December 2011 O&P Almanac

OP

The American Orthotic & Prosthetic Association

DECEMBER 2011

&

WWW.AOPANET.ORG

THE MAGAZINE FOR THE ORTHOTICS & PROSTHETICS INDUSTRY

ACTIVE DUTY

Col. Paul F. Pasquina, MD, explains how specialized care helps combat amputees ambulate sooner

Advancing AOPA’s LEGISLATIVE AGENDA Do’s and Don’ts of YEAR-END GIFT GIVING

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O&P Almanac CONTENTS

DECEMBER 2011, VOLUME 60, NO. 12

DEPARTMENTS

COVER STORY

20 Active Duty

By Deborah Conn In this O&P Almanac exclusive, Col. Paul F. Pasquina, MD, discusses the specialized, coordinated care combat amputees receive at the Walter Reed National Military Medical Center.

4

AOPA Contact Page How to reach staff

6

At a Glance Statistics and O&P data

10

In the News Research, updates, and company announcements

38

AOPA Headlines News about AOPA initiatives, meetings, member benefits, and more

46

AOPA Membership Applications

FEATURES

28

48 Marketplace

Advancing AOPA’s Legislative Agenda The wars in Iraq and Afghanistan have focused a lot of attention on the O&P field, but more education is needed on Capitol Hill to reduce future health-care costs and ensure patients receive appropriate care.

COLUMNS

16 Reimbursement Page

Six business practices to revisit before the year’s end

Products and services for O&P

54 Jobs

Opportunities for O&P professionals

60 Calendar

Upcoming meetings and events

63

Ad Index

64

AOPA Answers Expert answers to your FAQs

32 Ask the Expert

Answers to common questions about holiday gift giving

34 Facility Spotlight

Denham Orthotics & Prosthetics

Want a Taste of O&P History?

Get your fill at www.oandplibrary.org/op— a digital archive of issues ranging from 1975 to 1988 of O&P Journal, predecessor of the O&P Almanac.

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

DECEMBER 2011 O&P ALMANAC

3

AOPA CONTACT INFORMATION AMERICAN ORTHOTIC & PROSTHETIC ASSOCIATION (AOPA) 330 John Carlyle St., Ste. 200, Alexandria, VA 22314 AOPA Main Number: 571/431-0876 AOPA Fax: 571/431-0899 www.AOPAnet.org

EXECUTIVE OFFICES

MEMBERSHIP AND MEETINGS

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

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

Don DeBolt, chief operating officer, 571/431-0814, ddebolt@AOPAnet.org O&P ALMANAC Thomas F. Fise, JD, publisher, 571/431-0802, tfise@AOPAnet.org Josephine Rossi, editor, 703/914-9200 x26, jrossi@strattonpublishing.com

Kelly O’Neill, manager of membership and meetings, 571/431-0852, koneill@AOPAnet.org Steven Rybicki, communications manager, 571/431-0835, srybicki@AOPAnet.org Michael Chapman, coordinator, membership operations and meetings, 571/431-0843, mchapman@AOPAnet.org

Catherine Marinoff, art director, 786/293-1577, catherine@marinoffdesign.com

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

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

AOPA Bookstore: 571/431-0865

Steven Rybicki, production manager, 571/431-0835, srybicki@AOPAnet.org Stephen Custer, staff writer, 571/431-0876, scuster@AOPAnet.org Teresa Tobat, editorial/production assistant, 703/914-9200 x33, ttobat@strattonpublishing.com

GOVERNMENT AFFAIRS Catherine Graf, JD, director of regulatory affairs, 571/431-0807, cgraf@AOPAnet.org Devon Bernard, manager of reimbursement services, 571/431-0854, dbernard@AOPAnet.org Joe McTernan, director of coding and reimbursement services, education and programming, 571/431-0811, jmcternan@AOPAnet.org Reimbursement/Coding: 571/431-0833, www.LCodeSearch.com a

AOPA MEMBER-GET-A-MEMBER CAMPAIGN GROWING FOR

THE FUTURE CLUB

TAKE 10% or MORE OFF YOUR 2012 DUES

Every major membership organization in the world has found their current members to be their most successful growth partners.

And there has to be something in it for the current member!

You, as an AOPA member, are invited to join our Growing for the Future Club. For each new member company you sign up who designates you as its recruiting member, AOPA will discount your current 2012 renewal by 10%. Get 10 new members and enjoy your 2012 AOPA benefits for free. The 10% discount per new member applies to company members signed up who pay the full 2012 dues of $1,745. For affiliates signed up at $305 each, AOPA will provide a credit of $30 against 2012 dues. You may also use the earned discount as a credit when you purchase any AOPA product, service, or seminar.

Discover MORE HUGE BENEFITS—To enroll in the club and receive your Growing for the Future membership marketing kit, email scuster@AOPAnet.org and we’ll take it from there. You can help make it happen!

4

O&P ALMANAC DECEMBER 2011

OP Almanac &

PUBLISHER Thomas F. Fise, JD EDITORIAL MANAGEMENT Stratton Publishing & Marketing Inc. ADVERTISING SALES M.J. Mrvica Associates Inc. DESIGN & PRODUCTION Marinoff Design LLC PRINTING Dartmouth Printing Company

BOARD OF DIRECTORS OFFICERS President Thomas V. DiBello, CO, FAAOP, Dynamic O&P, a subsidiary of Hanger Orthopedic Group, Houston, TX President-Elect Tom Kirk, PhD, Hanger Orthopedic Group, Austin, TX Vice President Anita Liberman-Lampear, MA, University of Michigan Orthotics and Prosthetics Center, Ann Arbor, MI Treasurer James Weber, MBA, Prosthetic & Orthotic Care, Inc., St. Louis, MO Immediate Past President James A. Kaiser, CP, Scheck & Siress, Chicago, IL Executive Director/Secretary Thomas F. Fise, JD, AOPA, Alexandria, VA

DIRECTORS Kel M. Bergmann, CPO, SCOPe Orthotics and Prosthetics Inc., San Diego, CA Michael Hamontree, OrPro Inc, Irvine, CA Russell J. Hornfisher, MBA, MSOD, Becker Orthopedic Appliance Co., Troy, MI Alfred E. Kritter, Jr., CPO, FAAOP, Hanger Prosthetics & Orthotics Inc., Savannah, GA Eileen Levis, Orthologix LLC, Philadelphia, PA Ron Manganiello, New England Orthotic & Prosthetic Systems LLC, Branford, CT Mahesh Mansukhani, MBA Össur Americas, Aliso Viejo, CA Michael Oros, CPO, Scheck & Siress, Chicago, IL Frank Vero, CPO, Mid-Florida Prosthetics & Orthotics, Ocala, FL Copyright 2011 American Orthotic and Prosthetic Association. All rights reserved. This publication may not be copied in part or in whole without written permission from the publisher. The opinions expressed by authors do not necessarily reflect the official views of AOPA, nor does the association necessarily endorse products shown in the Almanac. The Almanac is not responsible for returning any unsolicited materials. All letters, press releases, announcements, and articles submitted to the Almanac may be edited for space and content. The magazine is meant to provide accurate, authoritative information about the subject matter covered. It is provided and disseminated with the understanding that the publisher is not engaged in rendering legal or other professional services. If legal advice and/or expert assistance is required, a competent professional should be consulted.

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At a Glance

Veterans Administration Statistics and Data Life Insurance Most Utilized Benefit‌

VA Health Enrollment Increases‌ Annual enrollment in the Veterans Health Administration

VA benefits ranked by usage BENEFICIARIES*

VA BENEFIT

Life Insurance

7.23

Disability Compensation

3.30

Home-loan Participants Education Beneficiaries Pension Recipients

1.53 .80

TOTAL ENROLLEES*

FISCAL YEAR

2010

8.1

2009

8.1

2008

7.8

2007

7.8

2006

.31

7.9

*Note: Numbers in millions.

Source: Department of Veterans Affairs Statistics at a Glance 2011

22.7 million The total U.S. veteran population over the age of 17 in 2010.

40%

Percentage of veterans receiving VA disability compensation who did not use VA health care in 2009.

61

Median age of male veterans, compared to the median age of 41 for female veterans in 2009.

*Note: Numbers in millions.

Source: Department of Veterans Affairs, Veterans Health Administration, Office of Assistant Deputy Under Secretary for Health, 2010

8.1%

Percentage of the total female veteran population in 2010.

13%

Approximate percentage of veterans who did not have health insurance in 2010.

804

Total number of VA community-based outpatient clinics in 2010.

Sources: Department of Veteran Affairs 2008; National Center for Veterans Analysis and Statistics, 2011; Analysis of Unique Veterans Utilization of VA Benefits & Services, Office of Policy and Planning, April 2009; The National Survey of Veterans, Active Duty Service Members, Activated National Guard and Reserve Members, Family Members and Survivors, August 2011.

6

O&P ALMANAC DECEMBER 2011

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In the News

Photo: University of South Florida

Research to Help Amputee Soldiers Return to Service

Photo: University of South Florida

John Mayer of the University of South Florida is investigating how exercise may protect combat soldiers against lower-back injuries.

Jason Highsmith of the University of South Florida is studying the best prosthetic foot to accommodate soldiers and veterans with below-the-knee amputations.

10

O&P ALMANAC DECEMBER 2011

The University of South Florida School of Physical Therapy & Rehabilitation Sciences has received a $1.59 million U.S. Department of Defense award for leading-edge musculoskeletal research intended to benefit active-duty soldiers and veterans, and improve overall military preparedness. The research has the potential to transform the lives of amputee soldiers by giving them the option of returning to active service and possibly even the war zone.

The award will fund two randomized two-year studies that cost about $715,000 each. One will investigate whether a specific exercise training regimen protects combat soldiers against lower-back injury. The second will evaluate the best prosthetic foot to accommodate soldiers and veterans with below-theknee amputations who wish to return to active duty.

The lower-back injury study will use healthy soldiers as participants and test the effectiveness of a high-intensity exercise training program that isolates and strengthens the lumbar extensor muscles—long, large muscles used to keep the arch in the back.

Lower-back pain is one of the most frequent causes of medical visits and lost training and duty time in the U.S. Armed Forces, according to a report by the Armed Forces Health Surveillance Center. A recent study from Germany indicated that only 13 percent of soldiers evacuated out of combat operations in Iraq and Afghanistan for back pain returned to active duty.

Often, injuries leading to disabling back pain were not sustained directly during battle, but in the interim—after a fall, while lifting heavy loads, driving

or marching over rough terrain, or during fitness training.

The study testing the effectiveness of high-tech, multifunctional prosthetic feet will evaluate how well three different types of prosthetic feet work for the rigorous and agile maneuvers soldiers must perform on the battlefield, such as running, jumping, dodging, crawling, and climbing.

The trial will involve soldiers who wear prostheses for below-the-knee amputations.

“This will be one of the first studies to compare the physical performance of highly mobile amputee soldiers using optimal components with that of non-amputees,” says Jason Highsmith, University of South Florida assistant professor of physical therapy. “We hope to identify which prosthetic foot may be best suited for military applications.”

Scientifically determining which prosthesis comes closest to a real foot when performing battlefield maneuvers is important, Highsmith says, because an amputee uses more energy than someone with a natural foot for comparable movements at the same speed. Along with higher survival rates, better prosthetics and treatments have improved amputees’ ability to regain mobility. More of these amputee soldiers are seeking to return to the front lines.

“We’re upping the ante on the scientific rigor applied to prosthetic research,” says Highsmith. “Anything we can do to advance knowledge, reduce disability, and improve the lives of our wounded soldiers, who have served our country so selflessly and constantly seek to stretch their limits, is valuable.”

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In the News

Researchers to Study Rationale for Breast Reconstruction Deciding whether or not to have post-mastectomy breast reconstruction is an emotional experience for many patients, but one that has not been studied extensively. Clara Lee, MD, a University of North Carolina School of Medicine physician and scientist, plans to change that.

Lee has received a five-year grant award to examine patients’ decisionmaking process about reconstruction and the effects of reconstruction on quality of life and body image.

The National Institutes of Health awarded her with the $862,700 career-development award.

TRANSITIONS

Lee hopes “this research will Clara Lee, MD eventually lead to more patients receiving the treatments they prefer is so critical to decision making yet and ultimately to better quality of life largely unexplored. for women with breast cancer.”

“The decision about whether or The study will use “conjoint not to have breast reconstruction analysis”—a statistical technique used should depend almost completely on in market research to determine how a patient’s personal preferences,” she people value different features that make continues. “And yet we find that rates up an individual product or service. of breast reconstruction in the United “We will use it to better underStates vary greatly by race, socioecostand women’s preferences about nomic status, and geography. In this breast reconstruction,” says Lee. “We study, we will evaluate the decisionalso plan to evaluate the ability of making process and the quality of breast cancer patients to predict how decisions about reconstruction.” they will feel after surgery, which

PEOPLE IN THE NEWS Thomas DiBello, CO, FAAOP, presented Snell with the award for his lifetime achievements in advocacy for the O&P profession on Capitol Hill in Washington, D.C.

