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The Magazine for the Orthotics & Prosthetics Profession

N OV E M B E R / D E C E M B E R 2020

Meet the 2021 AOPA Board of Directors P.13

Appealing “Same or Similar” Denials P.16

O&P Stakeholders Step Up and Give Back P.34



Quiz Me!




This Just In: Competitive Bidding 2021: Preparing for Launch P.22





E C + 0 10 S IT D E R C
















Hear from the best in business education and advanced clinical programming. The Assembly has something for everyone…technical, orthotic, prosthetic, pedorthic, and business education all available.

National Assembly Content Available for Remainder of 2020

Earn over 100 CE credits. The platform will remain open until the end of 2020, so you have plenty of time to watch any and all sessions and peruse the exhibit booths. All of this is right at your fingertips on the easy-to-use Assembly platform that is mobile, computer, and tablet responsive. If you attended, just use your Assembly login. Registration is still available if you didn’t attend. Visit www.AOPAassembly.org to learn more.



#AOPA2020 FOLLOW US @AmericanOandP

Questions about the National Assembly? Contact AOPA at 571/431-0876 or email Assembly@AOPAnet.org.


NOV./ DEC. 2020 | VOL. 69, NO. 10





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

‘Same or Similar’ Situations Appealing denials of replacement orthoses

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

Member Spotlight.................................46

24 | Communicating With Care


Sampson’s Prosthetic & Orthotic Laboratory

After significant drops in patient visits during the early months of the pandemic, O&P businesses need to reconnect with their patients. Experts at marketing firms and healthcare companies share tips for crafting effective patient communications and sharing them on platforms that will have the most visibility. By Christine Umbrell

22 | This Just In

Competitive Bidding Countdown CMS is moving forward with plans to implement competitive bidding for select off-the-shelf knee and spinal orthoses beginning in January. Find out how single payment amounts were established and learn the next steps once you are offered a contract—or a disqualification notice.

34 | Gratefully Giving Frequent demonstrations of charity and philanthropy by O&P organizations and clinicians have served as bright spots during a challenging year. Learn how some O&P stakeholders donated COVID-19 supplies, O&P devices, time, and money to support individuals and communities in need. By Michael Coleman

PRINCIPAL INVESTIGATOR Natalie Harold, MSPO, CPO............................... 41 Meet an O&P researcher from Washington state who is in the early stages of developing a customizable outcome measures electronic toolkit to support evidence-based practice within O&P clinics. 2


DEPARTMENTS Views From AOPA Leadership......... 4 Humbled and inspired

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

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

At-a-glance statistics and data

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

Research, updates, and industry news

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

Transitions in the profession

AOPA News............................................... 48

AOPA advocacy, announcements, member benefits, and more

Marketplace.............................................. 49 Careers......................................................... 52

Professional opportunities

Ad Index....................................................... 53 Calendar...................................................... 54

Upcoming meetings and events

State By State........................................... 56

Illinois, New York, Oregon, and Virginia

New free virtual training sessions! CE credits awarded by the ABC

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November 5 November 10 November 17 December 1 December 8 Sign up at marketing@cascade-usa.com

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It Has Been an Honor To Serve You


HAD HOPED AT THE beginning of my tenure as AOPA president that we would

have a clear 20/20 vision of our future. We would pass legislation keeping the patient at the center of policy. We would leverage our evidence base and increase access to quality O&P care when and where our patients need it. I also was pretty excited about AOPA hosting a record-setting educational event at the National Assembly in Las Vegas. Then, along came COVID-19 and its challenges. Despite those challenges, you went above and beyond to ensure patients continued to receive the care they deserve. You adjusted quickly, provided care via telehealth, instituted new policies, and shared lessons learned with one another. I was both humbled and inspired. In order to serve you, AOPA had to adjust as well while staying true to our mission: Through advocacy, research, and education, AOPA improves patient access to quality orthotic and prosthetic care. I believe it is important for our members to know that to preserve cash for mission-based initiatives to be completed, our dedicated staff continued their work with energy and enthusiasm on reduced pay. Because of them, my predecessors, the Board of Directors, and you, significant progress has been made. The Medicare O&P Patient-Centered Care Act has been introduced in both the House of Representatives and the Senate; we monitored insurance trends across the country and assisted members with challenging reimbursement policies; and we fought for legislative and regulatory fixes to mitigate COVID’s impacts. Our research efforts reinforced the clinical efficacy and effectiveness that we provide. In 2020 alone, AOPA awarded more than $139,000 in research dollars through the Center for O&P Learning. We did not lower our mission-oriented commitment to evidence outcome-based research. A wide variety of educational opportunities were moved to virtual formats, and content relevant to the demands you were facing was provided. Due to the pandemic’s challenges, we provided free access to AOPAversity for all members. We established a new partnership with the Amputee Coalition. As a result, AOPA’s patient-care facilities can provide Amputee Coalition materials to their patients for free and will be listed on the Amputee Coalition website as partners. So, although we did not reach 20/20 vision, I am proud to have led these efforts. I truly feel that AOPA and all of you are part of my extended family. Along with my gratitude to the AOPA Board and staff, I would like to thank my wife, Tara, our adult children, and my employer and the team at Hanger Clinic, for their support that has enabled me to serve over the past year. I also am thankful to my fellow board members’ companies for their support. Serving as AOPA’s president has given me the opportunity to pay forward to the profession for all your support and guidance. It has been a privilege. I could not be handing the torch over to a more qualified individual, Traci Dralle, CFm. She is smart, talented, hard-working, and a true leader. I look forward to working with and supporting her in my role as immediate past president. Again, thank you for all you do for the profession and your patients. Thank you for your support, and thank you for this opportunity to serve. Jeffrey Lutz, CPO, completed his term as president of AOPA on November 30.



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


distances every day with my dogs and HIKING with my family are things that give meaning to my life! My Allard AFO never lets me down! I can rely on the SUPERIOR function and DURABILITY!

- Wendy, Oregon. Foot Drop as a result of incomplete Spinal Cord Injury and Spinal Syrinx due to serious traffic accident.


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

Publisher Eve Lee, MBA, CAE 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.

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. EXECUTIVE OFFICES


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

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

Tina Carlson, CMP, senior director, membership, education, and meetings, 571/431-0808, tcarlson@AOPAnet.org Akilah Williams, MBA, SHRM-CP, senior manager for finance, operations, and HR, 571/431-0819, awilliams@AOPAnet.org GOVERNMENT AFFAIRS Justin Beland, director of government affairs, 571/ 431-0814, jbeland@AOPAnet.org COMMUNICATIONS, MEMBERSHIP & MEETINGS Joy Burwell, director of communications and membership, 571/431-0817, jburwell@AOPAnet.org Betty Leppin, senior manager of member services, 571/431-0810, bleppin@AOPAnet.org Kelly O’Neill, CEM, manager of membership and meetings, 571/431-0852, kelly.oneill@AOPAnet.org Ryan Gleeson, CMP, assistant manager of meetings, 571/431-0836, rgleeson@AOPAnet.org Kristen Bean, membership and meetings coordinator, 571/431-0876, kbean@AOPAnet.org AOPA Bookstore: 571/431-0876



Devon Bernard, assistant director of coding and reimbursement services, education, and programming, 571/431-0854, dbernard@AOPAnet.org Reimbursement/Coding: 571/431-0833, www.LCodeSearch.com

STRATEGIC ALLIANCES Ashlie White, MA, director of strategic alliances, 571/431-0812, awhite@AOPAnet.org O&P ALMANAC Eve Lee, MBA, CAE, executive director/publisher, 571/431-0807, elee@AOPAnet.org

Design & Production Marinoff Design LLC Printing Sheridan 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 info@aopanet.org. Yearly subscription rates: $59 domestic, $99 foreign. All foreign subscriptions must be prepaid in U.S. currency, and payment should come from a U.S. affiliate bank. A $35 processing fee must be added for non-affiliate bank checks. O&P Almanac does not issue refunds. Periodical postage paid at Alexandria, VA, and additional mailing offices. ADDRESS CHANGES POSTMASTER: Send address changes to: O&P Almanac, 330 John Carlyle St., Ste. 200, Alexandria, VA 22314. Copyright © 2020 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.

Josephine Rossi, editor, 703/662-5828, jrossi@contentcommunicators.com Catherine Marinoff, art director, 786/252-1667, catherine@marinoffdesign.com Bob Heiman, director of sales, 856/673-4000, bob.rhmedia@comcast.net 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 11,400 subscribers. Engage the profession today. Contact Bob Heiman at 856/673-4000 or email bob.rhmedia@comcast.net. Visit bit.ly/AOPAMedia2021 for advertising options!

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HHS Assists Providers During COVID-19 U.S. healthcare facilities relied on distributions from the CARES Act Provider Relief Fund amid the pandemic Many O&P facilities received funding via the Coronavirus Aid, Relief, and Economic Security (CARES) Act to keep their facilities running during the COVID-19 public health emergency this year. Data from the U.S. Department of Health and Human Services (HHS) demonstrates just how much money was distributed to healthcare firms of all types and sizes in 2020.




Distributed to rural hospitals, rural health clinics, and community health centers in rural areas

$1 Billion

Distributed for specialty rural hospitals, urban hospitals with rural Medicare designations, and hospitals in small metropolitan areas

Distributed April 10, 2020, from HHS to eligible providers

Distributed in a second phase to Medicare fee-for-service providers through an application process

$4.9 Billion

Distributed in first phase

$2.5 Billion

Distributed in second phase


$25,822,070,722 Awards Total Amount*

SOURCE: https://taggs.hhs.gov/coronavirus



*The map provides data on awards made by HHS using the ermergency supplemental appropriation funding provided in the Coronavirus Preparedness and Responses Supplemental Appropriations Act, the Families First Coronavirus Response Act, the CARES ACT, and the Paycheck Protection Program.

Anticipated amount of new, third phase funding for providers, including those who were previously ineligible, such as those who began practicing in 2020

“HHS has worked to ensure that all American healthcare providers receive support from the Provider Relief Fund in a fast and fair way, and this new round helps ensure that we are reaching America’s essential behavioral health providers and takes into account losses and expenses relating to coronavirus. We’ve worked with all of the resources we have across HHS to ensure that America’s heroic healthcare providers know they can apply for support.” —HHS Secretary Alex Azar in an Oct. 1, 2020, press statement regarding the third phase of funding

SOURCES: U.S. Department of Health and Human Services, www.hhs.gov/coronavirus/cares-act-provider-relief-fund/data/index.html

$10 Billion

$30 Billion $20 Billion $20 Billion


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Researchers Study Benefits of Microprocessor-Controlled Orthoses “The findings that were most significant were related to self-selected gait speed, balance [both standing and dynamic], risk of falls, and quality of life,” said Shenan Hoppe-Ludwig, CPO, a study author and clinician at the AbilityLab’s Max Nader Lab for Rehabilitation Technologies & Outcomes Research. “Though not all outcomes tested showed significance, the ones that did have implications to patients’ daily function and may translate to improved quality of life. The ability to be more active with less risk of injury allows for mobilitychallenged patients to be engaged in their environment and improve or maintain their independence.” The study, “Microprocessor-Controlled Knee Ankle Foot Orthosis Vs. Stance Control Vs. Locked KAFO: A Randomized Control Trial,” was published in the September 22 issue of Archives of Physical Medicine and Rehabilitation. The research team is currently working on a follow-up study, seeking a better understanding of which patient diagnoses/presentations benefit the most from use of an MPO, what happens with longer use of an MPO, and related questions.

