align, which couples up to 2 3/4 inches of heel height adjustability with the mechanical power of the three-blade Pro-Flex design—so users can maintain proper alignment across a variety of everyday footwear, from sandals to sneakers to dress shoes.

Visit ossur.com/pro-flex-family or ask your Össur representative about a Pro-Flex demo today.

Ottobock’s ProFlex™ Plus Sealing Sleeve Countdown to flexibility for you and your patients with Ottobock’s ProFlex Plus Sealing Sleeve • Three colors and sizes • Two lengths • Number one choice.

ProFlex Sleeves—delivering proven performance for the last 10 years.

This soft, yet tough, sealing sleeve is designed with a more flexible fabric and smoother proximal seam. It features 15 degrees of flexion for easier bending and less bunching behind the knee; a preformed knee cap for lower stress on the patella; and a conical shape proximal for improved thigh fit and tighter distal shape for enhanced sealing on socket.

Check out professionals.ottobockus.com for details.

Ottobock’s WalkOn® Carbon-Fiber AFO WalkOn ankle-foot orthoses (AFOs) are prefabricated from advanced prepreg carbon composite material designed to help users with dorsiflexion weakness walk more naturally. WalkOn AFOs are lightweight, low profile, and extremely tough. Their dynamic design can help patients achieve a more physiological and symmetrical gait, offering fluid rollover and excellent energy return. WalkOn offers a full range of AFO sizes and designs, including the WalkOn Reaction Junior pediatric sizes.

Fast and easy to fit, the WalkOn footplate is trimmable and can be shaped with scissors, often requiring only one office visit. Contact us at 800/328-4058 or professionals. ottobockus.com for details.

RUSH Foot EVAQ8® Collection An elevated vacuum system that seamlessly integrates effective vacuum with the same rugged simplicity of all the RUSH Foot® designs, the RUSH Foot EVAQ8® Collection is the easy solution to providing maximum vacuum efficiency in just a few quick steps.

No batteries or complicated, mechanical pump required.

Upwards of 22 inHg can be achieved! The RUSH Foot EVAQ8 Foot Collection is all-terrain, fully submersible (fresh or salt water), free of bulky components, and requires minimal maintenance. The RUSH Foot EVAQ8 Collection is available in the RUSH LoPro, HiPro, and ROGUE models .

The RUSH Foot EVAQ8 Collection elevates your life. For more information, contact 855/450-7300 or visit www.rushfoot.com.

Spinal Technology Spinal Technology Inc. is a leading central fabricator of spinal orthotics, upper- and lower-limb orthotics, and prosthetics. Our ABC-certified staff orthotists/ prosthetists collaborate with highly skilled, experienced technicians to provide the highest quality products and fastest delivery time, including weekends and holidays, as well as unparalleled customer support in the industry.

Spinal Technology is the exclusive manufacturer of the Providence Scoliosis System, a nocturnal bracing system designed to prevent the progression of scoliosis, and the patented FlexFoam™ spinal orthoses.

For information, contact 800/253-7868, fax 888/775-0588, email info@spinaltech.com, or visit www.spinaltech.com.

JAWS VO PRENENSOR JAWS is a high-performance, voluntary opening, prosthetic terminal device operated with or without a cable. JAWS's gripping force is easily user adjustable, utilizing proven “vector” technology. JAWS has a prehensile, not a hook, configuration for better control of ATVs, motorcycles, snowmobiles, personal watercraft, and lawn mowers, as well as working tools, domestic, garden, and yard tool handles. It snaps on and off objects with variable gripping forces exceeding 50 pounds. Additionally, JAWS features an integral, friction adjustable, radial-ulnar pivot.

Preview models of JAWS at the AOPA conference in September. TRS is BODY POWER. For more information, 800/279-1865 or visit trsprosthetics.com.

O&P ALMANAC | SEPTEMBER 2018

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CALENDAR

2018

September 26–29

AOPA National Assembly. Vancouver Convention Center. For general inquiries, contact Ryan Gleeson at 571/431-0836 or rgleeson@AOPAnet.org, or visit www.AOPAnet.org.

September 7–8

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

September 12

Medicare As a Secondary Payor: Knowing the Rules. Register online at bit.ly/2018webinars. For more information, email Ryan Gleeson at rgleeson@AOPAnet.org.

October 1

ABC: Application Deadline for Winter CPM Exams.