Robert E. Arbogast (left), and Rudolf B. Becker III

The Lifetime Achievement Award was presented to Robert E. Arbogast, president of WillowWood, and Rudolf B. Becker III, president and chief executive officer of Becker Orthopedic, at the 2011 AOPA National Assembly.

W. Clint Snell, CPO, president of Snell OrthoticsProsthetics, was presented with the Legislative Advocacy Award at the AOPA 2011 W. Clint Snell, CPO National Assembly. (left), and Thomas DiBello, CO, FAAOP AOPA President

12

O&P ALMANAC DECEMBER 2011

Bret Bostock, CO, received the 2011 Sam E. Hamontree, CP, Business Education Award and presented on the “Total Care” business strategy at the National Assembly.

Edward Neumann, PhD, PE, CP, FAAOP (left); Carmen Hawkins, PhD; and Maria Gerschutz, PhD

Maria Gerschutz, PhD; Edward Neumann, PhD, PE, CP, FAAOP; and Carmen Hawkins, PhD, were honored as the 2011 Howard R. Thranhardt Award winners and presented at the Assembly’s final General Session event.

Bret Bostock, CO (left), and Thomas DiBello, CO, FAAOP

In recognition of the best orthotic abstracts submitted as a poster presentation, Tyler Manee, MSPO, received the first annual Otto and Lucille Becker Award and Chrysta Irolla received the first annual Edwin and Kathryn Arbogast Award.

E����� D������ �� P�������� � V����� C�� ��� R������ F������� Visit www.kiss-suspension.com or Call 410-663-KISS (5477) © 2011, U.S. Patent, Patent Pending Worldwide KISS is a registered trademark

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In the News

Photos: Seth Astle, Art Center College of Design

Cutting-Edge Prosthetic Design Recognized Seth Astle, a student at Art Center College of Design, located in Pasadena, California, won the U.S. portion of the James Dyson Award 2011 for his design of a prosthetic limb and bike pedal (pictured at right) that allows amputee cyclists to experience a full range of motion. An international student design award, the mission of the James Dyson Award is to encourage student design engineers to be creative, challenge, and invent.

Toronto, Canada-based Ryerson University students Thiago Caires and Michal Prywata’s brain-controlled prosthetic arm (featured in the July 2011 issue of O&P Almanac) was named one of the top 15 projects in the international James Dyson Award 2011 competition as well.

TRANSITIONS

BUSINESSES IN THE NEWS

The Amputee Coalition, Össur, and Johns Hopkins University are working together to create a new, nationwide program to help prosthetists address the emotional needs of people with limb loss. This program will launch later this year.

Bioness Inc. received 510(k) clearance from the U.S. Food and Drug Administration and CE Mark Approval by the European Union for its NESS H200 Wireless Hand Rehabilitation System.

led by Dan Cox, First Swing instructor, and assisted by Iowa Amputee Golf Association Past President, Chuck Kruse.

DJO Global Inc. signed a distribution agreement with Exos Corporation, providing DJO with exclusive rights to sell Exos’ upperextremity products in North and South America.

Cadence Biomedical has been awarded a Phase I Small Business Technology Transfer (STTR) grant worth up to $254,000 from the National Institute on Minority Health and Health Disparities, part of the National Institutes of Health, for research aimed at developing a kinetic prosthesis to improve mobility for transfemoral amputees.

Atlanta’s Good Samaritan Health Center and Prosthetic Hope International, in cooperation with the Georgia Institute of Technology’s Master of Science in Prosthetics and Orthotics program, are opening the Prosthetic and Orthotic Community Clinic at Good Samaritan. Second-year graduate students at Georgia Tech will primarily operate the new O&P lab and will be supervised by Georgia Tech research scientist Rob Kistenberg, MPH, CP, LP, FAAOP, and licensed prosthetists and orthotists.

Clark & Associates Prosthetics and Orthotics hosted an OPAF First Swing Learn to Golf Clinic at the All Golf Shop, Waterloo, Iowa. The clinic was

Orthotic Holdings Inc. acquired Arizona AFO, of Mesa, Arizona. Arizona AFO represents the third franchise brand in the Orthotic Holding’s family

14

O&P ALMANAC DECEMBER 2011

of companies, alongside The Orthotic Group and Langer Biomechanics.

Arizona AFO’s management and technical team are remaining with the company and manufacturing will continue at its current location.

The Orthotic and Prosthetic Education and Research Foundation (OPERF) is soliciting applications for the 2012 OPERF Research Award Program. The program, now in its fourth year, is designed to encourage and stimulate research at all levels in the O&P profession. More than $37,000 in awards is being offered in 2012.

Awards ranging from $1,000 to $25,000 are available. Össur opened its new manufacturing facility in Tijuana, Mexico, on September 23. Össur started to build the manufacturing unit in September 2010, and has since transferred the manufacturing of spinal products from the United States to Mexico. By the end of the year, all bracing and supports currently manufactured in the United States will be transferred to Mexico. a

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Reimbursement Page

By Joseph McTernan, AOPA government affairs department

Year-End Business Checkup Resolve now to take a fresh look at your O&P practices

A

nother year is coming to an end, and a new one is dawning just around the corner. This a good time to take a step back and evaluate your O&P business.

Spending a few moments now to examine what’s working and what isn’t can save time and worry down the road—and may lead to a more successful 2012.

So before you turn the last page of the calendar, here are six business practices you might want to revisit:

1

Review Your Contracts.

“How can I possibly stay in business when insurance companies are paying at such discounted rates?”

The reimbursement staff at AOPA often takes phone calls that begin that way. The first question we always ask the caller is, “Have you reviewed your contract?” More often than not, our response is met with silence.

Although not all contracts with insurance companies are renewed on a calendar year basis, many are. If you are unhappy with the reimbursement terms you have agreed 16

O&P ALMANAC DECEMBER 2011

to in the past, now is a perfect time to review your existing contracts and renegotiate them. Just like in the financial markets, market conditions in O&P are constantly changing.

By taking the time to examine your existing insurance contracts, you may identify some that are no longer favorable to you based on current market conditions.

Insurance companies want to obtain contractual terms that are most favorable to them, but it is a two-way negotiation process in which you have significant input. Once you sign on the dotted line, you are bound to the terms of the contract for the length of its effective period, so make sure you’re comfortable with the terms.

Every market is different, and market conditions—such as competition, the number of beneficiaries in the market, and quality of care—all factor into the negotiation process. Never simply sign a contract because you don’t believe you have any other option. Because everything is negotiable, make every effort to get the best contractual terms you can.

If, through your review, you find a contract with unfavorable terms that is up for renewal down the road, make sure you set up a reminder to alert you when it’s time to renegotiate.

Many contracts contain an “evergreen” clause that automatically renews the contract under the existing terms if no action is taken by either the provider or the insurer. Review those contracts carefully to make sure you understand what action you need to take and when in order to renegotiate the terms.

2

Review Your Medicare Participation Status.

Now is the only time of the year that you can make a change in your Medicare participation status. From mid November until December 31, Medicare providers have a window in which they may elect to change their Medicare status from participating to nonparticipating or vice versa.

If you are currently a participating provider and you want to be nonparticipating, you must notify in writing any DME MAC to which you submit claims that you have decided to be

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Reimbursement Page

2012 MEDICARE O&P FEE SCHEDULE INCREASE ANNOUNCED The Centers for Medicare and Medicaid Services (CMS) has announced that the 2012 Medicare fee schedule for orthotic and prosthetic services will be increased by 2.4 percent. This increase is effective for claims with a date of service on or after January 1, 2012.

The annual Medicare fee schedule increase is legislatively tied to the percentage increase in the consumer price index for all urban consumers (CPI-U) for the 12-month period ending with June of the previous year. This percentage, which was 3.6 percent in June 2011, is then reduced by an annual productivity adjustment, which for 2012 was calculated to be 1.2 percent, resulting in a net positive fee schedule increase of 2.4 percent.

CMS also has released 2012 reimbursement rates for L4205 and L7520, which represent 15 minute segments of orthotic and prosthetic labor respectively. These codes are not subject to the productivity adjustment and will be increased by the full 3.6 percent CPI-U based adjustment.

The official 2012 Medicare DMEPOS fee schedule will be released sometime after November 16, 2011. AOPA will download and make this file available to members as soon as it published by CMS.

a nonparticipating provider for the upcoming calendar year. If you choose to become a participating provider, you must complete and sign a participation agreement for each DME MAC to which you submit claims.

There is no wrong decision when it comes to Medicare participation. The decision you make should take into account what is in the best interest of your company.

A copy of the CMS participation agreement is available at www.cms. gov/cmsforms/downloads/cms460.pdf. For more information about the pros and cons of Medicare participation, see the October 2011 Reimbursement Page.

in a while, inviting them to come to your office for a consultation. In fact, this is a fairly common practice in other medical industries.

Make sure that you are familiar with Medicare restrictions on other forms of patient contact, however. Medicare supplier standards state that providers may not initiate contact via telephone or in person with Medicare patients unless they have provided a Medicarecovered service within the past 15 months or are contacting the patient to coordinate the delivery of a Medicare covered item.

Review Your Patient Files for Follow Up.

O&P care starts with a referral to your practice from a physician or other health-care practitioner. The beginning of a new year is always a good time to strengthen and enhance relationships with referral sources, so think ahead.

Brief in-service sessions that provide education on the latest O&P technology often are well received.

Strong professional relationships between an O&P provider and its referral sources almost always pay dividends in the form of increased referrals and trust in your ability to provide quality service. Unfortunately,

3

Repeat business is an important revenue source for any company, and O&P is no exception. The end of the year is a great time to review your files and identify patients who may require additional service. While Medicare has very clear restrictions on how and when you may contact Medicare beneficiaries, there are no restrictions on sending information about new products or services through the mail.

It is perfectly acceptable to send a postcard to patients you have not seen 18

O&P ALMANAC DECEMBER 2011

4

Reach Out to Your Referral Sources.

many O&P patient-care facilities do not make full use of marketing strategies.

Referral sources may not be patients, but they are still considered consumers because they are making decisions that affect your bottom line. By marketing your practice to this group, you can increase your referrals, which may lead to higher revenue.

5

Update Your Policy and Procedures Manual.

Now also is a great time to blow the dust off of your company’s policy and procedures manual and to ensure it is up to date and relevant. While it is important to have such a manual, it is even more important to follow the information within it. Because rules and regulations are constantly changing, you should review the manual at least annually to verify that the policies and procedures you follow remain compliant.

6

Update Your Fee Schedules.

The vast majority of insurance fee schedules are updated each calendar year. To avoid unnecessary loss of revenue, all of your fee schedules should be updated to reflect current rates. The Medicare O&P Fee Schedule for 2012 is 2.4 percent after a 1.2 percent downward productivity adjustment. If you have insurance fee schedules that are based on Medicare prevailing rates, these schedules will increase by the same amount.

Failure to adjust these fee schedules may result in under billing that can quickly add up to significant amounts of lost revenue.

Of course, every O&P office is different and operates according to its individual strengths and needs, but paying attention to the details as the New Year approaches will never hurt you. a Joseph McTernan is AOPA’s director of coding and reimbursement services. Reach him at jmcternan@AOPAnet.org.

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Col. Paul F. Pasquina, MD, chief of the Department of Orthopaedics and Rehabilitation, Walter Reed National Military Medical Center, addresses attendees of the 2011 AOPA National Assembly.

20

O&P ALMANAC DECEMBER NOVEMBER 2011 2011

COVER STORY

Active DUTY Col. Paul F. Pasquina, MD, discusses how a strong interdisciplinary team, coupled with the latest technology, helps combat amputees rebuild their lives

BY DEBORAH CONN

T

housands of young men and women have put themselves in harm’s way serving in the United States armed forces. And when their bravery leads to injury—and, as often happens, to amputation—they are receiving the very best care and rehabilitation a grateful nation can provide.

Treating service members who have lost limbs as a result of war, however, presents a different set of challenges from treating civilians. At Walter Reed National Military Medical Center, these wounded warriors receive unique medical, surgical, and rehabilitative care. In fact, nearly all combat amputees from the wars in Iraq and Afghanistan—more than 1,280 over the past 10 years—have been treated at the facility, which recently relocated

from Washington, D.C., to Bethesda, Maryland.

Walter Reed’s Department of Orthopaedics and Rehabilitation—the largest department of its type in the Department of Defense—comprises seven clinical specialty services: orthopaedic surgery, physical medicine and rehabilitation, physical therapy, occupational therapy, orthotics and prosthetics, traumatic brain injury, and amputee care services. As a result, combat amputees, who often suffer multiple and interrelated injuries, receive coordinated care across all relevant specialties.

Col. Paul F. Pasquina, MD, is chief of the Department of Orthopaedics and Rehabilitation at Walter Reed. He is a graduate of

the United States Military Academy at West Point, New York, and the Uniformed Services University of the Health Sciences. He is board certified in physical medicine and rehabilitation, as well as electrodiagnostic medicine and pain medicine.