Study Finds Early Prosthetic Intervention May Reduce ED Visits Researchers analyzed data on 510 patients with lower-limb amputations to conduct Hanger’s second IMPACT study, which evaluates how receipt of a prosthesis affects overall healthcare utilization. Emergency department (ED) use, a common proxy for healthcare utilization, was assessed in the context of timing of receipt of a lower-limb prosthesis following amputation, as well as not receiving a prosthesis. The research team, which included Shane R. Wurdeman, PhD, CP, FAAOP, and Taavy A. Miller, PhD, CPO, from Hanger, accompanied by Rajib Paul, PhD, and Melinda Forthofer, PhD, from the University of North Carolina at Charlotte’s Department of Public Health, found that individuals who received an early prosthesis—within three months following amputation—were 48 percent less likely to use the ED compared to those who did not receive a prosthesis. The finding was true across all age groups. The researchers also found that the percentage of ED use as a measure of overall 10


healthcare utilization appears to have an upward trend as the time from surgery to prosthesis receipt increases. Additionally, individuals who experienced a fall had 2.8 times the odds of ED utilization. The findings were published in PM&R: The Journal of Injury, Function, and Rehabilitation. “The IMPACT 2 study not only underscores the significance of long-term health benefits for the patient, including reduced falls and better quality of life; it also highlights the value of cost savings in healthcare utilization that comes with receipt of a prosthesis early on in the rehabilitation process,” said James Campbell, PhD, Hanger chief clinical officer. “This is yet another illustration of the holistic benefits of early prosthetic rehabilitation.” The IMPACT series is part of a collection of research studies published by, or in various stages of publication by, Hanger Clinic’s Clinical and Scientific Affairs Department, in collaboration with researchers, clinicians, and academic institutions.

PHOTOS: Shirley Ryan AbilityLab

A team of researchers at the Shirley Ryan AbilityLab has published a randomized crossover study evaluating the potential of a microprocessor swing- and stance-controlled knee-ankle-foot orthosis (MPO) to improve balance, functional mobility, and quality of life among users, when compared to stance-control orthoses (SCOs) and conventional knee-ankle-foot orthoses (KAFOs). The researchers recruited 18 Chicago-area individuals who actively used a KAFO or SCO for impairments due to neurologic or neuromuscular disease, orthopedic disease, or trauma, then trained the subjects to acclimate and use MPOs. Once training was complete, researchers measured participants’ gait speed and endurance, balance, risks of falls and reductions in falls, and quality of life via various outcome measurement tools. Significant changes were identified in participants’ self-selected gait speed between baseline and post-MPO assessment. For example, MPO users were found to walk significantly longer during the six-minute walk test than when using their baseline devices.


VR-Based Therapies Could Alleviate Phantom Limb Pain


Coapt has been awarded a $2.3 million grant from the U.S. Department of Defense (DoD) to develop virtual reality (VR) and hardware-based therapies for individuals with amputation. The grant is part of the DoD’s Restoring Warfighters With Neuromusculoskeletal Injuries Research Award. The company will use the grant to continue studying technology-based therapies to help individuals with limb loss better manage phantom limb pain (PLP), according to Chief Executive Officer Blair Lock. “For some, PLP can be really severe and greatly impact daily life,” he said. “Mirror therapy or opioids are often used to treat PLP, but preliminary studies are showing us that a VR-guided muscle actions therapy may be more effective and last longer than traditional therapy.” The new therapies leverage myoelectricbased technology to enable upper- and


Diabetes-Related Amputations

A total of


U.S. hospitalization discharges lower-limb amputees to don a prosthetic interface embedded with electrodes that detect similar myoelectric signals, according to Lock. “These signals allow the user to control actions in the interactive VR and provide an effective treatment for PLP,” he said. “The great part about this therapy is that it’s not only very promising, but because it can be in an immersive VR video game, it can also be fun and engaging.”

for a lower-extremity amputation were reported with diabetes as a listed diagnosis among U.S. adults aged 18 or older in 2016 (5.6 per 1,000 adults with diabetes). SOURCE: “National Diabetes Statistics Report, 2020,” U.S. Centers for Disease Control and Prevention

Grant To Fund Development of Socket Fit-Sensing System The U.S. Army Medical Research Acquisition Activity has awarded a $1.5 million contract to Liberating Technologies Inc. (LTI), the research branch of College Park Industries, to develop a socket fit-sensing system to assist amputees in the self-management of prosthetic socket fit. For the next four years, Ben McDonald, LTI’s senior software engineer, will lead the company’s efforts and coordinate partnerships with the Minneapolis VA Health Care System and the University of Michigan in completing this project. This project aims to refine and optimize a previously developed socket fit-sensing prototype for robustness, durability, and ease of use, in preparation for take-home testing. Researchers will enhance the socket fit detection algorithms

through testing on a larger population. While evaluating the effectiveness of the system, the LTI team and its partners will determine the improvement in amputees’ self-management of socket fit through the use of prosthetic socks and generate pilot data to fuel a future clinical trial. “We are excited to continue our partnership with the Minneapolis VA and University of Michigan to develop a tool to help persons with limb difference optimize their daily prosthetic fit,” said Todd Farrell, director of research at LTI. “Challenges with prosthetic fit are a common issue, particularly for those individuals with sensory neuropathy or those that have recently had an amputation and are therefore inexperienced wearers. We believe that the proposed device will help to improve socket fit and therefore help us reach our goal of improving the quality of life for our patients.” O&P ALMANAC | NOVEMBER/DECEMBER 2020




Most Healthcare Facilities Lack Cybersecurity Protections

Only 44 percent of

healthcare organizations, including hospitals, physician practices, accountable care organizations, and business associates, are meeting national cybersecurity standards designed to protect against cyberattacks. SOURCE: “Cynergistek Annual Report 2020,” Cynergistek, September 2020.


Researchers Compare Microprocessor Knees Hanger Inc. has completed its Outcomes ASsessment and DISsemination (OASIS) 1 study evaluating the effectiveness of four common microprocessor-controlled knee (MPK) models. The research team studied outcomes in the areas of mobility, satisfaction, quality of life, and injurious falls among patients using MPKs from four separate manufacturers. The study is anticipated to be the first of a series that will compare a variety of O&P components across different patient groups, with a goal of enhancing patient outcomes across the O&P profession. “The ability to select components from various manufacturers that yield the best outcomes is critical to effective patient care,” said James Campbell, PhD, Hanger chief clinical officer. The researchers found that there was a degree of parity among the four different MPK models

for the sample of 602 individuals, with no differences reported in mobility or satisfaction. There was, however, a significant reduction in injurious fall rates for users of two types of MPKs compared to injurious fall rates for patients with amputation due to diabetes or vascular disease using a non-microprocessor knee. Additionally, the study reported similar age-related changes in outcomes with each MPK. “This clinical insight will help support professionals in making informed, unbiased decisions about patient care, and in turn, provide the best possible treatment for each individual who requires O&P services,” said Hanger President and Chief Executive Officer Vinit Asar. Additional information on this study and previously published research can be found on Hanger’s website at hangerclinic.com/ for-professionals/research-innovation.


Netflix Documentary Features Paralympic Athletes



Team Össur members Bebe Vio and Ntando Mahlangu are among six athletes profiled in the Netflix documentary about the Paralympic movement “Rising Phoenix,” now airing on the streaming service.

PHOTOS: Courtesy of Össur

A documentary film recently released on Netflix features the stories of six Paralympic athletes who have made a significant impact on the sports world. “Rising Phoenix,” which premiered on August 26, shares the stories of several athletes, including Team Össur members Bebe Vio and Ntando Mahlangu, along with Össur Ambassador Jean-Baptiste Alaize and Paralympic sprinter Jonnie Peacock. The documentary also features Prince Harry, the Duke of Sussex, as well as para-athletes Ellie Cole, Matt Stutzman, Cui Zhe, Ryley Batt, and Tatyana McFadden. “We are pleased that Netflix, a major global streaming network, has chosen to dedicate such well-deserved attention to the Paralympic movement and especially to these extraordinary athletes, who truly embody the spirit of life without limitations,” said Jon Sigurdsson, Össur’s president and chief executive officer.


AOPA Board of Directors Sets Goals for 2021 AOPA leadership is preparing now for the challenges and opportunities that 2021 is sure to bring. New and returning board members have voiced their excitement about the possibilities to come in the new year, as companies recover from pandemic-related shutdowns and the profession advocates for O&P-friendly legislation during the new congressional session. The AOPA Board of Directors is planning to step up its focus on advocacy, research, and education efforts as the new year begins. The 2020-2021 AOPA Board of Directors, whose members were elected during the AOPA Virtual National Assembly in September, will be led by President Traci Dralle, CFm. Dralle takes the reins from Jeffrey Lutz, CPO, who served as president for the 2019-2020 term. Lutz will continue serving the association as immediate past president. As Dralle begins her term as president, she will be supported by Dave McGill, president-elect; Teri Kuffel, JD, vice president; Rick Riley, treasurer; Eve Lee, MBA, CAE, secretary; and eight additional board members. Two individuals are new to the board this year: John “Mo” Kenney, CPO, FAAOP, and James O. Young Jr., LP, CP, FAAOP. In addition, 2020 Board Member J. Douglas Call, CP, and 2020 Immediate Past President Jim Weber, MBA, are concluding their board service at this time. To the right is the full list of 2020-2021 AOPA Board of Directors members, who take office Dec. 1, 2020, and will serve through Nov. 30, 2021.



2021 AOPA Officers

Traci Dralle, CFm President

Dave McGill President-Elect

Teri Kuffel, JD Vice President

Rick Riley Treasurer

Jeffrey Lutz, CPO Immediate Past President

Eve Lee, MBA, CAE Secretary (Nonvoting)

2021 AOPA Board Members

Jeffrey M. Brandt, CPO

Mitchell Dobson, CPO, FAAOP

Elizabeth Ginzel, MHA, CPO

Kimberly Hanson, CPRH

New Board Members

Linda Wise

Special Thanks

Retiring Shane Wurdeman, PhD, CP, FAAOP(D) John “Mo” Kenney, James O. Young CPO, LPO, FAAOP Jr., LP, CP, FAAOP

J. Douglas Call, CP

Jim Weber, MBA




Coleson Chase has been promoted to vice president, operations, and Jamie Seabold has been promoted to director, sales, at SPS. “These promotions are critical next steps to ensure SPS growth leading into 2021,” said Regina Weger, who was recently promoted to president, products and services. Kristin Wacker has been hired as sales representative at Proteor USA for the Great Lakes territory covering Michigan, Ohio, Indiana, and Kentucky. Wacker, who has a communications degree from Columbia, joins the team with Kristin Wacker several years of sales experience in the medical field. “I am excited to have Kristin join the team,” said Proteor USA Vice President of Sales Frank Oschell. “Her energetic, process-driven approach to uncovering needs and providing solutions will serve this customer base extremely well.”


The Orthotic & Prosthetic Activities Foundation (OPAF) has announced new board members for the 2020-2021 fiscal year: Travis Young, CPO • Travis Young, CPO, a clinician at Advanced Prosthetics, will serve as president. • Michelle Jamin, DPT, who works at Drayer Physical Therapy, will serve as vice president. • Becky Snell, who is IT director Lesleigh Sisson, at Dankmeyer Inc., will service CFO, CFM as treasurer and secretary. • Lesleigh Sisson, CFO, CFM, will serve as immediate past president.