All practitioner candidates have an additional 30 days after the application deadline to complete their residency.

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

WEBINAR

September 14–15

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

September 17–22

ABC: Written and Written 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 300 locations nationwide. Contact 703/836-7114, email certification@abcop.org, or visit www.abcop.org/certification.

October 1

ABC: Practitioner Residency Completion Deadline for November Certification Exams. All practitioner candidates have an additional 30 days after the application deadline to complete their residency. Contact 703/836-7114, email certification@abcop.org, or visit www.abcop.org/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 10

Year-End Review: What Should You Do To Wrap Up the Year & Get Ready for the New Year? Register online at bit.ly/2018webinars. For more information, email Ryan Gleeson at rgleeson@AOPAnet.org.

WEBINAR

Apply Anytime!

Apply anytime for COF, CMF, CDME; test when www.bocusa.org ready; receive results instantly. Current BOCO, BOCP, and BOCPD candidates have three years from application date to pass their exam(s). To learn more about our nationally recognized, in-demand credentials, or to apply now, visit www.bocusa.org.

SHARE

your next event!

80

Cascade Dafo Institute offers eight free ABC-approved online continuing education courses for pediatric practitioners.

Earn up to 11.75 CE credits. Visit cascadedafo.com or call 800/848-7332.

CE For information on continuing education credits, contact the sponsor.

Questions? Email ymazur@AOPAnet.org.

Calendar Rates Let us

Free Online Training

CREDITS

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, fax 571/431-0899, or email ymazur@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.

SEPTEMBER 2018 | O&P ALMANAC

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

CALENDAR

October 18–20

International African-American Prosthetic Orthotic Coalition Annual Meeting. Embassy Suites Downtown Medical Center, Oklahoma City. For more information, contact Tony Thaxton Jr. at 404/875-0066, email thaxton.jr@comcast.net, or visit www.iaapoc.org.

October 20

Advancements in Conservative Treatments of Scoliosis. San Mateo, CA. Schroth instructors, orthotists, and MDs from around the country will be joining us to discuss topics relating to conservative and surgical scoliosis treatment. Grant Wood, Align Clinic, & Beth Janssen, Scoliosis Rehab. For more information, visit www.align-clinic.comor email evaldez@align-clinic.com.

October 27

POMAC (Prosthetic and Orthotic Management Associates Corporation) Fall Continuing Education Seminar. LaGuardia Airport Plaza Hotel, New York. Contact Drew Shreter at 800/946-9170, ext. 101, or email dshreter@pomac.com.

November 1

ABC: Application Deadline for Certification Exams.

Applications must be received by November 1 for individuals seeking to take the January Written and Written Simulation certification exams. Contact 703/836-7114, email certification@abcop.org, or visit www.abcop.org/certification.

November 1

ABC: Practitioner Residency Completion Deadline for Winter CPM Exams. All practitioner candidates have an additional 30 days after the application deadline to complete their residency. Contact 703/836-7114, email certification @abcop.org, or visit www.abcop.org/certification.

November 4–10

Health-Care Compliance & Ethics Week.

AOPA is celebrating Health-Care Compliance & Ethics Week and is providing resources to help members celebrate.

Learn more at bit.ly/aopaethics.

November 5–10

ABC: Written and Written 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 300 locations nationwide. Contact 703/836-7114, email certification@abcop.org, or visit www.abcop.org/certification.

November 7–9

NJAAOP. Harrah’s, Atlantic City, NJ. For more information, visit www.njaaop.com. Contact Brooke Artesi, CPO, LPO, with questions at Brooke@sunshinepando.com.

November 12–13

2018 Mastering Medicare: Essential Coding & Billing Techniques Seminars.

Las Vegas. Register online at bit.ly/2018billing. For more information, email Ryan Gleeson at rgleeson@AOPAnet.org.

Coding & Billing Seminar

November 14

Evaluating Your Compliance Plan & Procedures: How To Audit Your Practice.

Register online at bit.ly/2018webinars. For more information, email Ryan Gleeson at rgleeson@AOPAnet.org.

WEBINAR

November 28–30

New England Chapter AAOP. Please join us at Mohegan Sun in Connecticut for an outstanding ABC/ BOC continuing education program. Registration and more information at www.neaaop.org.