Pasquina has served as the medical advisor to the North Atlantic Regional Medical Command for quality health care, and continues to serve as a consultant to the Office of the Army Surgeon General and the Department of Veterans Affairs.

O&P Almanac recently spoke with Pasquina about the specific needs of combat amputees and how his department is uniquely positioned to provide that care. Excerpts from that interview follow.

DECEMBER 2011 O&P ALMANAC

21

: How are combat amputees different from amputees in the civilian population?

The first difference is the cause of the amputation. A majority of amputations among civilians are the result of disease, either vascular disease or diabetes. These patients have problems getting blood circulating to their legs and suffer unhealed wounds that lead to limb loss. By contrast, our military casualties suffer combat wounds, most commonly from blast injuries.

Civilians also lose limbs as a result of trauma, such as a motor vehicle or other accident, but that kind of trauma is very different. With a blast injury, you need to think about the fact that the blast takes place in a combat area, which is inherently dirty. The explosion pushes foreign particles into a large portion of the soft tissue, significantly compromising the skin, ligaments, and muscles.

An amputation that results from a combat injury is typically done in stages. If someone is injured in the war zone, in-theater surgeons will try to control the bleeding and preserve as much tissue of the limb as possible.

After undergoing life-saving and limbsaving procedures in theater, combat victims are sent to Germany where

22

O&P ALMANAC DECEMBER 2011

“All service members involved in combat face psychological challenges, and having an injury on top of their exposure to war is an additional burden.” they continue to get life-saving care, as well as washouts and debridement of their wounds. After that, they are moved to Walter Reed, where a series of surgeries will lead to a definitive amputation.

The extent of soft-tissue damage may be unclear, and our surgeons at Walter Reed try to preserve as much length of limb as possible. This often involves the use of creative muscle flaps or skin grafts to get adjacent soft tissue coverage of an amputated limb.

Another difference is that if the blast is strong enough to cause the amputation of one limb, it’s very likely that it will cause upper-limb loss or multiple-limb loss. In the civilian population, the vast majority of amputees are lower-limb and singlelimb amputees. We see a significant number of soldiers, sailors, and airmen coming back with multiple-limb

amputations. More than 20 percent have upper-limb loss, and the same proportion has multiple-limb loss.

Blast injuries can also cause traumatic brain injury, which means patients have to recover from a brain injury as well as limb loss. This complicates training and rehabilitation, and using a prosthesis becomes much more complex for someone with a brain injury. Hearing or vision loss also is common with blast injuries, and any sensory impairment on top of limb loss makes recovery more difficult.

All service members involved in combat face psychological challenges, and having an injury on top of their exposure to war is an additional burden. And they don’t face those challenges alone. Many are married and have children, so whole families are involved in the patient’s journey to recover both mentally and physically.

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: What effects do the age and physical condition of combat amputees have on their recovery?

The vast majority of individuals we’re taking care of are under 35.

This brings both challenges as well as some hope.

When young service members lose a limb, it has a strong impact on their body identity, their sexual identity, and their ability to form relationships. It also affects their career choices. Many service members join the military thinking it will be their career, and losing a limb makes that more challenging. The military has changed its paradigm and culture, so that anyone who wants to stay on active duty with limb loss is given every opportunity. We try to accommodate them.

Some service members decide they want to stay on active duty, and others decide they don’t, depending on the level of impairment and how it will affect the kinds of jobs they want. Some perhaps joined the military uncertain as to what profession to pursue, and now they have to figure that out with one or more limbs missing. When we are trying to set up rehab goals—what you need a prosthesis for—it makes a difference whether someone is going back to farming or construction work, or going back to school and using a computer all day. It makes it tough for some of our young service members who aren’t sure yet what they want to do.

But being young has benefits, too.

Most of these amputees are healthy, active, and highly motivated to get back to an active lifestyle. This is positive, but it can also be very frustrating for these men and women who are used to high performance in sports and recreation and now have to perform with a missing limb.

Another big plus for them is that technology is advancing so quickly that their future can improve significantly.

24

O&P ALMANAC DECEMBER 2011

“The military has changed it paradigm and culture, so that anyone who wants to stay on active duty with limb loss is given every opportunity.”

: How do these multiple challenges influence your care of service members?

We are fortunate to have a strong interdisciplinary team, including nurses, physicians, rehab specialists, surgical specialists, occupational and physical therapists, and prosthetists.

Working together, we are constantly trying to meet whatever challenges we find.

We also welcome family members to play a major role in the care and recovery of our injured service members. We offer on-post housing for families, who can serve as nonmedical attendants for their loved ones, providing both physical and emotional assistance through therapy and rehab.

A huge plus is that we have access to the most technologically advanced

prosthetic components available, and we have a highly skilled staff of prosthetists and therapists working with patients. We also offer a very productive therapeutic milieu, where multiple service members face the same challenges side by side. They can motivate one another, and whenever someone has a down day, they’ll have a buddy there who can pick them up.

: What are some of your rehab goals for these service members?

The long-term health-care risks associated with losing a limb are well known. It makes someone much more likely to develop arthritis, cardiovascular disease, diabetes, high cholesterol, and hypertension. These medical problems have been all well documented among service members from both World Wars and in Vietnam.

A lot of our emphasis and our rehab strategy is to provide prostheses as well as training that most normalize the mechanics of ambulation or upperlimb movement. We also encourage amputee veterans to manage a good diet, take regular exercise, and avoid tobacco because all of those are much more important to someone who loses a limb.

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: How do you address the psychosocial needs of combat amputees?

“…Even with all these advances, it does not lessen the importance of the human element of providing care to individuals with limb loss…”

: What kinds of new technology are you using with amputees?

For those with lower-limb loss, especially above-knee amputations, we use the latest microprocessor knees as initial prostheses. We have found these to be very helpful, but they are not the standard of care in the civilian population.

We also have access to the latest powered prostheses, including a powered knee and a powered ankle/ foot. We are looking at the effectiveness of the newest generation. We have now treated several patients with a powered knee for their first prosthesis and have found they were able to get up and walk without assistive devices much sooner.

The true impact of all these devices will be how they can potentially reduce the long-term incidence of arthritis and overuse problems. We’ve been looking at that and are very excited about what we have learned so far.

For upper-limb amputees, we are partnering with the Revolutionizing Prosthetics Program at DARPA [the Defense Advance Research Projects Agency]. Most of the scientists and engineers in that program have been

26

O&P ALMANAC DECEMBER 2011

to Walter Reed to meet with our patients and providers. We’ve been excited to work with newly developed prostheses that offer multiple additional degrees of freedom for hand and arm motion These are not yet commercially available, but our hope is that they will eventually benefit all individuals who need them.

Technology does make a difference, and future R&D money needs to be spent. The industry needs to listen to the consumer, and it is important that research happens on clinically relevant topics. Nevertheless, I think it is important to mention that even with all these advances, it does not lessen the importance of the human element of providing care to individuals with limb loss, whether it is psychological, medical, or rehab care or the actual fitting and alignment of prostheses.

There is significant art to medicine and prosthetic care, and technology will never replace that. Some people find technology intimidating, or even threatening. It is certainly an augmentation of someone’s specialty skills, and can be more demanding, particularly for orthotists and prosthetists who understand the technology and make the most use of it for each patient.

Our interdisciplinary team includes behavioral health experts who see every one of our patients as a matter of course. This removes any stigma from getting counseling. Many service members feel uncomfortable talking about the emotional aspects of limb loss, so having mental health experts as a standard part of the treatment team has been a very positive practice here.

We partnered with the Amputee Coalition early on in the war, and we have a strong peer visitation program that patients report as very helpful in recovery. Meeting others who have sustained limb loss and seeing what they have been able to do has had a positive influence on the program. But just losing a limb doesn’t make someone a good mentor, so it’s important to mention the Amputee Coalition’s peer visitation training program, which gives past amputees the skills they need to be effective mentors. These peer programs continue after patients return to their communities. We also bring in peer visitors from the Vietnam War, Operation Iraqi Freedom, and Operation Enduring Freedom [Afghanistan], and all those relationships remain very strong.

One last point: We are very fortunate to have a great recreational and sports program here. Often an amputee’s first exit from the hospital is on some type of outing with our recreational therapist. We’ve been very fortunate to have multiple nonprofit and charity organizations through which folks give up their time to teach our injured service members how to kayak, fish, play tennis, go horseback riding, create art, and take part in many other activities. All those things have had a huge impact on our program and have improved the lives of our wounded service members. a Deborah Conn is a contributing writer to O&P Almanac. Reach her at debconn@ cox.net.

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Advancing AOPA’s

Legislative Agenda U.S. Senate subcommittee underscores O&P research needs

28

O&P ALMANAC DECEMBER 2011

A

new U.S. Senate report acknowledging the importance and serious challenges in providing prosthetic and orthotic care to a future generation is the first step in an important AOPA-driven funding initiative for research dollars to define patient outcomes— particularly how O&P advances affect the average patient/citizen. The O&P field must be prepared to treat the expanding number of patients plagued by obesity, diabetes, cardiovascular disease, and other ailments. Another part of the solution must be to expand the number of O&P teaching institutions.

This Senate report just didn’t happen, however. Outcomes research to measure the cost-effectiveness of specific treatment options Sen. Tom Harkin has been an important

initiative for AOPA since the 2007 Member Survey. In September 2010, AOPA retained Linchpin Strategies, a firm specializing in securing congressional funding for research and other worthy projects, to help the O&P community access the funding needed to expand outcomes research and education opportunities.

Sen. Richard Shelby Linchpin President Catriona Macdonald has conducted nearly 200 one-on-one visits with key people who have influence over prosthetics and orthotics funding decisions across federal agencies. The report, drafted by Senate Labor, Health, and Human Services Subcommittee Chairman Sen. Tom Harkin (D-Iowa) and Ranking Member Sen. Richard Shelby (R-Alabama) is one of the first tangible indications that this issue is gaining traction, and recognition is growing that O&P research and patient outcomes deserve significant funding.

DECEMBER 2011 O&P ALMANAC

29

Ask the

Lobbyist O&P Almanac interviewed Catriona Macdonald, president of Linchpin Strategies LLC, concerning the best ways to educate Congress about the need for O&P funding and how AOPA members can help.

O&P Almanac: The field of O&P has received a lot of attention over the course of the wars in Iraq and Afghanistan. Why is more education still needed on Capitol Hill?

Macdonald: Many members of Congress and their staffs have a “sound bite” understanding of O&P. They read the articles about the veteran running with the president or the huge investment made by DARPA [Defense Advance Research Projects and Agency] and feel that the problem is being taken care of.

As we all know, there is much more work to be done in the field. As I speak to scores of offices, I’m finding decision makers are hungry for more information about O&P. O&P Almanac: For the last decade or more, health care has been moving toward evidence-based practice, and recent federal legislation has provided significant sources of funding for outcomes-based research. Why has O&P been left behind?

Macdonald: O&P is a relatively small field, and outcomes-based research has focused largely on conditions that affect large populations, with large patient groups for studies. And, until recently, technology wasn’t widely available in the O&P field to track patient outcomes accurately, objectively, and cost-effectively.

Now, there is a growing focus on evidence-based practice in the O&P field.

For example, at the Veterans Administration’s Prosthetics and Sensory Aids Service, Dr. Lucille Beck is beginning to instill an evidence-based practice approach to delivery of care throughout the VA system. Notwithstanding other challenges at the VA, this view on evidence-based practice is not inconsistent with AOPA’s position and may create opportunities for some productive collaborations not seen before between the VA and the O&P industry.

O&P Almanac: What can AOPA members do to help?

Macdonald: Lobbying is a contact sport: The more contacts you make, the more opportunities you have to inform and persuade people, the more likely you are to win. That’s why I spend so much time in congressional offices, with congressional committees and federal agencies. Staying on the radar screen, being at the forefront as decision makers are considering their options and establishing their priorities, is critically important. Members and their staffs want to hear from constituents. Phone calls, emails, and meetings—in Washington and in the district—really can and do make a difference.

I can help with talking points, contact information, and backgrounders, but AOPA members from home are often the most persuasive advocates. If you can’t join us in Washington for AOPA’s Policy Forum, April 17 and 18, then make appointments at home to get to know your congressional offices.

30

O&P ALMANAC DECEMBER 2011

Here’s an excerpt from the report: PROSTHETICS RESEARCH. The Committee is aware that increasing numbers of Americans are undergoing amputation as a result of the growing prevalence of diabetes, cardiovascular disease, and other reasons. The Committee also understands that, to date, little research has been done to examine prosthetic outcomes and to link prosthetic and orthotic treatments, devices and supports to patient outcomes.

In order to support evidence-based healthcare practice in prosthetics and orthotics, and establish which approaches work best for which patients, the Committee encourages NICHD (National Institute of Child Health & Human Development) to work with the National Institute on Disability and Rehabilitation Research (NIDRR) and experts in the field of prosthetic research to develop a prosthetics outcomes research agenda and implement needed research.