Michelle Jamin, DPT

Becky Snell

OPGA has announced the addition of Össur Bracing and Supports to its offering of supplier partners. “OPGA has had a long and successful partnership with Össur Prosthetics over the years, and I am thrilled to be bringing their Bracing and Supports Division into our community,” said OPGA President Todd Eagen. Össur and the Challenged Athletes Foundation (CAF) recently surprised five people with limb loss/limb difference in five days, all of whom received Össur’s running prostheses as the 14


latest recipients of grants from CAF. The five beneficiaries were treated to special “Zoom” meetings with some of their heroes. Recipients included 14-year-old quadruple amputee Landis Sims, a Yankees fan who was visited by MLB greats Eric Byrnes and Kevin Millar; 11-year-old Shweta Bronberg, who met Össur Ambassador and international model Paola Antonini; youth football coach Darren Stroman, who was connected with the NFL’s Luke Kuechly; Greg Griffin, who met with three top Supercross/Motocross racers; and Team USA wheelchair volleyball player Kimmie Champion, CPO, of Eastside O&P, who was presented with a compilation video of appreciative messages from patients. “For athletes with limb loss, participation in sports is not always possible due to the high cost of adaptive sports equipment not covered by medical insurance,” said Travis Ricks, programs director for CAF and ambassador for Össur. “Our long-standing partnership between CAF and Össur has allowed individuals to regain their independence using running prosthetics, connecting with the community, and getting instructional support for running and mobility.” Proteor USA LLC, a wholly owned subsidiary of France-based Proteor Group, has signed an agreement with Ottobock to acquire a significant portion of the lower-limb prosthetics portfolio of Freedom Innovations. The agreement was reached by Proteor and Ottobock at the end of September, and the proposed transaction is anticipated to close by the end of 2020. Under the agreement, Proteor will expand its lower-limb prosthetics portfolio and acquire a range of Freedom Innovations’ products. “Through the acquisition of a significant portion of Freedom Innovations, Proteor is eager to combine the teams in the United States and Europe and expand globally, thereby providing a clear choice to prosthetists and their patients for enhanced outcomes,” said Edouard Archambeaud, chief operating officer and member of the managing board of Proteor. “We are dedicated to providing inventive, dependable products to the orthotic and prosthetic community that offer increased independence with an outstanding product portfolio,” added Matthew Swiggum, president and chief executive officer of Proteor USA. VGM Insurance Services, a division of VGM Group Inc., is celebrating 30 years providing specialty insurance programs for a variety of niche industries. “We’re excited to celebrate such an important milestone,” said Mike Mallaro, VGM Group’s chief executive officer. “VGM Group as a whole has experienced significant growth over the past three decades, and VGM Insurance has been essential to that progress.” “We’re just in the beginning,” said Mike Kloos, president of VGM Insurance. “Thirty years is young for an insurance company. To have grown the way we have in such a short amount of time is extraordinary, but I’m even more excited for the next 30 years.”

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‘Same or Similar’ Situations Joint publication offers guidance on appealing denials of replacement orthoses

Editor’s Note—Readers of Reimbursement Page are eligible to earn two CE credits. After reading this column, simply scan the QR code or use the link on page 20 to take the Reimbursement Page quiz. Receive a score of at least 80 percent, and AOPA will transmit the information to the certifying boards.



Medicare administrative contractors (DME MACs) recently released a joint publication about the appeals process, with a focus on claims related to “same or similar” denials. The publication offers tips for what should be shown, explained, and documented when appealing a same or similar denial when you have provided a replacement orthosis during its reasonable useful lifetime.

Replacement Documentation






Change in Condition If the orthosis was replaced because of a change in condition, it is recommended that—in addition to providing the standard pieces of documentation (proof of delivery, standard written order, advanced beneficiary notice, etc.)—you also should provide documentation to substantiate the medical or physiological change in the condition of the patient. This documentation should focus on, at a minimum, the diagnosis and prognosis, the clinical course of care, and the patient’s past experience or results with the previous orthosis. The documentation should indicate why

Lost or Stolen If the orthosis was replaced because it was lost or stolen, you must be able to document the loss or theft—understanding that “lost” doesn’t always equate to “misplaced.” For example, the orthosis may be lost as a result of a natural disaster, such as a fire or flood. The documentation used to demonstrate the loss or theft could include copies of police or insurance reports as well as statements from the patient or the facility (if the brace was lost in a facility). If the brace was lost as a result of a natural disaster, that should be noted in the record— and check if CMS has declared an emergency, because there may be special rules to follow and modifiers to use when replacing the item. Be sure there is a standard written order on file, unless you have been specifically instructed that one is not needed. Make sure that all other coverage criteria and medical necessity criteria have been met.

PHOTO: Getty Images


Providers fit patients with replacement orthoses for several reasons. The reason for replacement guides the documentation that should be submitted by the provider.

the previous orthosis did not meet the patient’s goals and why it is no longer appropriate, and should explain why the new orthosis is medically necessary and appropriate. You also may choose to document that the previous orthosis could not be altered or adjusted to meet the patient’s current needs.

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Irreparably Damaged For a device being replaced due to irreparable damage, you must be able to explain both the actual damage and what caused it. Remember that irreparable damage is damage that can be pinpointed to one specific event or cause—not damage caused by everyday wear and tear—so it’s important to show the specific cause for the damage and to explain why the device cannot be repaired. Combination If the replacement is due to a combination of issues—for example, the brace was lost and there has been a change in condition—be sure to document both reasons.

Understanding the Appeals Process

The release of the new joint publication is an appropriate time to review the five levels of the Medicare appeals process. The original blueprints for the current Medicare appeals process—including the five levels and the timeframes for each level—stem from the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act, as well as the Medicare Modernization Act of 2003. Below is a synopsis of the five levels of appeals.



limitation for scope of review only applies at the first two levels of appeal. Reconsideration All reconsideration requests must be made within 180 days of receipt of the redetermination decision. The review will be handled by a qualified independent contractor (QIC); the current QIC is MAXIMUS Federal. Reconsideration is your last chance to provide any new evidence or documentation to support your claim, and the QIC should respond within 60 days. The QIC is currently conducting a Telephone Discussion and Reopening Process Demonstration, which was extended in August 2020 and will now run through Dec. 31, 2021. This discussion and reopening process allows the QIC to directly discuss with you, over the phone, the facts of your appeal and provides an opportunity for you to submit any missing documentation or information identified by the QIC to support a favorable outcome. MAXIMUS also is conducting an analysis of previously completed unfavorable reconsideration decisions to determine if any potential appeals can be resolved favorably through the reopening process. So, the QIC has the ability to reopen previously adjudicated claims, even if they are pending at the next level, and re-review them if the analysis supports the possibility of a favorable outcome.


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Redetermination After you receive a determination on a claim, you have 120 days of receipt of the claim determination to file an appeal. Keep in mind that, for redetermination as well as for the other levels, the appeal is considered to be filed on the date the contractor receives the appeal, and not the date you submit it. If you are unable to comply with the deadline, or otherwise miss the deadline, you may still file an appeal if you can show or establish a good cause for the delay. An example from the Medicare Claims Processing Manual of a cause for delay that may be deemed acceptable is an unavoidable circumstance—a situation that is beyond your control, such as a natural disaster or a public health emergency (for example, the COVID-19


coronavirus public health emergency). On the other hand, a lack of office management skills or expertise by you or a business associate will not be considered a good cause for missing the deadline. The redetermination request will be reviewed by the DME MAC that initially processed and denied the claim. However, an individual other than the person who made the initial determination will review the redetermination. This will be your first chance to submit any new evidence or documentation that was not present during the initial review, or to clarify any documentation already submitted. The DME MAC should respond to your request within 60 days. If you are unsuccessful with the redetermination, you should closely review the decision letter or response to make sure the reason for the denial remains consistent. CMS has instructed the DME MACs to limit their review of a claim denial to the initial reason(s) for the denial of the claim and to avoid denying the claim for a new undocumented or previously unreported reason. However, this limitation for the scope of review does have some limits and stipulations: It only applies to claims denied in a postpayment review, such as a recovery audit contractor audit or a comprehensive error rate testing audit. Prepayment denials may continue to be denied for different reasons, other than those originally identified. The



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While your reconsideration request may automatically be selected to take part in the Discussion and Reopening Process Demonstration project, you also have the option to contact MAXIMUS and ask that your claim be included in the demonstration—especially if the claim is a reopening. Early results of this project show a favorable outcome of more than 80 percent. Thus, if you are selected for the discussion, you should consider taking part; and if you had an unfavorable outcome with the QIC, you may want to request a reopening. Administrative Law Judge An administrative law judge (ALJ) will perform an independent review/hearing of a claim based only upon the information that has been submitted during prior levels of appeal. An ALJ hearing must be made within 60 days of the receipt of the reconsideration decision, and providers must meet a minimum amount in controversy (AIC) threshold. The AIC for 2020 is $170, and in 2021 will increase to $180. Given the delays and backlogs at the ALJ level, you have the option of seeking a negotiated settlement, especially if you have several appeals awaiting an ALJ review. In this process, you seek to have your appeals dismissed without a final decision regarding coverage being determined, and you are paid at a negotiated percentage of the full value of the claim(s). Some conditions must be met if you wish to engage in this process. (Please review the Reimbursement Page in the August 2020 issue of O&P Almanac for a more thorough discussion of the settlement option.)




appeals process works and which documentation is required could be the difference between a successful appeal and an unsuccessful one.

disagree. For this reason, it is vital that your request for a DAB/MAC review clearly identifies the parts of the ALJ’s decision with which you disagree and explains why you disagree with decision. At the DAB/MAC stage, you may want to consider involving an attorney— although this is not a requirement. An attorney’s expertise may be helpful because some of the possible reasons for submitting a DAB/MAC request may be based on the ALJ’s decision being inconsistent with established statutes, regulations, Medicare agency rulings, etc. Also note that the results of DAB/MAC reviews are published and made public via website, and, as of 2017, it is possible that some of those decisions could be used as precedent in your appeals. Judicial Review Judicial review, or federal court review, involves you filing a civil lawsuit in federal court, within 60 days of receiving the DAB’s decision, against the Medicare program. At this level, you also must meet an AIC threshold of $1,670 in 2020, which increases to $1,760 in 2021.


Know What You’re Getting Into The recent announcement about same and similar appeals from the DME MACs demonstrates the importance of understanding not only the reason for a claim denial, but also who is denying your claim as well as the rules of the appeals process. Knowing how the appeals process works and which documentation is required could be the difference between a successful appeal and an unsuccessful one.

Devon Bernard is AOPA’s assistant director of coding and reimbursement services, education, and programming. Reach him at dbernard@AOPAnet.org. Take advantage of the opportunity to earn two CE credits today! Take the quiz by scanning the QR code or visit bit.ly/OPalmanacQuiz. Earn CE credits accepted by certifying boards: www.bocusa.org

PHOTO: Getty Images

Departmental Appeals Board A request for a review by the Departmental Appeals Board (DAB)— also known as the Medicare Appeals Council (MAC)—must be made within 60 days of receipt of the ALJ decision. The DAB will review only the information present in the administrative record (what was presented to the ALJ), and only the issues addressed in the decision of the ALJ with which you


Knowing how the

This Just In

Competitive Bidding Countdown Single payment amounts and contracts announced for competitive bidding of off-the-shelf knee and spinal orthoses



payment amounts (SPAs) for select off-the-shelf (OTS) knee and OTS spinal orthosis codes included in the Medicare competitive bidding program for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS), scheduled for implementation on Jan. 1, 2021. AOPA has continually expressed a need for CMS to delay implementation of Round 2021 of the Medicare DMEPOS competitive bidding program due to the COVID-19 public health emergency. AOPA has engaged in multiple communications with high-ranking CMS officials; coordinated advocacy efforts with AOPA partner organizations, both within and outside of O&P; provided vocal support of congressional efforts, including a letter to CMS signed by more than 100 members of Congress requesting consideration of a program delay; and participated in comprehensive discussions with key legislators on the importance of ensuring Medicare beneficiaries have access to highquality, clinically appropriate care, delivered by properly credentialed and accredited providers.