December 6–8

Shirley Ryan AbilityLab: Elaine Owen. Pediatric Gait Analysis and Orthotic Management: An Optimal Segment Kinematics and Alignment Approach to Rehabilitation (OSKAR). Chicago.

25.5 ABC credits approved. For more information, contact Melissa Kolski, call 312/238-7731, or visit www.sralab.org/academy/PedsGait18.

December 12

New Codes, Medicare Changes, & Updates. Register online at bit.ly/2018webinars. For more information, email Ryan Gleeson at rgleeson@AOPAnet.org.

WEBINAR

2019 September 25–28

AOPA National Assembly. San Diego Convention Center. For general inquiries, contact Ryan Gleeson at 571/431-0836 or rgleeson@AOPAnet.org, or visit www.AOPAnet.org.

2020 September 9–12

AOPA National Assembly. Mandalay Bay, Las Vegas.

For general inquiries, contact Ryan Gleeson at 571/4310836 or rgleeson@AOPAnet.org, or visit www.AOPAnet.org.

O&P ALMANAC | SEPTEMBER 2018

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AD INDEX

Advertisers Index Company

Page

American Board for Certification in Orthotics, Prosthetics, and Pedorthics

ALPS South LLC Amfit Anatomical Concepts Inc. BCP Group Board of Certification/Accreditation Cailor Fleming Insurance Cascade Dafo Inc. Coapt LLC College Park Industries ComfortFit Orthotic Labs Inc. Coyote Design & Mfg. Inc. Fabrication Limited Fabtech Systems LLC Fillauer Flo-Tech O&P Systems Inc. Hersco Kingsley Manufacturing Company Naked Prosthetics Orthomerica Products Inc. Össur Ottobock RUSH Foot a PROTEOR Company Spinal Technology Inc. Surestep TRS

71

Phone 703/836-7114

3, 59 800/574-5426 19 800/356-3668 37 800/837-3888 5 615/550-8774 63 877/776-2200 69 800/796-8495 39 800/848-7332 47 844/262-7800 21 800/728-7950 9 888/523-1600 7, 61 800/819-5980 45 937/776-7301 28, 29 1-800-FABTECH 25 800/251-6398 23 800/356-8324 1 800/301-8275 57 800/854-3749 43 888/977-6693 15 800/446-6770 33 800/233-6263 C4 800/328-4058 11 855/450-7300 17 800/253-7868 27 877/462-0711 35 800/279-1865

Website www.abcop.org

www.easyliner.com www.amfit.com www.anatomicalconceptsinc.com www.bcpgroup.net www.bocusa.org www.cailorfleming.com www.cascadedafo.com www.coaptengineering.com www.college-park.com www.comfortfitlabs.com www.coyotedesign.com www.fabricationlimited.com www.fabtechsystems.com www.fillauer.com www.1800flo-tech.com www.hersco.com www.kingsleymfg.com www.npdevices.copm www.orthomerica.com www.ossur.com www.professionals.ottobockus.com www.rushfoot.com www.spinaltech.com www.surestep.net www.trsprosthetics.com

Thank you to Our Supplier Plus Members

AOPA Supplier Plus Partners

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SEPTEMBER 2018 | O&P ALMANAC

Thank You to Our AOPA Supplier Plus Partners

r

FREEMfoBERS

The Source for Orthotic & Prosthetic Coding

ME AOPA n . Log o e s u o t today!

Marketing Opportunity Enhanced Listing

AOPA members ONLY $1,000 per year!

An enhanced listing on LCodeSearch.com enables you to add as many products as you wish, with descriptions, images, and links to your website.

What if you had a chance to reach a potential of

10,000

O&P buyers

with product info, a link to your website, and your ordering information?

The Source for Orthotic & Prosthetic Coding

Included in Search Product Name Manufacturer Name

Basic Listing (Free)

Enhanced Listing ($1000)

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*This offer is only available for current AOPA members. It is offered independently of the Supplier Plus program.

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Don’t miss out on this great opportunity for buyers to see your product information! Contact Betty Leppin for more information at 571-431-0876. www.AOPAnet.org

www.AOPAnet.org AOPA 2016 PRODUCTS AND SERVICES DIRECTORY

5

ASK AOPA CALENDAR

Pocket Payments Answers to your questions about patients who pay out of pocket, HIPAA notices, and more

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@contentcommunicators.com.