Answering Research Questions Three government agencies may have a special role in outcomes research efforts: the Department of Veterans Affairs (VA), the Department of Defense (DoD), and the National Institutes of Health (NIH). The National Institute of Child Health & Human Development resides in NIH, and the National Institute on Disability and Rehabilitation Research is part of the U.S. Department of Education.

All three agencies have sponsored research that has restored maximum function to wounded warriors and veterans. This is important progress.

But, the agencies’ O&P research has not focused on outcomes to the extent that their research in other allied health professions has. More specifically, the DoD, VA, and NIH are in the best position to help find answers to questions such as these:

A research agenda focusing on O&P outcomes and cost-effectiveness can be a life-changing shift in public policy that can benefit millions of Americans in the coming generations.

• What interventions can prevent amputation or subsequent surgeries?

• At what point in the course of patient treatment is orthotic and prosthetic intervention most effective?

• Which patients benefit most from which technologies?

• What O&P practices facilitate successful aging, and how does the aging process affect the use of prosthetics—including increased skin breakdown, loss of balance, falls, and other issues—such as promoting return to work?

• What conclusions could longitudinal data provide relating to amputees, their treatment, and the possibility that there may be a natural history in recovery and potential complications relating to amputees? What conclusions would improve the quality and cost-effectiveness of amputees’ care?

• What should be the timing of O&P intervention to best prevent loss of activity, mobility, and ability to work and carry out activities of daily living?

Such elements of a coherent O&P research agenda are vitally important to reducing future health-care costs as well as ensuring that patients receive appropriate, necessary care.

Shifting Public Policy A research agenda focusing on O&P outcomes and cost-effectiveness can be a life-changing shift in public policy that can benefit millions of Americans in the coming generations. Adding the expanded education component

will be among priorities for the 2012 AOPA Policy Forum, to be held April 17 and 18 in Washington, D.C. In tandem with this AOPA/ Linchpin effort, AOPA has been working closely with DoD, VA, and Johns Hopkins University to investigate initiating a longitudinal study of VA and DoD patients, tracking their diagnoses and treatments to measure outcomes and effectiveness. a

to make sure there are enough O&P providers can help create a better world of O&P that is perfectly positioned to serve the ever-enlarging patient base.

Linchpin’s job for AOPA in the year ahead will be more one-on-one meetings to cement solid support for these two specific research and education legislative objectives. AOPA members should seek out opportunities to speak with their legislators about the critical need to ensure the future wellbeing of their constituents. These efforts

EDITOR’S NOTE: Make plans now to participate in the 2012 AOPA Policy Forum. Join your O&P colleagues April 17 and 18 at the L’Enfant Plaza Hotel in Washington, D.C., to learn more about the issues affecting the O&P community and present the case for O&P to your congressional representatives. For more information, visit www.AOPAnet.org.

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31

n

Ask the Expert

By Joseph McTernan, AOPA government affairs department

The Rules of Holiday Gift-Giving Check that list twice before you send gifts to patients and referral sources The decorations are up, the cards have been addressed, and now you’re wondering about gifts. Specifically, what kinds of gifts may you give to patients and referral sources in recognition of their business during the past year?

It’s a perennial question, so this month’s Ask the Expert will address some common scenarios about gifts.

Q:

I want to thank some of my regular patients for their loyalty and support over the years.

Can I send them a holiday gift to say thank you?

A:

The Office of Inspector General (OIG) published a Special Fraud Alert in August 2002 that addressed the practice of Medicare beneficiary inducement. In the alert, the OIG reiterated that it is illegal to give any remuneration that the provider believes will encourage the beneficiary to choose them over another provider.

The term “remuneration” includes waiver of copayments and deductibles, as well as anything that is offered free or at a cost that is less than fair-market value. A general exception to the rule allows for gifts of minimal value, as long as they are offered without conditions. The term “minimal value” is defined as applying to noncash items of $10 or less each and $50 or less total per Medicare beneficiary, per calendar year.

In short, you may offer Medicare beneficiaries a small token of your appreciation for their business, but these tokens cannot be cash and cannot exceed a value of $10 per gift and $50 per year. And of course, the gift must be given without any condition— especially not the condition that the patient must continue to choose you as provider. A link to the full fraud alert may be found at http://oig.hhs.gov/fraud/ docs/alertsandbulletins/sabgiftsandinduce ments.pdf.

32

O&P ALMANAC DECEMBER 2011

Th

ank

Yo

u

Q:

What about gifts to referral sources?

Do the same rules apply?

A:

The rules surrounding gifts to referral sources are even more stringent. Federal Anti-Kickback Regulations set severe penalties for people who “knowingly and willfully offer, pay, solicit or receive remuneration in order to induce business reimbursed under the Medicare or State health care programs.” Possible penalties include up to five years in prison and $25,000 in fines. These are certainly extremes, but you must be very careful to avoid even the appearance of providing what could be classified as a kickback.

To help practitioners understand what is acceptable and what is not, AOPA has created a Code of Interactions with Healthcare Professionals, available at www.aopanet. org/AOPA_Code_of_Interactions_ with_Healthcare_Professionals.pdf. This document outlines when it is appropriate to provide anything of value, no matter how small, to a current or potential referral source.

As a general rule, you may give a referral source something of value only when it is part of a program that provides scientific or educational value.

For example, you may present an in-service session to a physician’s office during the workday and provide a modest lunch for the staff. You may not, however, give staff members tickets to a sporting or other recreational

event, even if you intend to discuss new products and technologies during the event. The key difference is that the second scenario involves a recreational activity outside of the typical workplace environment.

In addition, the Code of Federal Regulations contains several safe-harbor provisions that allow remuneration to potential referral sources without violating the anti-kickback statutes.

These exceptions—42 C.F.R. §1001.952 in the code—are available online at http://edocket.access.gpo.gov/cfr_2010/ octqtr/pdf/42cfr1001.952.pdf.

cards to referral sources or even stopping by to personally thank them for their referrals.

Everyone likes to receive gifts, especially during the holidays, but a personal note or a brief visit will often go further than a tin of cookies or a fruit basket. The business of providing health care often is centered on the value of personal and professional relationships. Taking the time to nurture and grow the relationships between your office and its referral sources may prove to be more valuable than a generic gift.

Q:

Q:

If I am not allowed to provide gifts to my referral sources at the holidays, how can I thank them for their business throughout the previous year?

What about marketing materials such as pens, prescription pads, notepads, and so on with our company logo on them?

May I give them to referral sources?

A:

A:

Often, a simple “thank you” will do the trick. Let your referral sources know how much you appreciate their trust in your ability to provide excellent service to their patients. There is no prohibition on sending holiday

do not “advance disease or treatment education.” AOPA’s Code says that providing these types of items may “foster misperceptions that company interactions with healthcare professionals are not based on informing them about medical and scientific issues.” Providing inexpensive logo-branded items to referral sources as a reminder of your partnership might seem like a good marketing strategy, but it’s difficult to defend the practice should questions of inappropriate remuneration arise.

So when you make your holiday plans, remember this: Feel free to share all the good tidings you want, but only elves who have no patient or referral relationship with the recipients should be handing out gifts. a

It’s highly unlikely that the FBI will break your door down because it discovered a pen brandishing your company logo in the office of a referral source. But bear in mind, marketing materials

Joseph McTernan is AOPA’s director of coding and reimbursement services. Reach him at jmcternan@AOPAnet.org.

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Facility Spotlight

By Deborah Conn

Beating the Odds

Athletic training experience and a homegrown work ethic spell success for Denham O&P

David Denham, CO

FACILITY:

Denham Orthotics and Prosthetics

LOCATION:

Henderson, Nevada

OWNER:

David Denham

HISTORY:

11 years in business

34

O&P ALMANAC DECEMBER 2011

T

he odds of success have been daunting for Denham Orthotics and Prosthetics, located in a suburb of Las Vegas. The city depends on tourism for its economic base, and it was one of the hardest hit in the economic turndown of 2008. What’s more, the facility has 11 major competitors in a town of only about one million people. Nevertheless, Denham O&P will exceed $1 million in billings this fiscal year, says owner David Denham, CO. “We’ve rallied,” says Denham. “My staff is killer efficient, with collections of 85 to 90 percent of billings.”

Denham O&P is a small operation, occupying a single 2,000-square-foot facility that includes two patient rooms, a gait room, a laboratory, three

offices, and a waiting area. The three full-time staff members are Denham, a certified prosthetist, and a front office administrator. They are assisted part time by a retired athletic trainer and a retired CPO. The facility uses central fabrication for about half its devices.

Starting With Sports Denham became an orthotist in 1996 after a career as a certified athletic trainer. He opened the business in 2000, focusing mainly on lowerextremity work. Practitioners treat many high-level athletes, including players for the University of Nevada Las Vegas (UNLV) and Cirque du Soleil performers based in the city, as well as amputees active in sports.

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Facility Spotlight

David Denham, CO, and Dave Kovach, CP

“Our prosthetist, Dave Kovach, was also an athletic trainer before becoming an O&P practitioner,” says Denham.

“He does excellent work. I expect him to be nationally known before long.”

Denham relies on networking, patient satisfaction, and a commitment to education to bring patients through the door. “I have difficulty thinking that putting money out for ads works,” he says, “so to keep our budget down, I use word of mouth.”

From 1980 to 1994, Denham was part owner of a physical therapy business in the area, Sports Therapy and Arthritis Rehabilitation (since sold to NovaCare), and he continues to receive referrals from local PTs. He lectures to local osteopathic students, who often spend a day observing at the clinic, and to UNLV students in physical therapy and athletic training programs.

The facility’s website does double duty as a marketing tool and a patient education platform. Online videos demonstrate such activities as donning and doffing a below-knee prosthesis,

36

O&P ALMANAC DECEMBER 2011

using a reciprocal gait orthosis, and the athletic capabilities of amputees wearing prostheses.

“If the average consumer goes to buy a television, he’ll do some research. But if his doctor tells him he needs an AFO [ankle-foot orthosis] or a prosthetic leg, he’ll have no idea,” says Denham. “We think it’s important that every patient who walks in the door understands what’s happening— whether it’s how long for tissue or bone to heal or what to expect with wearing a brace.”

Getting It Right Denham also prides himself on getting it right. “Coming from the therapy world to the O&P world, I learned that you may need to remake a brace a number of times to get it right. What works for patient A may not work for B, even with the same pathology. You have to be willing to redo it,” he says. “[We do, and] as a result, all my AFO and prosthetic patients come back. They are good advertising in themselves.

“When a difficult lower extremity patient presents with unsuccessful results or transfers from another clinic, it is important to go back to the ‘mechanism,’” he continues.

“For instance, if a patient is wearing an AFO and he says his low back is keeping him from walking a long distance, it’s important to check leg length, gait, core strength, and flexibility and calculate some objective metric to measure if he’s getting better, even if it’s the distance he is able to walk.”

Denham points out that many factors affect the success of a brace.

“Another good example is that one should always look at the feet if a patient has a degenerative knee,” he says.” Excessive pronation puts much stress on the medial femoral condyle.

Or if a neuro patient complains of too much recurvatum [knee hyperextension], perhaps it can be controlled by staying below the knee. All these things help the patient and keep the bracing lighter in weight.”

Denham keeps his focus on patient care. “It shouldn’t be about how can I supplement my income in my medical practice or therapy practice, but more what is the very best I can provide for my patient.”

That philosophy is homegrown.

Denham grew up on a ranch in Colorado, where, he says, he learned the basics: “If you’re kind to people, honest, and do what you say you’ll do, it makes for a recipe of success.” a

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

Want your facility to be considered for the next Facility Spotlight column?

Contact Editor Josephine Rossi at jrossi@ strattonpublishing.com.

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AOPA Headlines AOPA WORKING FOR YOU

Re-election of Two Officers for 2012 Ensures AOPA Leadership Stability

T AOPA President Tom DiBello, CO, FAAOP

38

O&P ALMANAC DECEMBER 2011

homas V. DiBello, CO, FAAOP, and James A. Kaiser, CP, will continue to serve as AOPA president and immediate past president, respectively, for additional one-year terms beginning December 1, 2011.

As DiBello put it, “The succession order has experienced bit of a hiccup.� Ordinarily, DiBello would have moved up to the position of immediate-past president, Kaiser would have retired from the Board of Directors, and the presidentelect would have assumed the presidency. But when Bert Harman accepted a position outside the O&P field in early August and stepped down as president-elect, the Nominating Committee had to do some fancy footwork to be prepared for the September 20 election.

In consultation with the AOPA Board of Directors, it became clear that the best solution would be to ask Kaiser and DiBello to serve one additional year in their current positions. Real concerns were expressed about the myriad challenges and issues now confronting the O&P field, many as a result of the new Affordable Care Act. Everyone realized it just made sense to have the 2012 leadership completely knowledgeable about all the issues on the table. Fortunately, both men stepped up to the plate.

With this arrangement, Tom Kirk, PhD, moves up to president-elect, and Jim Weber, MBA, continues as treasurer, completing the second year of his two year term in 2012.