AOPA will continue to provide feedback to CMS through these and other channels. In addition, AOPA is still working to secure co-sponsors and congressional support for the Medicare O&P Patient-Centered Care Act, which includes a provision that, if enacted, would preserve patient access to OTS orthoses from certified and/or licensed orthotists and prosthetists by creating an exemption from the requirement to have a competitive bidding contract, similarly to physicians and other healthcare professionals. (Visit AOPAvotes.org to support this legislative effort.) CMS removed several product categories from inclusion in Round 2021, but it elected to move forward with competitive bidding for OTS knee and OTS spinal orthoses. The product categories removed from inclusion in competitive bidding by CMS represented product categories that have been part of the Medicare DMEPOS competitive bidding program in the past. Due to their inclusion in previous rounds of competitive bidding, SPAs were established nationally that resulted in significant savings to the Medicare program. New bids that

This Just In

were submitted as part of the Round 2021 competition for these product categories did not result in significant additional savings for the Medicare program. Because OTS knee and OTS spinal orthoses were not previously part of Medicare competitive bidding, the competition resulted in significant savings to the Medicare program over the three-year initial program length and the subsequent expansion of the SPAs into non-competitive bid areas. In its announcement, CMS indicated that in a limited number of competitive bidding areas (CBAs) where competitive bidding did not result in significant savings to the Medicare program, competitive bidding for OTS orthoses will not be implemented. AOPA will provide more information about these CBAs shortly. If you elected to participate in the competitive bidding program for OTS knee orthoses, OTS spinal orthoses, or both, you should have either been

The contracted suppliers and locations for each CBA will be listed in the Medicare Supplier Directory starting on Jan. 1, 2021.

offered a contract effective for claims with a date of service on or after Jan. 1, 2021, or you received a disqualification notice indicating that you were not offered a contract. If you were offered a contract, you had to accept or decline the contract offer by Nov. 10, 2020. Note that if your previously submitted bid was found to be at or below the median composite bid rate and you declined a contract offer, you will have forfeited your $50,000 bid surety bond. On Nov. 20, 2020, CMS announced the contracted suppliers and locations for each CBA. These locations and suppliers will be listed in the Medicare

Supplier Directory starting on Jan. 1, 2021. The SPAs and contract winners for each CBA and detailed information regarding next steps are available on the Medicare DMEPOS competitive bidding website at www.dmecompetitivebid.com/cbic/cbic.nsf/DocsCat/ Home. Questions regarding the Medicare DMEPOS competitive bidding program can be directed to AOPA’s Devon Bernard at dbernard@AOPAnet. org or Joe McTernan at jmcternan@ AOPAnet.org.

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Communicating WITH






NEED TO KNOW • With 2021 on the horizon, it’s time for O&P facilities to reconsider how they are connecting with patients to convey new safety protocols and the continuing importance of O&P intervention. • Facilities should take a strategic approach when pushing out communications via email, text message, and social media, and consider the demographics of the target audiences. • Patients expect to see robust facility websites when they go online to have their questions answered, so O&P companies should update their sites regularly with articles, blog postings, current photos, and even videos. • Marketing experts recommend taking a compassionate tone in communications, given the ongoing pandemic, and focusing on education rather than overly selling a company’s services.


FTER MANEUVERING TEMPORARY shutdowns and reduced

patient loads during the early months of the COVID-19 pandemic, O&P businesses are preparing for a difficult winter as infections rates increase around the country. The promise of vaccines and improved treatments bodes well for the future, but it will be several months before these interventions become widely available. Many patients—particularly older patients and those with comorbidities—will remain concerned about their safety in public venues for years to come. In the meantime, O&P companies are revamping patient-care processes and procedures to create safer facilities designed to limit face-to-face interactions and protect patients, clinicians, and staff. Many of these policy changes are expected to become permanent. Conveying to patients the continuing importance of O&P intervention and the changes facilities have made to accommodate patient and provider safety is critical. Here, O&P business professionals, patient advocates, and marketing and communications experts share six tips for overhauling communications strategies and connecting with patients as we head into 2021.

Share New Safety

Tip #1 Protocols With

Patients and Prospects

Facilities should encourage patients to return for appointments and follow-up care by highlighting new safety measures that offer patients peace of mind via regular, cadenced communications that engage them while explaining these new policies and procedures. Most healthcare facilities have shifted their practices to promote a safe and healthy environment for their patients, according to George Kuhn, owner and president of Drive Research, a firm that performs qualitative and quantitative market research for several industries, including healthcare. New protocols include scheduling appointments online; conducting health surveys to document that patients are symptom-free; taking temperatures; reducing in-office foot traffic; and requiring masks.




When Patients Forgo


While most facilities have seen their patient caseloads rebound in recent months, some patients remain reluctant to leave the safety of their homes to visit healthcare professionals—and the problem could get worse as positivity rates increase. “There’s a staggering number of people who are not seeing their healthcare providers,” says Denise Hoffmann, a nurse and mother of three who lost her leg in college—and an active member of the Amputee Coalition’s Scientific and Medical Advisory (SciMed) Committee. “We have to make sure patients feel safe,” she says. Shortly after the pandemic began, the World Health Organization published an announcement underscoring the unique challenges individ-

“Many of these new protocols are shared in their marketing emails, social media, and appointment confirmation calls to ensure everyone is aware of the new rules,” says Kuhn. “Through several studies [across several industries], our market research company found that promoting these safety protocols will increase consideration for using a specific organization among consumers.”

uals with disabilities face during a pandemic, explains Phil Stevens, MEd, CPO, FAAOP, director of the Department of Clinical and Scientific Affairs at Hanger Clinic. “It’s important for patients and clinicians alike to recognize that a global pandemic doesn’t erase chronic disabilities,” he says. “If you have a device that you need to accomplish your activities of daily living and you can’t use it, having those issues addressed becomes essential.” Kara Couch, CRNP, MS, has seen first-hand the negative impact of failure to keep up with diabetic foot care. Couch, who is chair of the Amputee Coalition SciMed Committee, works at an outpatient wound care clinic and the Limb Preservation Center at the George Washington University Hospital. She saw higher rates of amputation among those patients who delayed care at the wound care clinic during the early months of the pandemic. “We didn’t shut down the clinic—but some people were afraid to come in anyway,” says Couch. Couch’s anecdotal evidence has been borne out by recent scientific investigations. In Italy, researchers at the University of Campania found that delay of care among diabetes patients with foot ulcers led to higher amputation rates during the pandemic. And a separate research team at pandemic resulted in a significant increase in the number of major amputations. These findings emphasize the need for ongoing preventive and follow-up care at healthcare facilities, including O&P practices.



Transparency is key, agrees Denise Hoffmann, a nurse and mother of three who lost her leg in college—and an active member of the Amputee Coalition’s Scientific and Medical Advisory (SciMed) Committee. She advises facilities to communicate their waiting room policies clearly, as many senior patients or patients with underlying conditions are particularly afraid of these areas—even when they are empty. In addition, let patients know that clinicians and staff are wearing personal protective equipment (PPE). On its website, Hanger Clinic explains that facilities are equipped with face masks, gloves, and hand sanitizer for staff and visitors, according to Carrie Davis, vice president patient experience, at Hanger Clinic. “We’ve spaced out appointments to minimize the number of people in the clinic at one time and, when possible, have taken patients directly back to patient rooms for check-in,” she says. “Patients also have the option to wait in their cars and receive a call when it’s time to come in to be seen.”

PHOTOS: Getty Images

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Tip #2 Explain How and Why

Some Interactions Have Become Virtual

Since the pandemic began, the largest shift in consumer behavior “is how they interact with healthcare organizations,” according to Kuhn. “General consumers are shopping online for at-home delivery, or shopping online to pick up their items in-store. The same can be said for healthcare consumers.” COVID-19 has accelerated the push for virtual healthcare. In fact, two out of thee consumers are more likely to consider telehealth or digital healthcare since COVID-19 began, according to a survey conducted by Drive Research.

Phil Stevens, MEd, CPO, FAAOP



Facility Website

One easy—and important—tactic to communicate with both patients and prospective patients is to design a robust facility website and continuously update it. “Nearly all healthcare consumers turn to the internet when they have an immediate medical need or question,” explains Kuhn. “They also use it to support their decision-making process when choosing a healthcare facility.” He suggests that facilities consistently update their websites with new resources such as articles and blog postings. “This helps increase your authority and credibility among new patients. Plus, it’s free— other than your time to write and publish the information.” Many facilities have posted a COVID-19 statement or alert at the top of the home pages, but experts at CareCloud, a healthcare IT solutions firm, suggest taking this approach one step further, by creating a designated COVID-19 page or customized FAQ section. They recommend answering common questions on this webpage, with a goal of alleviating patient concerns regarding safety, appointments, and more.

Along with a list of safety measures in place, photos of staff in PPE on your website can visually demonstrate the protocols being taken, says Kara Couch, CRNP, MS, a nurse at the outpatient wound care clinic and the Limb Preservation Center at the George Washington University Hospital and chair of the Amputee Coalition SciMed Committee. Kuhn also recommends boosting your website’s prominence through online reputation management and search engine optimization to ensure prospective patients find your facility quickly when they search for O&P patient-care clinics.

Strategically Choose

Tip #4 Communications Platforms

Keep your patients top-of-mind when considering the most appropriate communications channels to use. “If most of your patients are 60 or older, they are most likely not active on social media. In this example, phone calls or text reminders are your best approach,” Kuhn says. “If your patients are a mix of generations, then I’d recommend email outreach, social media, and text reminders.”

PHOTO: Getty Images

Even in O&P, traditional extended face-to-face appointments aren’t always necessary, says Phil Stevens, MEd, CPO, FAAOP, director of the Department of Clinical and Scientific Affairs at Hanger Clinic. “Remote consultations, curbside appointments, and thoughtful phone calls can sometimes replace face-to-face visits and shorten those on-site visits when they need to occur,” he says. “While patients need to understand the privacy risks that come with telehealth encounters, they can be an effective means of assessing problems and determining next steps,” says Stevens. Some aspects of in-person appointments have changed, too. For example, more patients are being asked to check in via digital portals and call reception desks when they arrive, to reduce interactions with staff members. Because patients will have varying reactions to virtual healthcare, facilities should warn patients about all new processes well in advance of appointments—and be prepared to answer questions or guide them through their first virtual experiences.

Tip #3 Prioritize Your






Communications Do’s and Don’ts Consider these tips when crafting communications messages, suggests George Kuhn, owner and president of Drive Research, a firm that performs qualitative and quantitative market research for several industries, including healthcare: DON’T use humor. Although we could all use a good laugh right now, using too much humor can come off as though you’re making light of a sensitive situation, says Kuhn. DON’T overly self-promote. Focus on educating your patients and creating marketing that is relevant to their lives, Kuhn advises. “This is not the time to overly sell your services.”

Hanger Clinic has leveraged email messaging throughout the public health emergency. When the pandemic hit, “we got to work immediately connecting with patients to assure them we would safely continue to provide their essential care,” says Davis. “From our enterprise-wide electronic health records system and in collaboration with our Net Promoter Score survey partner, we sent thousands of email notifications to our patients about the precautions we were taking in our clinics and the options we had for safely delivering their care in person or remotely.” Many facilities also have ramped up their use of text messaging, with patients’ permission, by sending messages that patients will see instantly on their mobile phones. The experts at CareCloud suggest sending text messages regularly on topics that don’t involve PHI, such as home health instructions and device care information. 30


DO keep it consistent. Try and keep a consistent schedule, with regularly updated content through your website, social media, or email, says Kuhn. “Patients and healthcare consumers alike will start to engage and look forward to your messaging.”

Social media also is a great way to share videos and real-time updates: At Hanger Clinic, “we filmed a video detailing our safety protocols,” says Davis, “and posted it on our website so that patients know what to expect when they enter our clinics. We then shared that through our social media channels.”

Dana Glover In addition, Hanger facilitates interaction with the community by encouraging comments on its social channels, including on its update posts about COVID-19 precautions, according to Krisita Burkett, vice president of public relations and communications. “One advantage of social media is the ability to receive and answer questions quickly, whether via public comments or direct messages,” she says.

Tip #5 Take a Compassionate Tone

Finally, social media can be “a great free marketing channel to share messages,” says Kuhn, adding that some healthcare consumers look to a facility’s social media pages to review hours of operation, address, and consumer ratings.

Carrie Davis At Beacon Prosthetics & Orthotics in Raleigh, North Carolina, social media was instrumental when the facility adopted new processes during the pandemic, says Dana Glover, director of operations. Staff posted new guidelines on Facebook and Instagram. Recently, the facility has pivoted to posts that are less COVIDrelated, opting instead to share photos focusing on patient care, says Glover.