Q

If a patient wishes to pay out of pocket for a service or item, am I required to have a prescription/ order on file?

Q/

This question is a little tricky. In short, the answer is no.

However, it’s important to also consider liability issues and how the payment could affect your accreditation standing or local licensure rules.

For example, your accrediting body or state licensing board may require you to have prescriptions on file for all services, even if they are cash pay. So, before you provide a service without obtaining a prescription, verify the rules with your accrediting body and applicable state boards.

A/

84

SEPTEMBER 2018 | O&P ALMANAC

If a patient requests that I not bill his or her insurance but rather bill the patient directly, must I comply with the request?

Q/

The easy answer is yes. Under the Health Insurance Portability and Accountability Act (HIPAA), if an individual has paid for a service out of pocket, in full, and that individual requests a nondisclosure to his or her health plan, you must accommodate the request.

In previous years, you were not obligated to follow the patient’s request, but now you are obligated—especially when the patient is making a payment directly to you.

A/

Are we required to provide a patient a copy of our HIPAA notices with each visit, or can we do so annually?

Q/

You are not required to provide your patients with a Notice of Privacy Practices (HIPAA form) with each visit, and you are not required to provide them with a copy annually. You must provide a new copy only if they request it, or if you make any changes to your current Notice of Privacy Practices form.

A/

Q/

When are replacement orthoses covered by Medicare?

Medicare will cover a replacement orthosis during its reasonable useful lifetime under a few very select circumstances: • A replacement orthosis is covered if the original orthosis was lost or stolen.

• Medicare will cover a replacement orthosis if the original item is irreparably damaged, and the damage must not have been caused by normal wear and tear.

• Medicare will cover a replacement orthosis if there was a change in the patient’s condition.

A/

When providing a replacement item, should we submit the claim with an RA modifier or an RB modifier?

Q/

The appropriate modifier depends on what, exactly, you are replacing.

If you are replacing an entire device, including the base code and/or any addition codes, because the original item was lost, stolen, or damaged, then you would use the RA modifier.

However, if you are only replacing a component of the device and not the whole device, then you would use the RB modifier.

A/

AOPA Coding Experts Are Coming to

Las Vegas

November 12-13

ATLANTA

FEB. 26-27 | 2018

AOPA MASTERING MEDICARE:

ESSENTIAL CODING & BILLING TECHNIQUES SEMINAR Join AOPA November 12-13 in Las Vegas to advance your O&P practitioners’ and billing staff ’s coding knowledge. Join AOPA for this two-day event, where you will earn 14 CEs and get up-to-date on all the hot topics.

EARN 14 CEs

AOPA experts provide the most up-todate information to help O&P practitioners and office billing staff learn how to code complex devices, including repairs and adjustments, through interactive discussions with AOPA experts, your colleagues, and much more. Meant for both practitioners and office staff, this advanced two-day event will feature breakout sessions for these two groups, to ensure concentration on material appropriate to each group.

Don’t miss the opportunity to experience two jam-packed days of valuable O&P coding and billing information. Learn more and see the rest of the year’s schedule at bit.ly/2018billing.

The Tropicana Las Vegas 3801 S Las Vegas Blvd Las Vegas, NV 89109 Book your hotel by October 24

for the $95/night rate by visiting bit.ly/codingvegas.

Top 10 reasons to attend: 1.

Get your claims paid.

2.

Increase your company’s bottom line.

3.

Stay up-to-date on billing Medicare.

4.

Code complex devices

5.

Earn 14 CE credits.

6.

Learn about audit updates.

7.

Overturn denials.

8.

Submit your specific questions ahead of time.

9.

Advance your career.

10. AOPA coding and billing experts have more than 70 years of combined experience.

Find the best practices to help you manage your business.

Participate in the 2018 Coding & Billing Seminar!

Register online at bit.ly/2018billing.

For more information, email Ryan Gleeson at rgleeson@AOPAnet.org. .

www.AOPAnet.org

YOUR GOAL

Successful patient outcomes OUR COMMITMENT

To advance the standard of care. To provide you with leading medical technology backed by nearly 100 years of experience. To create better access for prosthetic devices that change lives. And provide the education and training needed to ensure your successful outcomes. Because when your patients succeed, we have all reached our goals.

professionals.ottobockus.com

8/18 Š2018 Ottobock HealthCare, LP, All rights reserved.

We all move forward, together.