Joining the Executive Committee as vice president is seasoned board member Anita Liberman-Lampear, MA, who has served five years on the AOPA Board of Directors.

(Opposite page, from left to right) 2012 AOPA Board of Directors at the 2011 National Assembly: Alfred Kritter, Jr., CPO, FAAOP; Frank Vero, CPO; Michael Hamontree; Kel Bergmann, CPO; Anita Liberman-Lampear, MA; Eileen Levis; Tom Kirk, PhD; (this page) Russell Hornfisher, MBA, MSOD; Mahesh Mansukhani, MBA; Michael Oros, CPO; and Jim Weber, MBA. (Not present) Ronald Manganiello and James Kaiser, CP.

Liberman-Lampear has been deeply involved in moving the AOPA research agenda forward and served as Board Champion for the Evidence-Based Practice Research Initiative, which grew out of needs cited by members in the 2007 Member Survey.

In addition, along with her husband Alan, LibermanLampear has been the point person for the annual O&P PAC Wine Tasting and Auction, which with Tom Watson, CP, as auctioneer raised more than $32,000 for the O&P PAC and Capital Connection during this year’s National Assembly.

Also joining the leadership team as new members of the Board of Directors are Michael Oros, CPO, of Scheck & Siress, Oak Park Terrace, Illinois, and Ronald Manganiello of New England Orthotics & Prosthetics Systems LLC, Branford, Connecticut. Oros represents four- to 10-facility operations on the board, and Manganiello was elected to an at-large seat.

Frank Vero, CPO, another veteran board member, was re-elected to complete the remaining year of LibermanLampear’s term, representing one to three facilities.

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DECEMBER 2011 O&P ALMANAC

39

n

AOPA Headlines

AOPA Launches Business Certificate Program

AOPA and O&P Alliance Respond to OIG Report

AOPA is proud to announce the launch of the AOPAversity O&P Business Management Certificate. This comprehensive certificate program targets business owners, managers, and practitioners of O&P patient-care facilities, manufacturers, and distributors. It comprises a series of business and management seminars that build participants’ skills to address crucial business challenges.

The program will focus on four subject areas: managements, sales and marketing, finance, and operations, with designated “required” and “elective” modules within each of the four subject areas. Participants will receive a certificate once they have completed eight of the Business Management Program Modules and passed a module-specific quiz. The program offers a variety of modules, of which four corerequired and four core-elective modules must be completed.

Module-specific quizzes will be submitted to AOPA upon completion of the course. To receive credit for a course, a participant will be required to pass the course-specific quiz with a grade of 80 percent or higher.

AOPA voiced concerns about a report issued by the Office of Inspector General (OIG) about lower-limb prosthetics that was referenced in a “Dear Physician” letter from the DME MAC Medical Directors. Specifically, the letter seemed to minimize the value of prosthetists’ documentation for claim payment purposes.

AOPA and others in the O&P field are concerned that the report indicates OIG does not understand how O&P care actually is delivered. If the OIG’s recommendations are implemented, hassle for practitioners and their patients will significantly increase. (CMS has rejected one of the OIG’s six areas of recommendations.)

AOPA and members of the O&P Alliance have expressed these concerns with four different levels in government.

Correspondence was sent to the DME MAC medical directors, OIG, and two high-level offices within CMS. AOPA’s Director of Coding and Reimbursement, Education, and Programming Joe McTernan sent the follow message in a letter requesting to meet and discuss the issue with Peter Budetti, MD, JD, deputy administrator of the center for program integrity at CMS:

O&P Almanac Wins Two Design Awards Graphic Design USA (GD USA) has awarded the August and December 2010 issues of the O&P Almanac with American Graphic Design Awards. The magazine was one of the winners chosen from more than 8,000 entries. GD USA has recognized exemplary work for almost five decades and describes its mission as to “honor outstanding work across all media.”

AOPA thanks O&P Almanac’s Art Director Catherine Marinoff of Marinoff Design and Editor Josephine Rossi of Stratton Publishing for their wonderful work on the magazine.

40

O&P ALMANAC DECEMBER 2011

“The misunderstanding of the normal, appropriate and legitimate course of care which arose first with respect to diabetic shoes, now threatens to be expanded to the detriment of America’s roughly 75,000 Medicare beneficiary amputees. The statements regarding the enormous challenges in securing expanded documentation from physicians for patients, who some time ago had been referred for treatment by other health professionals including accredited and licensed O&P professionals (who OIG inaccurately refers to as suppliers), referred to in the concluding paragraphs of our letter of September 13, 2010, are similarly accurate and applicable today to patients requiring either therapeutic diabetic shoes, as well as those requiring lower limb prosthetics….

We therefore are respectfully requesting a meeting with you personally, as well as others you deem appropriate both from CMS and the OIG with regard to this new policy requiring expanded documentation from physicians at the earliest possible time, and by copy of this letter are informing the other O&P Alliance organizations in the event that they may wish to join in this request and perhaps participate in the requested meeting.”

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AOPA Headlines

AOPAversity: Reviewing New 2012 Medicare Codes and Policies HIPAA requires all payers to use HCPCS Codes, and new codes and modifiers will become effective on Jan. 1, 2012. Having a plan in place to verify your business’ billing practices may prevent unnecessary audits down the road.

To ring in the New Year, join AOPA on Dec. 14, 2011, for an AOPAversity Mastering Medicare Audio Conference that will focus on new codes and medical policy changes for 2012 and explain why they are an important part of your business.

An AOPA expert will address the following issues during the audio conference: • new HCPCS codes effective Jan. 1, 2012 • verbiage changes to existing codes and how they may affect your business • codes that will no longer be used as of Jan. 1, 2012 • other changes to the HCPCS system • AOPA’s interpretation of why the changes took place.

The cost of participating is just $99 for AOPA members ($199 for nonmembers), and any number of employees may listen on a given line. Participants can earn 1.5 continuing education credits by returning the provided quiz within 30 days and scoring at least 80 percent.

Register online at https://aopa.wufoo.com/forms/2011telephone-audio-conferences.

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

Visit AOPA at www.AOPAnet.org

42

O&P ALMANAC DECEMBER 2011

DECEMBER 2011 O&P ALMANAC

43

n

AOPA Headlines

Online Digital Archive of O&P Publications Unveiled

IN MEMORIAM Kenneth Carozza, RPOA

Reading about O&P history is now easier than ever. Representations of the O&P Journal, the predecessor of O&P Almanac, are now available online at www.oandplibrary.org/op/.

A grant from the American Academy of Orthotists and Prosthetists provided The O&P Library Foundation with the funds for Paul E. Prusakowski, CPO, FAAOP, of Gainesville Prosthetics to digitalize these issues. Currently, the archive includes issues from 1975 through 1988, but the foundation will continue adding to the collections as funds permit.

Looking at past records of the O&P profession will allow for future innovations and provides clinicians with a helpful resource, says Anthony J. Filippis, CPO, president and CEO of Wright & Filippis.

“History always repeats itself, and a lot of things get recreated,” says Filippis. “Part of the advantage of this is that it Paul E. Prusakowski, CPO, FAAOP, allows people to see what’s been done in the past, things that may have been attempted and weren’t really successful. It’s a learning process. Maybe the materials, technology, components weren’t there to help it materialize, [but now they are].”

Rod Cheney, CPO, executive vice president of American Prosthethic and Orthotics Inc., joined the O&P profession in 1985 and enjoys reading older issues online instead of print.

“I think you’ll get more readability this way,” says Cheney. “It’s a great way to provide younger practitioners with historical background. [Digital archives] are the way we need to go in our profession. We need to go more green.” a

1986

1974 44

O&P ALMANAC DECEMBER 2011

Kenneth Carozza, RPOA, passed away on November 4, after a long health battle.

Carozza began his career at Dorsch Prosthetics in New York City and served the prosthetics community for more than 30 years. He provided services for many international patients as well as United Nations’ ambassadors. Carozza, who is survived by wife Marita Dorsch-Carozza CP, FAAOP, had been retired for 12 years. Marita’s mother, Mary Dorsch, CPO, (deceased) served as 1971-1972 president of AOPA.

Jose Garza, CO Jose (Joe) Garza, CO, passed away October 20 in Crown Point, Indiana. He practiced orthotics for 41 years at Calumet Orthopedic & Prosthetic Company in Hobart, Indiana. He joined Calumet in 1970, shortly after his discharge from the U.S. Army. He completed his formal orthotics education at Northwestern University and became ABC-certified in 1976.

He spent his career at Calumet and retired in June 2011. Garza is survived by his wife Judith, daughters Kristen Heilman and Nicole Bateman, son Eric Garza, and other relatives.

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AOPA Applications Advanced Prosthetics Inc.

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

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

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

Supplier levels are based on annual gross sales volume: Level 1: equal to or less than $1 million Level 2: $1 million to $1,999,999 Level 3: $2 million to $4,999,999 Level 4: more than $5 million

1661 E. Main Street Easley, SC 29640 864/859-4709 Fax: 864/855-9331 Category: Patient Care Facility Phillip Peters, CP

Flow & Go 4026 Scott Drive Hammond, LA 70401 985/320-0584 Category: Patient Care Facility Gerard Guerin, C.Ped

Hogan Prosthetics & Orthotics Inc. 1731 S. Orange Ave. Orlando, FL 32806 407/781-2360 Fax: 407/781-2362 Category: Patient Care Facility Michael Hogan, CPO, LPO, BOCPO

Horizon Orthotic & Prosthetic Experience Inc. 4900 S. Arrowhead Drive, Ste. A Independence, MO 64055 816/795-9600 Fax: 816/795-9609 Category: Affiliate Parent Company: Horizon Orthotic & Prosthetic Experience Inc., Overland Park, KS

Mueller Sports Medicine Inc. 1 Quench Drive Prairie du Sac, WI 53578 608/643-8530 Fax: 608/643-2568 Category: Supplier Level 4 Brett Mueller

Neu Technology Innovations/dba Hightech Rehab Solutions 109 Waterview Parkway, Ste. 102 Boerne, TX 78006 830/816-5377 Fax: 830/331-8587 Category: Patient Care Facility Regina Garza, CPO, LPO

46

O&P ALMANAC DECEMBER 2011

Optech Orthotics & Prosthetics Services Ltd. 3900 W. 95th Street Evergreen Park, IL 60805 866/996-7832 Fax: 815/932-8564 Category: Affiliate Parent Company: Optech Orthotics & Prosthetics Services Ltd., Kankakee, IL

OrthoFit Inc. 11556 Occohannock Road Exmore, VA 23350 757/414-0248 Category: Affiliate Parent Company: OrthoFit Inc., Virginia Beach, VA

Orthotic Prosthetic Solutions 1633 Fillmore Street, GL5 Denver, CO 80206 303/316-2615 Fax: 303/331-9019 Category: Affiliate Parent Company: Orthotic Prosthetic Solutions, Fort Collins, CO

Parker Hannifin Corp.

6035 Parkland Boulevard Cleveland, OH 44124 216/896-2175 Category: Supplier Level 1 Doug Santee a

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Bringing College Park’s innovative composite technology into the K2 market, the Celsus combines proven durability with controlled stability. Its balanced design and natural motion provide smooth, stable transitions. The perfect lightweight design promotes confidence and security for lower impact patients. Key features include: • Smooth proportional response with integrated spring technology (iST) • Low profile design 48

O&P ALMANAC DECEMBER 2011

Masterflex Black, a one-of-a-kind fabrication material, was recently added to Euro International’s program line. This material is exclusively distributed by our company and provides solutions for various problems clients face on daily basis such as cold flow, friction, discoloration (caused by creams, lotions, sweat etc.) or staining, unevenly pulling, and tearing; it even eliminates the use for powder to avoid stickiness or tackiness. Masterflex Black is an advanced range material with a pleasingly clean and attractive look, e.g., used for the production of flexible inner sockets. Masterflex Black will enable you to more easily achieve the desired patient outcome while helping you increase productivity and ruling out wastefulness which impacts your margins.

For more information, call 800/3782480 or visit www.eurointl.com.

INTRODUCING KISS REPLACEMENT KITS! AVAILABLE IN BEIGE OR BLACK These kits are designed to replace key components, without the need to purchase a distal base.

CMP32/A: Includes a velcro sewn placard, proximal nut and screw, proximal strap, and distal strap. CMP31/A: Includes an adhesive-ready placard, proximal nut and screw, proximal strap, and distal strap.

For more information, contact KISS Technologies LLC at 410/663-KISS or visit www.kiss-suspension.com.

SMARTKNIT® AFO SOCKS IN NEW CHARCOAL COLOR

Knit-Rite’s SmartKnit AFO Socks are now available in a new charcoal color available in Child Small, Child Regular, Adult Small, and Adult Regular sizes.

Patented SmartKnit® AFO and KAFO is a seam-free, wrinkle-free sock that fits like a second layer of skin, providing exceptional softness and wicking moisture away from the skin. In addition to being free of seams and the pressure that seams cause, each sock features a “heel-less” design to ensure a perfect fit every time. Anti-microbial fibers help inhibit odor in the socks.