COVID-19 has presented its fair share of challenges to healthcare consumers, says Kuhn, so it’s more important than ever to approach patients with compassion. “Many have lost loved ones, their jobs, or a sense of normalcy,” says Kuhn. “Each patient is living with unique circumstances. By creating content with empathy and compassion, consumers are more likely to trust they are in good hands.” Compassion plays an important role at Beacon P&O, where “we try to create a culture of patient advocacy and patient care first. We treat patients as we would want our families to be treated,” says Glover. Last spring, when safer-at-home recommendations were instituted, there was a “lull” in patient visits, and fewer staff in office to treat the patients who still required care. But staff went out of their way to check in on patients’ general wellbeing, rather than just their orthotic and prosthetic needs. “We reached out by phone, and … postcards worked


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well for people we couldn’t reach by phone,” says Glover. “We used handwritten, personalized notes to tell them we miss them,” and to ask them to call and check in—even if they were doing fine. At Hanger, “our clinicians and staff have responded to challenges presented by the pandemic with flexibility and ingenuity,” says Davis. “From a prosthetist in Ohio fitting devices on two pediatric patients in the clinic parking lot, to clinicians in New York City compliantly delivering services curbside, our employees around the country have been committed to making sure our patients have access to the care they need.”

media channels and encourage people to join. ... Providing peer support is aligned with our core value of being patient-focused, and anyone, whether they are a Hanger Clinic patient or not, can opt in to our AMPOWER peer support program and connect with others in a similar situation.”

engagement so patients can select their preferences for phone, text, or emailed reminders. They recommend providing a link to confirm, cancel, or reschedule appointments so that patients can react as soon as they see the reminder and do not forget to respond.

Herb Kolodny



Tip #6 Reduce Missed

Appointments By Sending More Reminders

A recent study of primary care settings published in “BMC Health Services Research” found an average missed appointment rate of approximately 18 percent. Because many facilities are limiting the number of patient visits each hour to decrease capacity, missed appointments have become even more costly. Researchers at Intrado, a firm that provides technology-enabled communications solutions for healthcare organizations, found that patients may need multiple reminders if they don’t respond right away: “The optimal cadence is setting a 10-day, three-day, and one-day notification schedule prior to their appointment,” they noted in the report, “Healthcare’s New Normal: Transforming How You Connect With Patients During COVID-19 and Beyond.” They also suggest providing multichannel

Of course, include verbiage in any reminder messages asking patients to reschedule if they are feeling sick. Given the ongoing spread of COVID-19, it’s important that patients with any symptoms stay home from healthcare facilities. Christine Umbrell is a contributing writer to O&P Almanac. Reach her at cumbrell@contentcommunicators.com. Editor’s Note: AOPA member companies now have access to more print communications to share with patients. As part of a new partnership with the Amputee Coalition, AOPA members receive complimentary copies of several Amputee Coalition resources to distribute to patients, including inMotion magazine and several brochures regarding adapting to limb loss, pain management, insurance coverage, and more. Sample pieces of literature and window clings were mailed out to AOPA members in late August, along with a form to order additional resources.

PHOTO: Getty Images

The face-to-face interactions that do occur should be extremely meaningful. Remember that some older or comborbid patients are only interacting with a select few individuals. For example, consider Herb Kolodny, an Amputee Coalition patient advocate and above-knee amputee in Connecticut, who shares that he was an extremely active senior prior to the pandemic, cycling on a regular basis in addition to his advocacy duties. Now, due to his age and underlying conditions, he won’t eat in a restaurant, go to a bar, or even visit the grocery store in-person. But he does feel comfortable visiting his clinician, due to the strict safety measures and efforts of the staff. Facilities also may want to help patients connect with other people with amputations or limb differences via peer support connections, facilitated by the Amputee Coalition or their own resources. After the pandemic hit, “Hanger Clinic began offering compliant AMPOWER peer community meetings through Zoom,” says Davis. “We share information about these group meetings on our social

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HE O&P PROFESSION has always

excelled at giving back to the community. Orthotists, prosthetists, and O&P business owners continuously go the extra mile—not only to help their individual patients, but also to strengthen the entire limb loss and limb difference population. That commitment to philanthropy was on full display over the past year, as the COVID-19 pandemic took a heavy toll on communities and economies around the world. Despite reduced



patient loads and revenues, pay cuts, staffing challenges, and ongoing fears of contracting the coronavirus, O&P facilities stepped up their efforts to help others—within their communities, across the country, and even around the globe. From manufacturing face shields for first responders, to building mobile units and swabs for COVID-19 testing, to raising money to fund devices for the uninsured, O&P professionals consistently rallied to lift people up.

Taking a closer look at just a few of the many acts of kindness committed by those in and associated with the profession shows us just how much can be accomplished by companies and people who take the time to help others—and sets an example for how to approach a new year filled with uncertainty.

Convening Famous Faces for O&P Fundraising

PHOTO: Össur

In 2005, Billy Brimblecom Jr., a professional drummer from Kansas, lost his left leg to Ewing’s sarcoma, a form of cancer. After his friends—including successful Hollywood actor Jason Sudeikis—rallied to raise money for a prosthetic leg, Brimblecom decided to pay it forward. He’s now the executive director of the Steps of Faith, a charity composed of several O&P clinicians and other individuals who coordinate prosthetic care by purchasing components and asking clinicians to donate their time. On November 14, Steps of Faith hosted Thundergong!, its fourth annual gala fundraiser— conducted virtually this year. The popular event featured performances by Sudeikis, fellow “Saturday Night Live” alums Will Forte and Fred Armisen, Wynonna Judd, Brandi Carlisle, Ben Harper, and many more well-known names. So, what is Steps of Faith all about? “The short answer is: It’s about hope,” Brimblecom says. “More specifically, we restore mobility and possibilities for amputees in need by getting prosthetic limbs to those who have no health insurance or have no prosthetic coverage.” This assistance has been particularly important in 2020. Between February and May of this year, more than 5 million Americans lost their health insurance, explains Brimblecom. “Due to the pandemic, we’ve seen people requesting our assistance who need a new leg or new prosthesis who never thought they would need to rely on charity to do it for them,” he says. “I dream of a world in which Steps of Faith doesn’t need to exist. But unfortunately, that is not the world that we currently live in.”

Össur helped custom manufacture mobile patient isolation units for transporting patients during the early months of the COVID-19 pandemic.

Donating COVID-19 Test Swabs

While O&P manufacturing firm Össur has a large presence in the United States, Europe, and Asia, the company is based in the relatively tiny capital city of Reykjavík, Iceland, where the population hovers around 122,000. Being a small, isolated country didn’t spare Iceland from COVID’s wrath. When the virus landed on Iceland’s shores after locals returned home from ski holidays in the European Alps last winter, it spread quickly, according to news reports. Luckily for Iceland, Össur was prepared to help. An Icelandic genetic research company called Decode took the lead for its country in conducting COVID-19 testing as hundreds of Icelandic residents began to fall ill. But supplies quickly ran low, and procuring reinforcements was proving next to impossible. Enter Össur. The

manufacturer donated 20,000 swabs it had on hand for testing devices and machinery. Conveniently, the swabs also worked as nasal swabs for COVID-19 testing. “Decode and the health authorities performed tests on them to make sure that they were, indeed, up to snuff, and it turned out they were just good enough quality to use in the testing,” explains Edda H. Geirsdottir, the company’s vice president of corporate communications. “We could see that the infection rates were rising. So, it was kind of a sigh of relief for everyone.” In addition to donating swabs for testing, Össur also was called upon by the Icelandic government to help custom manufacture mobile patient isolation units for transporting infected patients from remote parts of northern or eastern Iceland to hospitals in Reykjavík. O&P ALMANAC | NOVEMBER/DECEMBER 2020


Methodist Orthotics and Prosthetics staff manufactured face shields using an injection-molding process typically used to make O&P devices. “We had about six or seven people all-hands-on-deck within [our research and development and engineering sectors], and they just ripped five units off within a week,” Geirsdottir marvels. She says the entire Össur team was gratified to be able to help their country at a time when so many people felt helpless. “We’re lucky enough to be working in an industry where people are proud of what they do. But, in a situation like this—where this is literally life-and-death—and people are banding together as a team ... it all just hit really close to home,” she says. “That was extremely important for morale. Everyone wants to do something good. And, the fact that we were just in a position to do that was incredibly valuable.”

Based in Flowood, Mississippi, Methodist Orthotics and Prosthetics might not be the biggest name in the O&P profession, but the company had a huge impact on its community when COVID-19 began to surge in the South last spring. Sensing a need among its own employees, other healthcare workers, 36


Wallace. “We had several of our techs who were not as busy as they needed to be because of COVID, and we had some furloughs that were taking place throughout the organization. We needed something positive to happen just to keep people coming to work with a good attitude every day. It just gave everybody a common goal to work toward.”

Caring for Displaced Patients and Communities

Hanger Clinic has gone to great lengths to keep its patients and clinicians safe during the pandemic. But sometimes it’s the small things that make the biggest impact. In early October, a Hanger patient from Phoenix traveled to Houston and was unexpectedly hospitalized. Hanger’s team in Houston was there to help. Sandra De La Garza-Perez, Alexis Santana, CPO, and Keith Sardo, MBA, CPO, LPO—employees from Hanger’s Houston location—jumped into action. At the request of the patient’s Phoenix clinician, Jillian Okimoto, CPO, they helped secure and deliver some art and craft supplies and set up a way to get her service dog some regular exercise.

PHOTOS: Methodist Orthotics and Prosthetics

Manufacturing Face Shields for the Most Vulnerable

and police officers, the facility modified an injection-molding process typically used to make O&P devices to manufacture face shields. The first batch of shields went to protect residents and staff at Flowood’s Specialty Care Center, a long-term care facility that is home to 60 severely disabled residents, who may be especially vulnerable to infections due to conditions such as quadriplegia and amyotrophic lateral sclerosis. Shortly thereafter, Flowood Emergency Operations Director Nathan Harvell accepted 50 face masks for use by the city’s police department during the crisis. “It was a great gift,” Harvell says. “While this [pandemic] is going on, we are being extra cautious. And this is an extra tool we can use to protect our officers. It really helps and we appreciate that.” Chris Wallace, CPO, FAAOP, director of Methodist O&P, explains that they donated the face masks not only to local first responders and law enforcement, but also to each of their state legislators—to enable them to meet more safely in-person. “It was a wonderful thing, and I think it was a morale boost for our staff as well,” says



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“We were running around the clock,” she adds, referring to the manufacturing process. “I think our employees are proud that they were able to be part of that and give back to our community. And that’s kind of the core of our mission.”

Boosting Mobility and Athleticism Among O&P Patients

Hanger clinicians went above and beyond when a patient was unexpectedly hospitalized—including ensuring her service dog got regular exercise. “We not only care about our patients’ mobility, but we also want them to be comfortable wherever they are in the country,” says Jeffrey Elms, MBA, CPO, the Houston regional director of Hanger. “We wish to help in any way we can.” The Hanger staff members in Houston also were motivated to help out their greater community in September, when hurricanes battered the Gulf Coast, destroying many homes and neighborhoods. Lake Charles, Louisiana—a two-hour drive from Houston—was hit particularly hard, but official help was backed up for months, creating a need for volunteer workers. Elms helped organize a crew that spent Saturdays in September travelling to Louisiana to help clear trees from homes and cut them up, clean up debris from properties, and repair roof damage. “We make braces or artificial limbs for people, but it’s more than that,” Elms says. “We take care of people. That’s what we’re here to do.”

Donating Face Masks To Those in Need



masks in particular—was right in their wheelhouse, says Kam Howard, KnitRite’s executive vice president. The Kansas City-based designer, marketer, and manufacturer began focusing on making washable, reusable face masks. “We were able to step in and help with PPE and put aside some of the other things that we typically make, and just ramp this up,” Howard recalls. The company’s charitable goal was to give away one washable, reusable face mask for each one it sold. To date, Knit-Rite has given away a jaw-dropping 120,000 masks, many to those who struggle to put food on the table or keep a roof over their head, much less purchase a high-quality mask to navigate society. “People that could not obtain a mask otherwise, that’s who we really focused on first,” Howard explains.

PHOTOS: Hanger

When the pandemic hit in March and accelerated in April, Knit-Rite employees were given a measure of comfort in the fact that making personal protective equipment (PPE)—and

Hanger clinicians from Houston traveled to Louisiana in September to help repair hurricane damage.

Ottobock is a large manufacturing firm based in Duderstadt, Germany, with nearly 50 offices around the globe. So, when the company pitches in, it makes a big impact. In fact, the company’s stewardship group gave donations to 45 nonprofit organizations in the United States and Canada last year alone, says Aaron G. Holm, the company’s manager of marketing and consumer engagement. Both Steps of Faith, mentioned above, and Andy Roddick Foundation— based in Austin, Texas, and named for the tennis pro who helps at-risk youth—were among the entities that benefitted from Ottobock’s donations. “It’s incredible the impact that we can make on these organizations, and … a lot of them are prosthetic focused,” Holm says. “It could be giving running blades or activity blades to individuals or prosthetics like those in the Endeavor Games, Paralympic-style events held annually.” Holm, who lost his legs in 2007, also serves as founder and executive director of Wiggle Your Toes, which has a mission to help amputees regain independence and mobility. The nonprofit, which typically focuses on events that help amputees gather and participate in sports, was hamstrung by the COVID crisis and its strict social distancing requirements this year. “We wanted to spend the money that we had budgeted for 2020, but we needed to shift gears, and that’s where we came up with a ‘Stronger Fitness’ giveaway,” Holm explains. “We talked to the team at Ottobock, and they gave us a great access to their fitness componentry and a nice discount. So, we were able to just start fitting

individuals with running blades and fitness blades. We just tried to keep the disabled community active during the pandemic” by offering equipment to accommodate running, jogging, and other activities. “It’s really helpful to them.”

Celebrating Employees During the Holidays

A century-old O&P manufacturing firm with offices around the world, Fillauer values tradition. So, when COVID-19 put the kibosh on the company’s annual in-person holiday celebrations, the Tennessee-based company decided to innovate. “We do give back to our communities, but our employees have gone through a lot this year,” says Vikki Ledbetter, the company’s marketing director. “As a global company with campuses around the United States, and … some business in Europe ... we’ve been thinking about how to unite everyone.”

To that end, the company is compiling a digital photo album comprising photos, stories, or traditions submitted by employees. “It’s just giving people an opportunity to share what’s going on in their lives, even though we can’t all be physically in the same rooms at the same time,” Ledbetter explains. And instead of the traditional office cookie swap, they’ve sent out a call for recipes. Those recipes will be assembled into a cookbook to be distributed to employees at the end of the year. “These are some of our [company] traditions, so we want to figure out

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how to carry that on but be respectful of everyone’s health. One of the things I think this helps with is inclusion of different diverse backgrounds or traditions,” Ledbetter explains. “If we can get a recipe or a story or a photo from someone in Sweden about how they’re celebrating the holidays, compared to someone here in Tennessee, that might look very different. “So, it’s just giving exposure to one another, and just the different ways and things that people do, that they’re proud of, and feel good about around the holiday.”

Helping People When Insurance Won’t

Last spring, Teri Kuffel, JD, vice president and co-owner of Minnesotabased Arise Orthotics and Prosthetics, learned that Wiggle Your Toes was advocating for a bilateral amputee in Tuscon, Arizona, whose lower-limb devices were in serious disrepair.

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The Trowbridge Terra-Round foot mounts directly inside a standard 30mm pylon. The center stem exes in any direction allowing the unit to conform to uneven terrain. It is also useful in the lab when tting the prototype limb. The unit is waterproof and has a traction base pad.



The nonprofit organization Wiggle Your Toes assists in donating componentry that helps individuals with limb loss stay active. Kuffel’s brother, Joe Pongratz, CPO, FAAOP, owns Pongratz O&P Tucson so she got on the phone and asked him to help. Teaming up with Aaron Holm, founder of Wiggle Your Toes and a manager with Ottobock, Kuffel and Pongratz were able to secure two new Ottobock Challenger Blades.

Michael Coleman is a contributing writer to O&P Almanac.


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PHOTO: Wiggle Your Toes

The woman, a single parent of two young boys, works in a restaurant and spends a lot of time on her feet, so her defective prostheses were making life difficult. To make matters worse, the woman was having a hard time finding a provider in her Medicaid network to meet her specific needs.

The multi-purpose foot is designed for varying demands, from everyday walking to recreational sports. Kent Sluder, CPO, clinical lead at the Pongratz O&P Tucson office, provided the care. Wiggle Your Toes seeks to help those with active lifestyles and a commitment to improving their lives. The client in Tucson—a congenital amputee who enjoys working out and staying active—fit that bill. “Aaron (the founder of Wiggle Your Toes) is amazing, and I am so fortunate to be able to work alongside him on this journey (to be able) to give these gifts to people,” says Kuffel, who serves on the Wiggle Your Toes board. “We do what we can when the insurance doesn’t cover it, and there’s no coverage for things like running blades. So, we look for individuals who fit the WYT mission, who seek to heal, recover, and flourish.”


Researcher on the Rise Natalie Harold, MSPO, CPO, begins her first study as principal investigator, thanks to an AOPA/COPL grant

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



hopes that one day soon, “COMET” will be part of the O&P vernacular. She is currently working on a project, funded by a grant from AOPA and the Center for O&P Learning (COPL), titled, “Development of a Customizable Outcome Measures Electronic Toolkit (COMET).” The primary goal of this project is to develop a clinic-ready mobile application and web-based management

system to increase the utilization of outcome measures within O&P clinics to support evidence-based practice, according to Harold. “There are dozens of outcome measures available for clinicians to use; however, they lack standardization of their selection and implementation, as well as difficulty with analysis and follow-up,” she explains. “Outcome measure data can not only improve patient care, but it can also strengthen provider documentation for payor reimbursement,” adds Harold. By creating a tool that will help to standardize the process, she hopes to enable practitioners to select appropriate outcome measures, administer them accurately, analyze results quickly to help inform the treatment plan, and expand the wealth of data collectively from clinics across the United States.

Taking Root

PHOTO: Natalie Harold, MSPO, CPO

PHOTO: Johnson City Medical Center

Natalie Harold, MSPO, CPO, works with a patient while studying related outcome measures data.

Harold currently has positions as both a research prosthetist/orthotist at Orthocare Innovations in Edmonds, Washington, and a clinician at Cornerstone Prosthetics and Orthotics in Everett, Washington. “My role as both an O&P clinician and O&P researcher are to complement one another and keep me focused on the issues that truly matter to our patients and our profession,” she says. O&P ALMANAC | NOVEMBER/DECEMBER 2020



Harold studied mechanical engineering as an undergraduate at Seattle Pacific University, where she also played for the women’s soccer team. It was during that time that she was introduced to O&P. “In my first engineering seminar course, I was given the assignment to report on an engineer whose work I found to be inspirational. I reported on Dean Kamen,” she recalls. Among other accomplishments, Kamen’s work on innovative medical devices, including his contributions to the “LUKE” arm for the Defense Advanced Research Projects Agency, inspired Harold to pursue a path within engineering that she believed would have a positive impact on people’s lives. “From there, every project I completed until graduation was focused on prosthetic technology. Pursuing a master’s in O&P from the University of Washington was an obvious next step,” Harold recalls. She earned that master’s in 2016 and went on to residencies at University of Michigan Orthotics and Prosthetics Center and Cornerstone Prosthetics and Orthotics. As she completed the pathway to clinical practice, she never lost touch with her passion for research and innovation. “Today, I’ve found the perfect balance, working as both a research prosthetist/orthotist as well as certified and licensed clinical provider of prosthetics and orthotics.”

Branching Out



to develop a system to improve the prescription of AFOs, studying the effects of concurrent tasks on walking in individuals with transfemoral amputation compared to those without limb loss, researching low back pain among individuals with transtibial amputation, designing AFOs to improve stroke outcomes, and collaborating to develop an energy-harvesting knee prosthesis. Her commitment to aggregating data and evidence-based practice led Harold to pursue an AOPA/COPL grant to take her COMET project to the next level. “The importance of using outcome measures in clinical practice and in research has been continuously reinforced since I was initially introduced to the topic by Brian Hafner, PhD, as a student in the University of Washington MPO program,” explains Harold. “Practitioners face a challenging reimbursement climate, with record numbers of insurance claim denials and audits.” Adopting an evidence-based

approach to clinical care helps patients as well as clinicians, who benefit by safeguarding their investments, she explains. “There is no better protection from an insurance audit than having data on hand to support the choice in prescribed devices or componentry selection and to show the effect that each decision has had on the patient function.” That being said, Harold recognizes that it isn’t always easy to remember to collect outcome measures with every patient. “I am among one of the worst offenders for forgetting to collect outcome measures, when as a clinician my focus is on patient care, where it should be,” explains Harold. “This is why I’m committed to making the process easy to use for busy clinicians—and even easier to remember to integrate into each patient appointment.”

PHOTOS: Natalie Harold, MSPO, CPO

While the COMET project represents Harold’s first grant award as principal investigator, she has been involved in many other research endeavors over the past several years. Currently, she is part of an ongoing study, through a collaboration with Seattle Children’s Hospital, to evaluate the effectiveness of a tuned ankle-foot orthosis (AFO) and footwear combination versus a traditional solid ankle AFO for use on children with cerebral palsy. “For this study, I am primarily responsible for the walking gait data collection and gait data processing using the VICON motion capture system,” she says. Results of this study are expected to be published in early spring 2021. Additional past and current research projects have included collaborating

Harold (far left) has met with legislators to advocate on behalf of O&P patients and the profession.

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practice. “I believe that one of the most pressing O&P-related questions that can be answered by research—and perhaps identified by outcome trends— is the question surrounding what type of prosthetic or orthotic componentry is most appropriate for a patient’s current and potential functional abilities,” Harold asserts. “A prosthesis or orthosis should enable someone to reach their physical potential and/or athletic goals, but it seems that this technology is often deemed ‘not medically necessary’ and excluded from coverage by many insurance plans. There is a huge amount of ambiguity surrounding medical necessity that I think can be resolved through scientific research.” More than 630 athletes participated in a race across America as part of the Forrest Stump initiative.

Active Growth

In addition to her research endeavors, Harold says she enjoys innovating new and exciting prosthetic and orthotic technologies to help patients restore or improve their abilities. On a personal note, the athlete in Harold enjoys outdoor activities such as backpacking, cycling, running, skiing, and snowboarding—and she takes pleasure in helping others participate in athletics or other activities and adventures as well. “I continue to seek out any opportunity that comes my way for learning



Harold presented at the ISPO PACRIM conference in January 2020. When coverage policies are determined by a lack of evidence, “it should signify the need for researchers to identify knowledge gaps and stimulate further scientific investigation,” Harold adds. “Furthermore, I believe that this research needs to take place in the clinic because if outcomes data can be collected nationwide in a consistent and standardized way, then it has the potential to create a unique wealth of evidence that couldn’t otherwise be studied. If an outcome measure analysis is only considered for an individual patient, clinic, or single research subject pool, then it can only provide anecdotal evidence at best.” Importantly, Harold emphasizes that issues surrounding patient access should be central to the product development. “I, too, am interested in advancing the cutting edge of prosthetic technology, but not at the expense of making healthcare more expensive and therefore out of reach to the majority of patients.”