For more information, contact Knit-Rite at 800/821-3094 or via email customerservice@knitrite.com.

NEW FROM MOTION CONTROL: NEW TRIAD PREAMP

adjustable anterior and posterior plastic panels contour and conform to patients of all shapes, sizes, and lordotic curves with no heat molding necessary. Your patients will appreciate the streamline design that is virtually undetectable under clothing.

Contact Optec USA for all your bracing needs at 888/982-8181 to speak with our customer service team or check out our website at www.optecusa.com.

INTRODUCING OPTEC USA’S NEWEST PRODUCT • Three mounting options • Water-resistant case • High-interference rejection • Gain adjustments on preamp • Compatible for use with: ✔✔ Utah Arm 3 & 3+ (kit: p/n 4050214) ✔✔ Utah Hybrid Arm (kit: p/n 4050214) ✔✔ ProControl Systems (kit: p/n 4050216) ✔✔ Otto Bock electrode cables.

For more information, call 888/6962767, email info@UtahArm.com, or visit www.UtahArm.com.

VERTAMAX- PDAC APPROVED L0627 VertaMax is designed and manufactured utilizing dense elastic material, which provides significantly more compression than those conventionally used for lumbar supports. Vertamax provides unparalleled anterior-posterior support, abdominal support, perfect anatomic fit, ease of donning and doffing, and soft comfort. Abdominal compression can be increased or decreased with the fastening tabs. The

Combining comfort and support that is out of this world. Galaxy LSO LP is part OPTEC USA’s newest line of spinal braces.

The brace features our patented CROSSOVER closure system, as well as durable polyurethane panels with a comfortable, removable liner.

The Galaxy’s anterior opening design provides easy donning and doffing, and the adjustable strap length ensures a comfortable fit for your patients.

OPTEC’s Galaxy LSO LP is approved

by PDAC for L0627 coding.

Contact Optec USA for all your bracing needs at 888/982-8181 to speak with our customer service team or check out our website at www.optecusa.com.

THE NEW BALANCE KNEE BY ÖSSUR: THE PERFECT BALANCE OF SAFETY AND STABILITY FOR K2 PATIENTS Balance Knee offers less active users a balance of stability and security, providing superior adjustability and durability accommodating all single-speed ambulators. The four-bar geometric design is easily adjusted, optimizing the required balance between stability and walking dynamics. Key features include: • Mid-swing shortening increases toe clearance, preventing hip hiking while reducing chances of tripping • Adjustments are quickly completed without taking off the distal tube • Adjustable extension assist ensures full knee extension (externally accessible) • Self-adjusting friction maintains constant friction, preventing terminal impact from building over time • Adjustable stance control balances stability and swing initiation.

For more information, please visit www.ossur.com or call 800/233-6263.

DECEMBER 2011 O&P ALMANAC

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Marketplace

NEW WATERPROOF PROSTHESES FROM OTTO BOCK—DIVE IN!

Otto Bock now offers a line of waterproof components. Designed specifically for use in the water, the Aqualine® waterproof prostheses provide waterproof protection for either below-knee or above-knee users.

The Aqualine components are perfect for use as a shower leg or for other water activities. The Aqualine accommodates users who weigh up to 330 lbs and includes specially modified adapters, pylons, and a tube clamp along with the waterproof knee and foot.

Call your local sales representative to learn more 800/328-4058.

WALKON FIT KITS FROM OTTO BOCK—ASSESS YOUR WALKON PATIENT ANYWHERE! At hospital, clinic, home or office— evaluate your drop-foot patients on the spot for a WalkOn AFO with either the 28T1N WalkOn Fit Kit or the 28T2 WalkOn Flex Fit Kit. Each kit comes in a handy carrying bag and contains four WalkOns (two small, L&R; two medium, L&R; plus four calf pads). With the smaller footplates, there’s no need for grinding needed to get them into the shoe. Get an instant check of the WalkOn function— and then take the order for a fit.

Contact your local sales representative at 800/328-4058 to order your Fit Kits today.

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O&P ALMANAC DECEMBER 2011

HOSMER REGAL PARTIAL FOOT FROM PEL SUPPLY Available from PEL Supply, the new Hosmer Regal Partial Foot is a high definition silicone cosmetic partial foot covering that offers a variety of customized options.

It is available in sizes 22-28 cm, with connected or separated toes, and with silicone or foam filling. The new model (HDSF) comes with a high ankle. It also comes with an optional carbon fiber energy-restoring footplate (HDSF-ER).

Another option is the X Series finish that includes life-like higher definition toenails, realistic skip pigmentation and optional imbedded hair.

For more information on the new Regal High Definition Partial Foot Cover and other outstanding O&P products from the Fillauer Companies, call PEL at 800/321-1264, fax 800/2226176 or email customerservice@pelsupply. com.

ABBY™ ARTICULATING ANKLE/ FOOT ORTHOSIS FROM PEL SUPPLY PEL Supply now offers the new multifunctional ambulatory Articulated AFO from Anatomical Concepts. For your patients in the earliest stages of rehabilitation, the new ABBY Orthosis offers: • Multifunctional ambulatory articulated AFO • Replicates biomechanical effects of semi-solid or PLS AFO • Immediate fit in acute or sub-acute rehab • Adjustable dorsi and plantar flexion • Adjustable inversion and eversion • Heat moldable foot orthosis—fits left or right • Stable base of support • Adjustable foot length and calf height • Optional Varus/Valgus Adaptation (VCA) for improved ankle stability • Secondary maintenance of soft tissue length and offloading • L1971 - PDAC verified code for your ambulatory patients meeting the medical necessity requirements.

For information on the ABBY orthosis and the full line of Anatomical Concepts’ products, contact PEL customer service at 800/321-1264, by fax 800/222-6176, or email customerservice @pelsupply.com. Order online at www. pelsupply.com.

Toll Free 1-888-937-2747

Call for product catalogs & free samples

OFF-THE-SHELF

ACCOMMODATE, NEVER CORRECT. CHARCOT, EDEMA, BUNION, HAMMER TOES, THEY ARE ALL COVERED.

2239 Tyler Ave. South El Monte, CA 91733 Tel: 1-888-937-2747 Fax: 626-448-8783 www.bignwideshoes.com

Marketplace

CORELINE STATIC POSITIONING AFOS AVAILABLE CoreLINE® Static Positioning AFOs are now in stock and available at SPS. Available with either fleece or Vel Foam lining, the CoreLINE boot has been uniquely designed to increase patient comfort and prevent edge pressures. CoreLINE’s Static Positioning AFO boot has a wider toe post than other commercially available models to address a greater range of shapes and deformities present in a vast spectrum of patients.

The Kydex plastic shell allows re-forming and increases breakage resistance. Its universal sizing decreases your on-hand inventory

while the lack of straps ensures an easy fit across a wide range of applicable patients. It is applicable to prevent heel ulcers and contractures, and for recumbent positioning. Regular fits calf circumferences of less than 16 in, and large fits those with calf circumferences of 16 in and greater.

Please call SPS customer service at 800/767-7776 x3 for more information.

ALPHA® SILICONE LINERS BY WILLOWWOOD Alpha Liners are the standard for comfort and performance for thermoplastic elastomer liners.

With the release our new Alpha Silicone Liners, we’re pleased to offer

DYCOR

H

Save the

clinicians even more liner choices.

WillowWood’s Alpha Silicone Liner uses proprietary platinum-cured, medical grade silicone that is designed for comfort and performance. Alpha Silicone Liner benefits include: • A custom blend of silicone with Vitamin E and skin conditioners for a non-greasy and non-tacky surface • One-way stretch select fabric controls pistoning without using a distal matrix • A flexible knee panel provides enhanced knee flexion • A flared shape that contours to a limb’s surface • Retrofits with thermoplastic elastomer liners with a progressive profile • Offered in locking and cushion.

For information, please call 800/8484930 or visit willowwoodco.com. a

Date H

ONE SMALL STEP FOR TECHNOLOGY,

SEPTEMBER

ONE GIANT LEAP FOR REHABILITATION

6-9, 2012

n

Dycor’s “K-Series” K3U* (L5981) feet have been upgraded to meet

the ever increasing demands of “high-end” K3 level ADL with a new

aluminum alloy dome/titanium pyramid and integrated fiberglass reinforced foot shells.

Dycor’s energy storing applied technologies and sales policies

minimize profits at the manufacturing and distribution level which

allows the prosthetist the greatest opportunity to maximize rehabilitation potential in their clients.

The

For additional technical or clinical information, please visit our

website at www.dycormfg.com or contact our technical service dept. at 1-800-794-6099.

Dycor’s full ADL product line is available

through SPS, Pel, Ortoped and Dycor.

*Patent & Patent Pending 52

O&P ALMANAC DECEMBER 2011

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

Placee!

To B

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Jobs

INCREASE EXPOSURE AND SAVE!

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

- Northeast - Mid-Atlantic - Southeast - North Central - Inter-Mountain - Pacific Use our map to find which region you fit into!

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

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

1/2 page, color

$482 $678 $634 $830

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

No orders or cancellations are taken by phone.

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

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

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

JOB BOARD RATES Visit the only online job Member Nonmember board in the industry at Rate Rate jobs.AOPAnet.org! $80 $140 Save 5 percent on O&P Almanac classified rates by placing your ad in both the O&P Almanac and on the O&P Job Board, online at jobs.AOPAnet.org.

54

O&P ALMANAC DECEMBER 2011

Northeast Certified Prosthetist Vermont Yankee Medical, providing orthotic and prosthetic services for more than 64 years, is looking for a certified prosthetist ready to relocate to Vermont.

With five locations in some of the most scenic areas of the country, Yankee Medical offers a lifestyle that attracts professionals. Send resume to:

Attn: President, Yankee Medical 276 North Avenue, Burlington, VT 05401 Email: jnf@yankeemedical.com

Certified Orthotist/Certified Fitter Long Island/New York City We are a well-established practice offering an excellent opportunity for a driven person with a positive attitude. We offer benefits including 401(k), health, and profit sharing.

Send resume to:

O&P Ad 0611 C/O: The O&P Almanac 330 John Carlyle Street, Ste. 200 Alexandria, VA 22314 Fax: 571/431-8099

Certified Prosthetist/Orthotist, Certified Prosthetist, Board-Eligible/ Certified Orthotist Southern Maine Do you want to be more than a number? We are a terrific, patient-oriented company looking for some awesome practitioners. Is this you? Our well-established, O&P facility is seeking self-motivated, energetic practitioners. Our Southern Maine locations are in close proximity to the coast and mountain region. Our comprehensive compensation package includes bonuses commensurate with productivity.

Learn more about joining our team of dedicated specialists by contacting:

O&P Ad 1111 C/O: The O&P Almanac 330 John Carlyle Street, Ste. 200 Alexandria, VA 22314 Fax: 571/431-0899

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Northeast Certified Prosthetist/Orthotist Nashua, New Hampshire We are expanding our business into the New Hampshire area and are looking for a dynamic individual with excellent communication and patient care skills who can provide competent, comprehensive care to our patients. We can offer a very competitive salary/benefit package along with relocation assistance and signing bonus potential.

Management skills would be a plus! Send resume to:

O&P Ad 1011 C/O: The O&P Almanac 330 John Carlyle Street, Ste. 200 Alexandria, VA 22314 Fax: 571/431-0899

Jobs

For Sale

Used O&P Carving Equipment

Seattle Systems SM 2000 CV

PDI Pros Series 110-60

Very fast even at high resolution

A little easier to use and clean

Both systems are are wellwell-suited suited for BKs, Knees.

Both systems for AKs, AKs,Spinals BKs andand spinals.

Also: Provel D1 digitizers, thermoformer Seattle thermoformer •* Also: and oven. *• Trial Trial runs, spare parts and support available.

CHAPMAN ASSOCIATES (414) 570-9700 Chapman Associates (414) 570-9700 dchapman1@wi.rr.com

AVAILABLE POSITIONS Orthotist Tucson, AZ Frisco, CO Roswell, GA Belleville, IL Quincy, IL Urbana, IL

Philadelphia, PA Spartanburg/Union, SC San Antonio, TX Parkersburg, WV Milwaukee, WI

Prosthetist Port St. Lucie / Melbourne, FL Macon, GA

Jackson, MS Waukesha, WI

Prosthetist / Orthotist Springdale, AR Tucson, AZ American Canyon / Fairfield, CA Denver, CO Hollywood, FL Naples, FL Tamarac, FL West Palm Beach, FL Griffin, GA Belleville, IL Indianapolis, IN Bangor, ME Baltimore, MD Brooklyn, NY

Long Island, NY metro Oneonta, NY Syracuse, NY Wilmington, NC Mayfield Heights, OH Tallmadge, OH Bend, OR Salem, OR Portland, OR Lancaster, PA Austin, TX Houston, TX San Antonio, TX Bridgeport, WV

Certified Pedorthist Denver, CO Portland, OR Roseburg, OR

Nashville, TN Tacoma / Renton, WA Huntington, WV

DECEMBER 2011 O&P ALMANAC

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Jobs Inter-Mountain

Certified Orthotist or Certified Prosthetist (licensed or eligible) San Antonio, Texas Seventh largest city in the U.S. and second-largest in Texas. San Antonio is home to five Fortune 500 companies; regional headquarters to other large companies such as Kohl’s, Nationwide Mutual Insurance, Chase Bank, Toyota, AT&T, QVC, and Lockheed Martin; Brook Army Medical Center; the Center for the Intrepid; the South Texas Medical Center; one of the largest military concentrations in the U.S. employing over 89,000; San Antonio Spurs! San Antonio is blessed with museums, Six Flags, Sea World, and Splashtown San Antonio. And, we must mention the Tex-Mex cuisine at many fine restaurants. If you want more than a job and are ready to make a move, we would love to discuss your goals. We offer a very competitive salary and benefit package accompanied by relocation assistance and sign-on bonus potential…plus much more! To apply for this position, please contact, in confidence:

Sharon King Hanger Prosthetics & Orthotics Inc. Phone: 512/777-3814 Fax: 512/777-3772 Email: Sking@hanger.com www.hanger.com/careers

Certified Orthotist, Certified Prosthetist/ Orthotist Tucson, Arizona Are you excited about coming to work every day? Excited about the improvements you can make in others’ lives? Want to be a part of a team that values education and professional advancement? Want to be part of a group that will change the field of orthotics and prosthetics? Do you want to be at place where business is never usual? We are looking for energetic practitioners who possess great communication, organization, and patient care skills in the following positions: CO or CPO. We offer a very competitive benefit and salary package, along with relocation assistance and the opportunity to work for a company that can provide security from being the oldest O&P patient care company in the world. If you have been looking for the good life and a great company to work for, visit www.hanger.com/careers. Contact, in confidence:

Sharon King Hanger Prosthetics & Orthotics Inc. Phone: 512/777-3814 Fax: 512/777-3772 Email: Sking@hanger.com www.hanger.com/careers

North Central ABC Certified Prosthetist/Orthotist St. Louis Area Privately owned rapidly growing practice located in St. Louis, Missouri, has an opening for Certified Prosthetist/ Orthotist. This is a great opportunity for someone looking to become part of a motivated successful team. We offer a competitive compensation package including healthcare, 401k, and profit sharing.

Send resume to:

Premier Prosthetics and Orthotics Richard Doerr 633 Emerson Road St. Louis, MO 63141 Fax 314/743-3575 Email: Richard.Doerr@premierpando.com

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O&P ALMANAC DECEMBER 2011

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Pacific Certified Pedorthist and/or Practitioner Assistant Tacoma, Washington We are searching for individuals who possess great communication, organizational, and patient care skills. We offer a very competitive benefit and salary package, along with relocation assistance and the opportunity to work for a company that can provide security from being the oldest O&P patient care company in the world! If you have been looking for the good life and a great company to work for, contact, in confidence:

Sharon King Hanger Prosthetics & Orthotics Inc. Phone: 512/777-3814 Fax: 512/777-3772 Email: Sking@hanger.com www.hanger.com/careers

Get Involved in Cutting Edge O&P Research Researchers at the University of Washington are developing the Prosthetic Limb Users Survey (PLUS), a free tool to help clinicians and researchers measure prosthetic mobility.

Southeast Certified/Board Eligible Orthotist Sarasota, Florida Immediate opening for a certified orthotist or board eligible orthotist to join our well established practice in Sarasota, Florida. The candidate must have or be eligible for Florida State Licensure. The ideal candidate should possess at least three years of broad experience in orthotics. The position demands comprehensive patient management to include clinical patient evaluation, casting/measurement, and fitting of a wide assortment of orthotic devices. Fabrication skills are desired. This is a great opportunity for a professional clinician to provide quality care to patients ranging from pediatrics to geriatrics. Salary will be based upon experience and skills.

Forward resumes in confidence to:

Suncoast Orthotics & Prosthetics Inc. Fax: 941/366-8513 soapincpo@gmail.com

CO or CPO Marshfield Clinic is one of the largest patient care, research and educational systems in the United States. The Marshfield Clinic’s Orthotic and Prosthetic department is dedicated to helping patients regain their active lifestyles and live life without limitations.

Our department offers the newest advancements in orthotic, prosthetic and pedorthic technology combined with friendly, highly skilled and experienced staff that is committed to the highest quality patient care.

Discover Marshfield, Wisconsin & enjoy:

We need clinical partners to help us recruit lower limb prosthetic users. We can provide free posters and take-home flyers for your clinic.

Help us to develop measurement tools to facilitate evidence-based care in O&P Patients who take our online survey will receive $25.

Jobs

• Low cost of living • Clean, safe environment • Short commutes with low traffic volume • Excellent educational opportunities for both you and your family • Recreational & cultural activities during all four seasons • Easy access to urban centers at Chicago, Madison, Milwaukee or Minneapolis/St. Paul • Competitive total compensation package

ABC Certified in Orthotics & Prosthetics and 3 years of experience required.

Experience in Pediatrics would be helpful.

Join us and see how your career can shine.

To apply, please visit:

www.marshfieldclinic.jobs Reference Job Number MC090202 Marshfield Clinic is an Affirmative Action/Equal Opportunity Employer that values diversity. Minorities, females, individuals with disabilities and veterans are encouraged to apply.

Contact info@mobilitysurvey.org or call 1-800-504-0564 for more information.

DECEMBER 2011 O&P ALMANAC

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SCHOOL OF PHARMACY SCHOOL OF NURSING SCHOOL OF DENTISTRY SCHOOL OF PHARMACY

58

SCHOOL OF DENTISTRY

SCHOOL OF MEDICINE

SCHOOL OF PHARMACY

UCSF seeks candidates whose experience, teaching, research, or community service has prepared them to contribute to our commitment to diversity and excellence.

UCSF is an Equal Opportunity/Affirmative Action Employer. The University undertakes affirmative action to assure equal employment opportunity for underutilized minorities and women, for persons with disabilities, and for covered veterans. All qualified applicants are encouraged to apply, including minorities and women.

SCHOOL OF NURSING

Applicants should submit a letter of intent and CV to: Matthew Garibaldi C.P.O. Director, Orthotic & Prosthetic Centers of UCSF University of California, San Francisco 1500 Owens Street, Box 3004 San Francisco, CA 94143-3004 Garibaldim@orthosurg.ucsf.edu

SCHOOL OF DENTISTRY

Incumbent will assist and work as an orthotist in the Orthotic and Prosthetic Center in a large medical center setting which includes several Intensive Care Units, Rehabilitation Units, Acute Care Units and many Out-Patient Clinics for service of patients with a wide variety of medical diagnoses. The candidate will be responsible for clinical evaluations, implementation of a wide assortment of orthotic treatment modalities, and technical fabrication of orthotic devices. Required qualifications: ABC Certified Orthotist; prior experience providing direct patient care in an orthotic/ prosthetic facility with demonstrated skills, knowledge and abilities essential to the successful performance of duties in the patient care setting. Demonstrated excellent communication and team-building / interpersonal skills. Preferred qualifications: Knowledge of disease processes and associated orthotic intervention; familiarity with the latest materials and fabrication techniques; ability to work efficiently.

Salary will be commensurate to applicant’s qualifications and experience.

SCHOOL OF PHARMACY

SCHOOL OF NURSING

Department of Orthopaedic Surgery Assistant/Associate Full Specialist

SCHOOL OF NURSING

SCHOOL OF DENTISTRY

CERTIFIED ORTHOTIST

SCHOOL OF DENTISTRY

SCHOOL OF DENTISTRY

University of California at San Francisco

SCHOOL OF NURSING

O&P ALMANAC DECEMBER 2011

Jobs Mid-Atlantic

Linkia Director, Clinical Services Rockville, MD The Director, Clinical Services is a certified clinician (CO, CP, or CPO) responsible for clinical and quality management programs including: Professional Review of Orthotic & Prosthetic Services (PROPS), Utilization Review Accreditation Commission (URAC) Accreditation, Quality Management Committees, and Credentialing. Directly reporting to the Director, Clinical Services are PROPS Program Director, Sr. Manager Credentialing, and URAC Coordinator. This individual is directly responsible for coordinating Quality Management program and meeting URAC accreditation requirements.

Performs all duties of the Chief Case Reviewer for PROPS. Works with direct reports to create and implement work flows to meet efficiency requirements; write standard operating procedures for all functions of responsibility, and support organizational goals.

Essential Functions: • Ensures policies, practices, & procedures comply with administrative, legal & regulatory requirements • Participates in developing and implementing Linkia’s strategic direction for clinical operations and programs • Performs all duties of Chief Case Reviewer — PROPS program clinical lead • Consult with all constituents (internal and external) as clinical expert • Oversee credentialing and compliance functions • Coordinates Quality Management Program and documents — QI/UM/ Credentialing Plan, QI • Indicators, QI Committees • Write SOPs for all areas of responsibility as appropriate • Performs other duties as assigned Required Skills & Abilities: • Demonstrated ability to lead & manage through influence & change • Strong interpersonal skills emphasizing flexibility and diplomacy • Exceptional presentation and public speaking skills • Strong analytical and creative problem solving skills • Ability to prioritize and manage multi-task functions • Knowledge of Microsoft Office Suite • Demonstrate excellent time management, organization, prioritization, research, analytical, negotiation, communication (verbal and written) and interpersonal skills.

Required Credentials: • 5-10 years clinical experience as Certified Orthotist and/or Prosthetist Clinician (CO, CP or CPO) • Education: BA/BS • 3-5 years Supervisory/Management experience preferred.

If interested, please contact in confidence:

Jim Gillette Hanger Orthopedic Group Email: JGillette@hanger.com www.hanger.com/careers

CPO Naples, South West Florida

CPO West Palm Beach, South Florida

Florida State licensed or eligible in both Prosthetics and Orthotics

Florida State licensed or eligible in both Prosthetics and Orthotics

Picture yourself relocated in the heart of beautiful West Palm Beach, Florida, where the climate year round averages 78 degrees. Enjoy the luxuries of outdoor living, including, BBQs, golfing, fishing, theater, and many more. West Palm Beach is located within 2.5 hours from Disney World in Orlando, and 1.5 hours from the Port of Miami, where you can catch your cruise to the Caribbean hassle free.

Imagine living in paradise, year round, surrounded by the warmth and beauty of the Gulf of Mexico, transitioning your career and skills into a well-established, successful clinical practice.

Yes, it’s true, and a reality. We have the opportunity of a lifetime for the right individual.

Our West Palm Beach-practice has been servicing the Palm Beach community for more than 20 years. Our practice’s new state-of-theart facility offers a full complement of services.

Our needs: • Integrity and clinical and operational excellence.

• Unsurpassed customer satisfaction.

• Flexible and entrepreneurial spirit.

• Creative and innovative.

• Demonstrates shared success.

• Demonstrates clinical competence.

• The ability to inspire and move others to become effective leaders.

• A leader and mentor with an inclusive style, whose former colleagues and referrals want to keep in touch.

• Someone who can turn a vision into reality.

• Demonstrates personal effectiveness.

We are searching for a candidate who possesses the following qualities: • Integrity and clinical and operational excellence.

• Unsurpassed customer satisfaction.

• Flexible and entrepreneurial spirit.

• Creative and innovative.

• Demonstrates shared success.

• Demonstrates clinical competence.

• The ability to inspire and move others to become effective leaders.

• A leader and mentor with an inclusive style, whose former colleagues and referrals want to keep in touch.

• Someone who can turn a vision into reality.

• Demonstrates personal effectiveness.

What’s in it for you?

• Enhance your career by capitalizing on Hanger’s multiple business units: SPS, SPS National Labs, SureFit, Dosteon Solutions, Innovative Neurotronics, Linkia, Accelerated Care Plus, CARES, clinical services, and many more.

• The opportunity to use the sum of your life’s experience and knowledge to expand a successful clinical practice. The opportunity to capitalize on the strengths and resources of a national company.

• Job security for you and your family.

• Join the Naples team that is ready to be mentored, encouraged, and developed for future career opportunities. Join an organization with a reputation of more than 150 years of international, national, and local prosthetic and orthotic recognition. We offer a very attractive compensation/benefits package that recognizes your experience, past performance, and future potential.

What's in it for you?

• Continuing education programs, career opportunities, and development.

• The opportunity to use the sum of your life’s experience and knowledge to expand a successful clinical practice.

• Enhance your career by capitalizing on Hanger’s multiple business units: SPS, SPS National Labs, SureFit, Dosteon Solutions, Innovative Neurotronics, Linkia, Accelerated Care Plus, CARES, clinical services, and many more.

• Job security for you and your family.

• Join an organization with a reputation of more than 150 years of international, national, and local prosthetic and orthotic recognition.

• A very attractive compensation/benefits package that recognizes your experience, past performance, and future potential.