PHOTOS: Natalie Harold, MSPO, CPO

Harold is co-founder of Forrest Stump, an organization that raises awareness and improves access to assistive technologies.

more about adaptive sports equipment and fitting principles because it is what I enjoy doing the most,” she says. In 2017, after completing an ultra-triathlon along the entire West Coast, Harold and her partner, Nicole Ver Kuilen (a transtibial amputee), co-founded a non-profit advocacy group called Forrest Stump (www.forreststump.org) to help raise awareness and improve access to the assistive technologies needed for individuals with disabilities to participate in physical activity. The organization has recently completed a nationwide initiative called “We Just Felt Like Running” to deliver to Congress a signed petition to uphold “The Rights of Americans With Disabilities to Exercise,” according to Harold. The campaign gathered more than 7,000 signatures in support of the petition, recruited over 630 athletes to participate in a virtual race across America, and raised more than $12,000. All of this was achieved in just under five months after the cancellation of the Hood To Coast Relay, which was originally set to take place in August. Of course, Harold will continue to focus on her research and move forward with the COMET study, as well as other investigations related to evidence-based


Sampson’s Prosthetic & Orthotic Laboratory

Telemedicine as a Tool New York facility adopts virtual medicine for collaborative appointments



launched Sampson’s Prosthetic and Orthotic Laboratory in the town of his birth: Schenectady, New York. The business was a success, and following the senior Sampson’s death in 2010, his son, Bill Sampson, CP, took over as president. Like his father, Bill Sampson is committed to learning about and adopting new technology to benefit patients. From left: Ellie M. Thompson, CRM, CPA; Joseph K. Fairley III, MSPO; Brian E. Clark, CPO, practitioner team leader; Bill Sampson, CP, chief executive officer; Gary D. Morey, CPT, CPA, technical team leader; Jacob Praga, MSPO; and Thomas Heller, CPO, LPO. Seated from left: Sarah Glowa, MSPO, CO, and Radha Bakshi, MSPO, CPO

wife, AnneMarie, is a registered

Sampson works with a patient who lost an arm in a car crash, after targeted muscle reinnervation surgery.


OWNER: Bill Sampson, CP

Bill Sampson, CP

LOCATIONS: Schenectady, New York, with offices in Albany, Amsterdam, Saratoga Springs, and Queensbury HISTORY: 52 years


Sampson studies the results. The facility allows patients to test different types of components, such as microprocessor knees, and uses Össur’s ProApp tool to collect data. Patient surveys are standard. “Our goal is to improve functional levels,” says Sampson. “This type of research allows us to make continuous adjustments to improve patient outcomes, based on what works and what doesn’t.” Some of that in-person research has taken a backseat during the COVID-19 pandemic. While the facility’s physical offices are open, Sampson allows most administrative staff to work from home, rotating in-office duties so that fewer people are on site at any one time. The facility now relies on telemedicine, combined with in-person visits, to treat many patients. “We set up three-hour virtual clinics,” he explains. “New

patients come in, and we conduct videoconferences with medical professionals while they are in the office. The physicians can see our patients on screen, ask questions, and observe as we assess range of motion, skin integrity, contractures, and other situations.” Sampson plans to maintain this hybrid approach even after the pandemic is over. “It allows us to do our job, it minimizes the number of places a patient has to go for treatment, and it definitely saves time and money.” Before 2020, Sampson’s educational and marketing efforts included hosting continuing education sessions for physical therapists. Virtual training sessions are not as effective, Sampson has found, because some elements require physical interaction, such as gait evaluation. Similarly, many of the facility’s community outreach efforts have been put on hold. The facility sponsors an annual Sarcoma Strong running event, which this year took a virtual approach. The group encouraged participants to run wherever they chose and share their experience on social media before, during, and after the run. Sampson’s P&O Lab’s commitment to education includes involvement with the residency program of the American Board for Certification in Orthotics, Prosthetics, and Pedorthics, with three residents currently on staff. “We turn out a lot of residents,” says Sampson. “Several did preliminary stints here as techs, and then went off for graduate studies. We are fortunate to have them back as residents. “We have a great team here,” he concludes. “We are passionate about patient care, and it shows.” Deborah Conn is a contributing writer to O&P Almanac. Reach her at deborahconn@verizon.net.

PHOTOS: Sampson’s Prosthetic & Orthotic Laboratory

“Forward thinking definitely sets us apart,” says Sampson. He stays current on O&P research and development and offers patients the latest technologies and devices. “We are involved in research in a number of areas, including prepreg manufacturing, and we work closely with the company PVA to develop new 3D devices and technology,” he says. In addition, “we fabricate partial foot prostheses with dynamic spring, do prepreg layups, and build toe-off ankle-foot orthoses.” Today, Sampson’s P&O Lab remains headquartered in Schenectady but has expanded within the state by opening offices in Albany, Amsterdam, Saratoga Springs, and Queensbury. The company employs 22 staff members and manufactures most devices at the Schenectady office. Sampson’s

FACILITY: nurse and serves as one of the Sampson’s facility’s two compliance officers. The latest technology is only Prosthetic & Orthotic Laboratory as good as its effectiveness, and



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DEC. 9

During these one-hour sessions, AOPA experts provide up-to-date information on a specific topic. Webinars are perfect for the entire staff—they’re a great teambuilding, money-saving, and educational experience! Sign up for the entire series and get two conferences free. Entire Series ($990 Members/ $1,990 Nonmembers). Register at http://bit.ly/2020AOPAwebinars.

New Year: New Codes, Fees, and Updates

Don’t miss one of the most anticipated webinars of the year. AOPA’s coding and billing experts will provide up-todate analysis and interpretation of the newest HCPCS codes and changes for the upcoming year. Presenters will recap the 2020 Medicare changes and share updates on what to expect in 2021.

2021 Webinars Coming Soon! Be on the lookout for the list of webinar topics for the new year.

Don’t Sleep on the Latest AOPA Member Resource




Attend the upcoming live tutorial to learn about one of the best resources available for O&P practices, the AOPA Co-OP. A Wikipedia for all things O&P, the Co-OP is a one-stop resource for information about reimbursement, coding, and policy. This searchable database provides up-to-date information on developments in Medicare policy, statespecific legislation, private-payor updates, and more. Members can access detailed information on everything from modifiers to product-specific L codes and associated policies. Register for the next Co-OP Live Tutorial hosted by AOPA Director of Strategic Initiatives Ashlie White, who will demonstrate how to use the Co-OP and answer all of your questions. Any employee of an AOPA member firm is welcomed to join this free tutorial.



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Tutorial Webinars • January 8 • February 5 • March 5 • April 2 • May 14 • June 4 • July 2


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ALPS Liner Selection Tool We are pleased to present our newest creation: Choose Your Liner!* This is the first tool starting from the patient clinical condition to help select the best solutions. After five quick questions to answer, you will know what Alps product to choose from. Questions can range from activity level, amputation level, limb shape, and various clinical conditions, to help pin-point your exact specifications. This great new online tool is also available on mobile devices as well, via Google Play. Explore it and share your experience with us. Call us or visit www.easyliner.com for more information.



Coyote Design’s Zero-Clearance Lock

The Proximal Lock is a zero-clearance lock mechanism that also controls rotation. Mounted on the side of the liner and socket proximally instead of distally allows for the use of any distal adaptor. The Proximal Lock was designed to work with and can be primary suspension for long limbs that may not have room distally for other lock options. The lock can also be used with seal band liners. This lock was created for Matt Perkins, chief executive officer of Coyote. Matt won five ITU Triathlon World Championships wearing this lock and still wears it every day. For more information, contact Coyote Design at 208/429-0026 or visit www.coyotedesign.com.

Aria Plate Valve by Cypress Adaptive

Apis custom programs offer practitioners best options and services for patient compliance. All products are covered under risk-free guaranteed-fit promise. We stand firmly behind our words. Call us at 1-888/937-2747.

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

The Aria Plate Valve by Cypress Adaptive is a simple and reliable solution for any suction suspension application that requires auto-expulsion function with push-button release. The Aria Plate Valve saves on fabrication time as it simply bolts to any four-hole mounting plate. It is cost effective, durably constructed, and easily disassembled for cleaning and servicing. To learn more, visit us at www.cypressadaptive.com or call 888/715-8003.

Custom Dynamic Walk Fillauer’s Custom Dynamic Walk is recommended for patients who need to accommodate the unique shape of their foot and leg, or specific functional needs. Whether the patient needs greater toe lift or unique sizing, including pediatric sizing, this device can be made to suit their needs. Order yours at Fillauer.com.



MARKETPLACE LEAP Balance Brace Hersco’s Lower-Extremity Ankle Protection (LEAP) brace is designed to aid stability and proprioception for patients at risk for trips and falls. The LEAP is a short, semirigid ankle-foot orthosis that is functionally balanced to support the foot and ankle complex. It is fully lined with a lightweight and cushioning Velcloth interface, and is easily secured and removed with two Velcro straps and a padded tongue. For more information, call 800/301-8275 or visit www.hersco.com.

Naked Prosthetics Naked Prosthetics designs and manufactures high-quality prosthetic devices specifically for finger loss. Our mission is to assist people with digit amputation(s) and positively impact their lives with fully articulating, custom finger prostheses. Our product aims to restore the ability to perform most tasks, supporting job retention and an active lifestyle. Our customers have lost fingers to power tools, equipment malfunctions, injury in the line of military service, random accidents, and infections; in some cases, multiple digits have been lost. NP provides a viable functional prosthesis, as opposed to a passive cosmetic solution. Our design mimics finger motion and utilizes the remainder of an amputee’s digit to power the device. For more information, visit www.npdevices.com.

Amparo Confidence TT Socket by Ottobock

Are you ready for a revolution in interim socket technology? The Amparo socket is formed over a liner directly onto the user’s residual limb which means a new socket can be made in one go. Benefits include: • One-visit fittings • Easy alignment with offset distal adapter • No plaster casting required • Re-moldable material for fast socket (re)shaping and adjustments • Mobile oven and toolset for anywhere, anytime socket adjustments • Valve or pin suspension options. For more information, contact your sales representative or visit professionals.ottobockus.com.

Ottobock Master Technicians at Your Service

The Xtern Foot Drop AFO by Turbomed Orthotics Think outside the shoe! This one-of-akind orthosis (AFO) is a game changer for foot drop patients: The Xtern is totally affixed outside the shoe to maximize comfort, and prevent skin breakdown and rubbing injuries. Its flexibility promotes maximal ankle range of motion and calf muscle strength. The Xtern allows running, walking, and even mountain hiking as long and as far as you want without any restrictions, and moves from sandals to boots flawlessly. Turbomed’s innovative products are designed in Quebec, Canada, sold in over 26 countries, and distributed by Cascade in the United States. Visit turbomedusa.com to get your life back! 50


At the Ottobock After-Sales Service Center, our mastertrained technicians are here to help with reliable, routine maintenance and high-quality repairs. We also offer the most generous loaner program in the industry so your patients can continue to live their lives safely while their devices are being serviced. Get peace of mind for you and your patients. For help with maintenance or repairs, call us at 800/328-4058.


Spinal Technology Inc.

The PDAC-approved RUSH ROGUE® provides the most realistic & dynamic foot and ankle motion available. The Vertical Loading Pylon (VLP) provides vertical shock relief while offering +/- 8 degrees of torsion, allowing the user to push the foot and themselves to the limits. The RUSH ROGUE is made of our advanced fiberglass composite, which is three times more flexible than conventional prosthetic feet. The roll-through characteristics of the foot provide exceptional energy return with no “dead spot.” The RUSH ROGUE is also available in the EVAQ8 elevated vacuum and H2O models. #goROGUE

Spinal Technology Inc. is a leading central fabricator of custom spinal and scoliosis orthoses. Our ABC-certified staff orthotists collaborate with our 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 Nocturnal Scoliosis® System, a nocturnal bracing system designed to prevent the progression of scoliosis, and the patented FlexFoamTM spinal orthosis. For information, contact 800/253-7868 or visit www.spinaltech.com.