Visit: http://www.hanger.com/careers

Visit: http://www.hanger.com/careers

Please forward cover letter, resumé, and salary requirements to: Sharon King Phone: 512.777.3814 sking@hanger.com

Please forward cover letter, resumé, and salary requirements to: Sharon King Phone: 512.777.3814 sking@hanger.com

DECEMBER 2011 O&P ALMANAC

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Calendar

2011 DECEMBER 6 WillowWood: Discover LimbLogic® VS via WebEx, 1:30 pm ET. Critical components and operation discussed. Covers interpreting feedback from fob and basic fabrication processes for system. Credits: 2.5 ABC/2.5 BOC. To register online, visit www.willowwoodco.com.

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PROMOTE EVENTS IN THE O&P ALMANAC

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

Member Nonmember Words Rate Rate 25 or less $40 $50 26-50 $50 $60 51+ $2.25 $3.00

per word per word Color Ad Special: 1/4 page Ad $482 1/2 page Ad $634

$678 $830

DECEMBER 7 WillowWood: LimbLogic® VS for Technicians via WebEx, 1:30 pm ET. Learn essentials of elevated vacuum socket fabrication using available socket adaptors with LimbLogic VS. Learn how to deal with airtight issues, unit operation, and diagnostics that will keep the system optimal for patient use.

Credits: 2.5 ABC/2.5 BOC. Visit www.willowwoodco.com.

■■

DECEMBER 10 Ultraflex: Pediatric Spasticity Continuing Education Course, via WebEx, 9–10 am ET. Covers clinical assessment of the pediatric neuromuscular patient with spasticity and using R1 and R2 for determining orthotic design for maintaining and improving muscle length.

Presenter: Keith Smith, CO, LO, FAAOP. To register, call 800/220-6670 or visit www. ultraflexsystems.com.

■■

BONUS! Listings will be placed free of charge on the Attend O&P Events section of www.AOPAnet.org.

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

For information on continuing education credits, contact the sponsor.

Questions?

Email srybicki@AOPAnet.org.

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O&P ALMANAC DECEMBER 2011

DECEMBER 13 Ultraflex: Adult UltraSafeStep® Continuing Education Course, via WebEx, Noon–1 pm ET. Focuses on normalizing adult pathological gait with the utilization of Adjustable Dynamic Response™ (ADR™) knee and ankle technology.

To register, call 800/220-6670 or visit www.ultraflexsystems. com.

■■

■■ DECEMBER 13-14 WillowWood: Existing OMEGA® Tracer® Users Prosthetics and Orthotics Course. Mt. Sterling, OH. Advanced course covers OMEGA Scanner use, modifying orthotic and prosthetic shapes, and review of custom liner, cranial, and spinal software. Must be current OMEGA Tracer facility to attend. Credits: 14.25 ABC/15.5 BOC. Visit www.willowwoodco.com.

DECEMBER 14 AOPA Audio Conference: “Are You Ready for the New Year? 2012 New Codes and Policies.” To register, contact Stephen Custer at 571/4310876 or scuster@aopanet.org.

■■

■■ DECEMBER 14 Ultraflex: Pediatric Spasticity Continuing Education Course, via WebEx, 8–9 am ET. Covers clinical assessment of the pediatric neuromuscular patient with spasticity and using R1 and R2 for determining orthotic design for maintaining and improving muscle length.

Presenter: Keith Smith, CO, LO, FAAOP. To register, call 800/220-6670 or visit www. ultraflexsystems.com.

■■ DECEMBER 22 Ultraflex: Complex Orthopedic Rehabilitation Continuing Education Course, via WebEx, Noon–1 pm ET. Focuses on Ultraflex combination dynamic and static stretching orthosis for addressing complex orthopedic rehabilitation goals and restoring range and function. Presenter: Jim Rogers, CPO, FAAOP. To register, call 800/220-6670 or visit www.ultraflexsystems. com.

2012 ■■ JANUARY 17 WillowWood: Discover LimbLogic® VS via WebEx, 1:30 pm ET. Critical components and operation discussed. Covers interpreting feedback from fob and basic fabrication processes for system. Credits: 2.5 ABC/2.5 BOC. To register online, visit www.willowwoodco.com.

■■ JANUARY 18 WillowWood: LimbLogic® VS for Technicians via WebEx, 1:30 pm ET. Learn essentials of elevated vacuum socket fabrication using available socket adaptors with LimbLogic VS. Learn how to deal with airtight issues, unit operation, and diagnostics that will keep the system optimal for patient use.

Credits: 2.5 ABC/2.5 BOC. Visit www.willowwoodco.com.

■■ JANUARY 19-20 WillowWood: Alpha Seminar.

Mt. Sterling, OH. Course breakdowns the Alpha family of products, identifies best clinical applications of liners, discussion of liners for vacuum suspension, and the latest in suspension systems.

Includes brief review of TPE liner benefits and fitting assessment. Credits: 12.75 ABC/12.25 BOC. Registration deadline December 29.

Contact 877/665-5443.

■■ FEBRUARY 16-18 PrimeFare West Regional Scientific Symposium 2012.

Salt Palace Convention Center, Salt Lake City. For more information, contact Jane Edwards at 888/388-5243 or visit www.primecareop.com.

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

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

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

AOPAnet.org.

The

e c a l P e!

To B

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

ate ★

e the D ★ Sav

*

SEPTEMBER

6-9, 2012

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

• • • • • •

Superior Clinical Education featuring the best speakers from around the world

• • •

Largest Display of O&P exhibits in the United States

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

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

Earn more than 34 CE credits!

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

DECEMBER 2011 O&P ALMANAC

61

n

Calendar Motion Control

SUPERCOURSE SPRING 2012 FEBRUARY 22 – MARCH 2, 2012

at Motion Control Headquarters, Salt Lake City, Utah • In-depth training of Utah Arm / U3+ / Hybrid / ProControl2.

• Hands-on experience with UI-software—bring your laptop.

• CEUs: 34 (estimated) awarded by ABC.

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

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

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

■■ MARCH 21–24 38th Academy Annual Meeting and Scientific Symposium. Atlanta. Hilton Atlanta. Contact Diane Ragusa at 202/380-3663 x208 or dragusa@oandp.org.

■■ APRIL 17-18 AOPA Policy Forum.

Washington, DC. L’Enfant Plaza Hotel. To register, contact Stephen Custer at 571/432-0876 or scuster@ aopanet.org.

62

O&P ALMANAC DECEMBER 2011

■■ MAY 17-19 WAMOPA: Western and Midwestern Orthotic and Prosthetic Association Annual Meeting at Peppermill. Hotel Reno, NV. Best CEU credit value available! Contact Steve Colwell at 206/440-1811, Sharon Gomez at 530/521-4541, or visit www.wamopa.com.

■■ JUNE 4-6 LAOP: Annual Educational Conference. Hilton Riverside, New Orleans. Earn up to 13 credits in O, P, and Administrative tracts. Come enjoy summer family fun, unique city culture, cuisine, and all that jazz. Contact Sharon at 504/464-5577, laymansh@yahoo.com, or visit www.laop.org.

■■ JUNE 15-16 PrimeFare East Regional Scientific Symposium 2012.

Nashville Convention Center, Nashville, TN. For more information, contact Jane Edwards at 888/388-5243 or visit www.primecareop.com.

■■ SEPTEMBER 6-9 AOPA National Assembly & NE Chapter Combined Meeting. Boston. Hynes Convention Center. The 2012 AOPA National Assembly will be held jointly with the NE Chapter Meeting. Please plan to join us for this significant event. Exhibitors and sponsorship opportunities, contact Kelly O’Neill at 571/431-0852 or koneill@ AOPAnet.org. To register, contact Stephen Custer at 571/431-0876 or scuster@ aopanet.org.

2013 ■■ FEBRUARY 20–23 39th Academy Annual Meeting & Scientific Symposium. Orlando. Caribe Royale Orlando. Contact Diane Ragusa at 202/380-3663 x208, or dragusa@oandp.org.

■■ SEPTEMBER 18-21 O&P World Congress.

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

n

Ad Index

COMPANY

PAGE

PHONE

WEBSITE

Allard USA Inc.

27

888/678-6548

www.allardusa.com

ALPS

17, 41

800/574-5426

www.easyliner.com

American Board for Certification in Orthotics, Prosthetics & Pedorthics

19

703/836-7114

www.abcop.org

Anatomical Concepts Inc.

39

800/837-3888

www.prafo.com

Apis Footwear

15, 51

888/937-2747

www.bigwideshoes.com

Cailor Fleming Insurance

43

800/796-8495

www.cailorfleming.com

College Park Industries Inc.

35

800/728-7950

www.college-park.com

DAW Industries

1, 53

800/252-2828

www.daw-usa.com

Dr. Comfort

5, C3

800/556-5572

www.drcomfortdpm.com

DYCOR

52

800/794-6099

www.dycormfg.com

Euro International

11

800/378-2480

www.eurointl.com

KISS Technologies LLC

13, 37

410/663-5477

www.kiss-suspension.com

KNIT-RITE

2

800/821-3094

www.knitrite.com

Motion Control

23

888/696-2767

www.utaharm.com

OPTEC

8, 9

888/982-8181

www.optecusa.com

Orthotic and Prosthetic Study and Review Guide

31

www.oandpstudyguide.com

Ossur Americas Inc.

25, C4

800/233-6263

www.ossur.com

Otto Bock HealthCare

C2

800/328-4058

www.ottobockus.com

PEL Supply Company

45

800/321-1264

www.pelsupply.com

SPS

7

800/767-7776 x3

www.spsco.com

Trulife

33

888/878-1238

www.trulife.com

®

FEATURED NEW AOPA CAMPAIGN

AOPA Member-Get-A-Member Campaign TAKE 10% or MORE OFF Your 2012 Dues Every major membership organization in the world has found their current members to be their most successful growth partners.

And there has to be something in it for the current member!

GROWING FOR

THE FUTURE CLUB

You, as an AOPA member, are invited to join our Growing for the Future Club. For each new member company you sign up who designates you as its recruiting member, AOPA will discount your current 2012 renewal by 10%. Get 10 new members and enjoy your 2012 AOPA benefits for free. The 10% discount per new member applies to company members signed up who pay the full 2012 dues of $1,745. For affiliates signed up at $305 each, AOPA will provide a credit of $30 against 2012 dues.

You may also use the earned discount as a credit when you purchase any AOPA product, service, or seminar.

Discover MORE HUGE BENEFITS—To enroll in the club and receive your Growing for the Future membership marketing kit, email scuster@AOPAnet.org and we’ll take it from there. You can help make it happen!

DECEMBER 2011 O&P ALMANAC

63

n

AOPA Answers

Miscellaneous Medicare Queries Answers to your questions regarding billing, surety bonds, and business changes AOPA receives hundreds of queries from readers and members who have questions about some aspect of the O&P industry. Each month, we’ll share several of these questions and answers from AOPA’s expert staff with readers.

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

Q.

We just completed the fabrication of a lower-limb prosthesis, but when we called the patient to schedule delivery, we were informed that the patient passed away. Are we able to bill Medicare for the prosthesis?

A.

Chapter 15, section 20.3 of the Medicare Benefit Policy Manual addresses the billing of custom artificial limbs and braces that are fabricated but cannot be delivered due to patient death, a change in patient condition that no longer warrants the need for the item, or cancellation of the order by the beneficiary.

In this situation, because the patient passed away, you may bill Medicare for the prosthesis using the date of death as your date of service. Because the prosthesis was not delivered to the patient, you should not bill for any components that were not customized for the individual needs of that patient.

Those components may be returned to stock and considered new since they were never delivered.

Q:

Are we required to have a surety bond before we can submit an application for a Medicare supplier number?

A:

Yes. If you are not exempt from obtaining a surety bond for the location in which you are submitting an application for a supplier number, you must have a surety bond before your application can be submitted for approval.

O&P facilities are not automatically exempt from

64

O&P ALMANAC DECEMBER 2011

obtaining a surety bond. To be exempt, you must meet the following criteria: 1. If you are in an O&P licensure state, your personnel are appropriately licensed. (If you are not in a licensure state, this does not apply.)

2. You are solely owned by orthotists and/or prosthetists.

3. You provide some custom items.

4. You provide only orthotics, prosthetics, and supplies in conjunction with custom O&P. If you provide diabetic shoes, you do not meet criterion #4, as shoes are not defined as orthotics or supplies. So you would have to obtain a surety bond.

Q:

When notifying Medicare of a change in our business, are we required to submit a new CMS 855S application?

A:

You are required to notify Medicare of any change in your business within 30 days of the change, but you are not required to complete a new CMS 855S form. You are only required to fill out the sections of the 855S form that are relevant to your change of information request. Typically, most changes of information will only require you to fill out the following sections: 1B, 1C, 2A, 13, and 15 or 16. To ensure you are filling out the proper sections, take a moment to read through the form first, or visit the National Supplier Clearinghouse website, www.palmettogba.com, and review the change of information guide. a

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