Statement of Ownership, Management and Circulation (required by U.S.P.S. Form 3526) 1. Publication Title: O&P Almanac 2. Publication No.: 1061-4621 3. Filing Date: 9/28/20 4. Issue Frequency: Monthly 5. No. of Issues Published Annually: 11 6. Annual Subscription Price: $59 domestic/$99 foreign 7. Complete Mailing Address of Known Office of Publication (Not Printer): American Orthotic & Prosthetic Association, 330 John Carlyle St., Suite 200, Alexandria, VA 22314 8. Complete Mailing Address of Headquarters or General Business Office of Publisher (Not Printer): Same as #7 9. Full Names and Complete Mailing Addresses of Publisher, Editor, and Managing Editor: Publisher: Eve Lee, address same as #7. Editor: Josephine Rossi, Content Communicators LLC, PO Box 938, Purcellville, VA 20132. 10. Owner (Full Name and Complete Mailing Address): American Orthotic & Prosthetic Association, same as #7 11. Known Bondholders, Mortgagees, and Other Security Holders Owning 1 Percent or More of Total Amount of Bonds, Mortgages, or Other Securities: None. 12. The purpose, function, and nonprofit status of this organization and the exempt status for federal income tax purposes: Has Not Changed During the Preceding 12 Months. 13. Publication Name: O&P Almanac 14. Issue Date for Circulation Data Below: August 2020 Avg. No. Copies Each Issue During Preceding 12 Months 15. Extent and Nature of Circulation: a. Total number of Copies (Net Press Run) b. Paid and/or Requested Circulation (1) Paid or Requested Outside-County Mail Subscriptions (2) Paid In-County Subscriptions (3) Sales Through Dealers and Carriers, Street Vendors, Counter Sales, and other non-USPS Paid Distribution (4) Other Classes Mailed through the USPS c. Total Paid and/or Requested Circulation d. Free Distribution by Mail (1) Outside-County as Stated on Form 3541 (2) In-County as Stated on Form 3541 (3) Other Classes Mailed through the USPS (4) Free or Nominal Rate Distribution Outside the Mail e. Total Free or Nominal Rate Distribution f. Total Distribution g. Copies not Distributed h. Total i. Percent Paid and/or Requested Circulation

No. Copies of Single Issue Published Nearest to Filing Date



10,817.27 0 27.55

10,880 0 0

4.45 10,849.27

3 10,811

0 0 0 369.64 369.64 11,218.91 162.64 11,381.55 97%

0 0 0 134 134 10,945 191 11,136 99%





Opportunities for O&P Professionals

WANTED! A few good businesses for sale.

Job Location Key: - Northeast

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

- Mid-Atlantic - Southeast - North Central

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

- Inter-Mountain - Pacific

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

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

Refer to www.AOPAnet.org for content deadlines. Ads can be posted and updated any time online on the O&P Job Board at jobs.AOPAnet.org. No orders or cancellations are taken by phone. Send classified ad and payment to: O&P Almanac, Calendar, P.O. Box 34711, Alexandria, VA 22334-0711 or email jburwell@AOPAnet.org along with VISA or MasterCard number, cardholder name, and expiration date. Make checks payable in U.S. currency to AOPA. Note: AOPA reserves the right to edit calendar listings for space and style considerations. O&P Almanac Careers Rates Color Ad Special 1/4 Page ad 1/2 Page ad

Member $482 $634

Nonmember $678 $830

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

Member $140 $190 $260 $2.25 per word

Nonmember $280 $380 $520 $5 per word

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

Member $85

AOPA’s O&P Career Center Connecting highly qualified O&P talent with career opportunities EMPLOYEE


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

• Apply online for job openings • Free résumé review

Nonmember $280

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

• Research who is hiring


• Post your job in front of the most qualified group of O&P professionals • Search anonymous résumé database to find qualified candidates • Manage your posted jobs and applicant activity easily on this user-friendly site.

LOG ON TODAY! https://jobs.AOPAnet.org 52



Ca reer Opportunities... California

CO-Sacramento CO-Modesto CPO-Salinas Established in 1987, Pacific Medical Prosthetics and Orthotics has become a tenured company in the industry for superior patient care, products and services.

Oregon CPO –Corvallis & Salem Washington CPO-Richland

The positions we offer are created for candidates that are looking to create opportunity, self-driven, motivated, and enjoy serving and helping others.

To apply, submit resume to:

A competitive salary, benefits and profit sharing are offered based on position/experience.

ca reers@pa cmedica l.com

Ou r C u l t u re & C om m i t m e n t “ We w i l l s e rve a n d h e l p oth e rs g row p e rs on a l l y , p rofe s s i on a l l y , a n d s tri ve to p u t oth e rs n e e d s fi rs t a n d fore m os t a s d e m on s tra te d b y ou r p os i ti ve a tti tu d e , te a m w ork a n d p rofe s s i on a l i s m . ”


Advertisers Index Company Allard USA ALPS South LLC

Page Phone 5 31

866/678-6548 800/574-5426

American Board for Certification in Orthotics, Prosthetics, & Pedorthics 47 703/836-7114 Amfit 37 800/356-3668 Apis Footwear Company 40 888/937-2747 Becker Orthopedic 21, 45 800/521-2192 Cailor Fleming Insurance 43 800/796-8495 Coyote Design 17 800/819-5980 Cypress Adaptive LLC 15 888/715-8003 ESP LLC 29 888/WEAR-ESP Ferrier Coupler Inc. 39 810/688-4292 Fillauer Companies Inc. 7 800/251-6398 Hersco 1 800/301-8275 Naked Prosthetics 19, 33 888/977-6693 Ottobock C4 800/328-4058 PROTEOR USA 9 855/450-7300 Surestep 23 877/462-0711 Spinal Technology Inc. 27 800/253-7868 TurboMed Orthotics 3 888/778-8726

Website www.allardusa.com www.easyliner.com www.abcop.org www.amfit.com www.apisfootwear.com www.beckerorthopedic.com www.cailorfleming.com www.coyotedesign.com www.cypressadaptive.com www.wearesp.com www.ferrier.coupler.com www.fillauer.com www.hersco.com www.npdevices.com www.professionals.ottobockus.com www.proteorusa.com www.surestep.net www.spinaltech.com www.turbomedorthotics.com O&P ALMANAC | NOVEMBER/DECEMBER 2020





December 9 New Year: New Codes, Fees, and Updates. For more information, visit

2021 January 1

APPLY ANYTIME. TEST ANYWHERE. Become a BOC-certified orthotic fitter, mastectomy fitter, or durable medical equipment specialist. Exams are offered year-round: in-person at test centers and select conferences and online from the location of your choice with a live, remote proctor! Visit www.bocusa.org/certification/apply. www.bocusa.org

Cascade Dafo Institute

Nine free ABC-approved online education courses to enhance your clinical practice. Take anytime, anywhere, and earn up to 14.5 CE credits. Visit cascadedafo.com or call 800/848-7332.

ABC: Practitioner Residency Completion Deadline for February Written and Simulation 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 ABCop.org/individual-certification.

January 8 WEBINAR

Co-OP Tutorial. Noon ET. For more information, visit www.AOPAnet.org.

January 8–9

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

January 13

2020 December 1

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

December 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 ABCop.org/individual-certification.


January 22–23

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

February 1

ISPO 18th World Congress Deadline for Symposia and Instructional Courses. For more information, contact the ISPO World Congress team at info@ispo-congress.com or call +49/341-678-8237.

February 5 WEBINAR



Co-OP Tutorial. Noon ET. For more information, visit www.AOPAnet.org.

February 10

December 7–12

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

AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.


AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.


Co-OP Tutorial. Noon ET. For more information, visit www.AOPAnet.org.


AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.

July 2

Co-OP Tutorial. Noon ET. For more information, visit www.AOPAnet.org.


July 14

March 29

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

August 11


Co-OP Tutorial. Noon ET. For more information, visit www.AOPAnet.org.

September TBD

AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.


AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.

September 9–12

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

May 4–7

47th Academy Annual Meeting & Scientific Symposium. Hyatt Regency, New Orleans. For more information, visit www.oandp.org/page/annual_meeting.

October 13

AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.

May 12–14

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

AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.



AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.


April 14 WEBINAR

AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.


November 1–4

ISPO 18th World Congress. Expo Guadalajara Convention & Exhibition Centre in Guadalajara, Mexico. For more information, contact the ISPO World Congress team at info@ispo-congress.com or call +49/341-678-8237.

November 10

AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.



December 8

Co-OP Tutorial. Noon ET. For more information, visit www.AOPAnet.org.



Co-OP Tutorial. Noon ET. For more information, visit www.AOPAnet.org.


AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.

Calendar Rates

AOPA Monthly Webinar. 1 PM ET. For more information, visit www.AOPAnet.org.


January 9–11

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

Let us share your next event!

Phone numbers, email addresses, and websites are counted as single words. Refer to www.AOPAnet.org for content deadlines. Send announcement and payment to: O&P Almanac, Calendar, P.O. Box 34711, Alexandria, VA 22334-0711, fax 571/431-0899, or email jburwell@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.

Words/Rate 25 or less 26-50 51+

Member Nonmember $40 $50 $50 $60 $2.25/word $5.00/word

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

$482 $634

$678 $830

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




Information Sharing Updates from Illinois, New York, Oregon, and Virginia

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

Request for Information

AOPA is seeking information from its members on current efforts to address health disparities and inequities in O&P patient populations across the country. If you are working to develop any initiatives or are aware of initiatives in your state, AOPA would like to hear about them. Please send information to AOPA’s Ashlie White, MA, at awhite@aopanet.org.

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




The Illinois Society of Orthotists and Prosthetists is working with the Illinois Department of Financial and Professional Regulation (IDFPR) to include online learning as an accepted form of continuing education due to limited in-person options as a result of the pandemic. The state’s Orthotics, Prosthetics, and Pedorthics Practice Act of 2000 was enacted when there was no virtual learning available; therefore, the IDFPR interprets the current Education Rule to require “solely in-person” learning unless other options are included in the language of the Administrative Rule. The IDFPR is not offering continuing education unit (CEU) waivers or reduction in CEUs for the September 2021 license renewal requirement, but it has negotiated a temporary Emergency Rule.

New York

O&P facilities in New York continue to pursue a Medicaid O&P fee schedule increase and have secured support from New York State Assembly Members Richard N. Gottfried (D-District 75) and Alieen M. Gunther (D-District 100). The group is working on a multipronged approach to garner support for the effort, including outreach to patient support groups and associations as well as the development of a white paper with supporting claims data. For more information, contact Ted Drygas at ted@carecrafters.com.


AOPA members in Oregon are working on efforts to increase Medicaid reimbursement for cranial remolding orthoses and to find a pathway for appropriate coding and reimbursement of contracture/serial casting. Nathanial Hampson, CPO, has shared a draft letter outlining the need for an appropriate pathway for reimbursement in order for orthotists to provide contracture/serial casting for patients with appropriate indications. The letter argues that serial casting is a proven protocol that maximizes functional outcomes without the risk or cost associated with surgery. A copy of the letter is available on the Oregon page of the AOPA Co-OP.


O&P providers in Virginia have expressed increasing concern with the lack of Medicaid coverage of orthoses for adult patients and the scope and enforceability of the Virginia Insurance Fairness Law. Following AOPA’s testimony to the Virginia House of Delegates in support of HB 503 and SB 382 last year, the Virginia Orthotic & Prosthetic Association confirmed that similar efforts would be pursued during the next legislative session.

Submit Your State News

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



to our 2020 AOPA Supplier Plus Members for their continued support of the association.



Sign up for the value-added Supplier Plus Program. Get $6,000 worth of print and online media advertising, and other benefits for $2,575—a $3,425 cost savings!



For more information, contact Kelly O’Neill at 571-431-0852 or kelly.oneill@AOPAnet.org.

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C-Leg 4 ÂŽ

1/20 Š2020 Ottobock HealthCare, LP, All rights reserved.

Studied, proven, preferred.

Your patients trust you to deliver the best care.

You committed to their quality of life when you trusted C-Leg 4. As the original MPK, C-Leg redefined the standard of care for above-knee amputees. Since its release in 1999, the microprocessor technology of the C-Leg has continuously raised the bar for an industry that demands innovation to achieve one primary goal: give amputees the mobility they deserve. professionals.ottobockus.com

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