September 2011 O&P Almanac

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The American Orthotic & Prosthetic Association SEPTEMBER 2011

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WWW.AOPANET.ORG

THE MAGAZINE FOR THE ORTHOTICS & PROSTHETICS INDUSTRY

MAN AND MACHINE Homayoon Kazerooni, PhD, wants high-tech robotics available to all

RAC AUDITS Need-to-Know CE! SPECIAL: 2011 A L E E

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P TO B

National Assembly Expo Directory

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O&P Almanac CONTENTS

SEPTEMBER 2011, VOLUME 60, NO. 9

COLUMNS

COVER STORY

20 Man and Machine

Cover photo: Sarah Peet Photography

By Tora Estep In this exclusive Q&A, robotics human augmentation expert Homayoon Kazerooni, PhD, discusses his 30-year career and personal mission to enhance quality of life for those with limited mobility by improving access to sophisticated, affordable exoskeleton technology.

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Reimbursement Page The reality behind industry myths

34

Ask the Expert Answers to your prescription and written orders questions

38

Facility Spotlight Snell Prosthetic & Orthotic Laboratory celebrates 100 years

DEPARTMENTS

FEATURES

28 Racking Up Recoupment

By Joseph McTernan As the new kids on the block, Recovery Audit Contractors are causing a stir in the Medicare payments arena. Not to worry. AOPA’s government affairs expert shares tips for ensuring that your billing processes are compliant and for preparing for a RAC audit.

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AOPA Contact Page How to reach staff

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At a Glance Statistics and O&P data

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In the News Research, updates, and company announcements

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

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AOPA Membership Applications

64 Marketplace

54 SPECIAL ENCORE:

2011 Exhibit Directory Use this listing and floor plan to organize your visit to the 2011 National Assembly Expo.

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70 Jobs 74 Calendar 79

Ad Index

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AOPA Answers Expert answers to your FAQs

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

SEPTEMBER 2011 O&P ALMANAC

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OP Almanac

AOPA CONTACT INFORMATION

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

Tom Wessel, director of business development, 651/724-8753, twessel@AOPAnet.org 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

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

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

Steven Rybicki, production manager, 571/431-0835, srybicki@AOPAnet.org

AOPA Bookstore: 571/431-0865

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

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 Orthotic and Prosthetics Inc. LLC, Houston, TX Vice President Tom Kirk, PhD, Hanger Orthopedic Group, Austin, TX 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 Rick Fleetwood, MPA, Snell Prosthetic & Orthotic Laboratory, Little Rock, AR Michael Hamontree, OrPro Inc, Irvine, CA Russell J. Hornfisher, Becker Orthopedic Appliance Co., Troy, MI Alfred E. Kritter, Jr., CPO, FAAOP, Hanger Prosthetics & Orthotics Inc., Savannah, GA Eileen Levis, Orthologix LLC, Philadelphia, PA Anita Liberman-Lampear, MA, University of Michigan Orthotics and Prosthetics Center, Ann Arbor, MI Mahesh Mansukhani, MBA Össur Americas, Aliso Viejo, CA

AMERICAN ORTHOTIC & PROSTHETIC ASSOCIATION SERVING THE O&P FIELD FOR MORE THAN 90 YEARS

Renew the Easy Way With AOPA ONLINE PAY Login to pay your dues and update your membership directory information at:

www.aopanetonline.org/profile 4

O&P ALMANAC SEPTEMBER 2011

Frank Vero, CPO, Mid-Florida Prosthetics & Orthotics, Ocala, FL

EASY! UPDATE MEMBERSHIP DIRECTORY INFORMATION ONLINE

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

State of O&P Education, Certification ABC Exam Pass Rates Rise…

More Practitioners Are BOC-Certified…

Percentage of Candidates Who Pass Written O&P ABC Exams 2010 Written Orthotic Exam

*Total Number of BOC-Certified Individuals YEAR 71%

2009 Written Orthotic Exam

2010

61%

2010 Written Prosthetic Exam 61%

Sources: The American Board for Certification in Orthotics, Prosthetics and Pedorthics Inc. Annual Report 2010, 2009

2004 The first year a class graduated with a Master of Science Degree in Prosthetics and Orthotics from Georgia Tech.

203

400

2009 83%

2009 Written Prosthetic Exam

BOC-CERTIFIED CANDIDATES

The number of pedorthists the ABC certified in 2010.

120 The maximum number of minutes allotted for an individual to complete a BOC-certifying exam.

350

2008

250

2007

250

*Note: Numbers are approximate.

Source: Board of Certification/Accreditation, International

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The total number of NCOPE-accredited O&P master’s programs in the United States as of 2011.

2,191

The total number of ABC examinations administered across all disciplines in 2010.

$1,200 The total cost—including application, clinical simulation, and exam fees—to take a BOCO certification examination in 2011.

Sources: The American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc. Annual Report 2010; Board of Certification/ Accreditation, International; Georgia Institute of Technology Master of Science in Prosthetics & Orthotics; National Commission on Orthotic and Prosthetic Education; The University of Texas Southwestern Medical Center at Dallas 6

O&P ALMANAC SEPTEMBER 2011

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In the News

disorders. They plan to design early systems that might involve remote or wearable devices that help guide rehabilitation exercises to remap brain signals and restore motor control.

Ultimately, the researchers hope to develop implantable prosthetics that are controlled by brain signals and include sensors that shuttle information back to users so they can react to their environment.

Top: University of Washington doctoral student Eric Rombokas works with a prototype prosthesis created in the university’s Neurobotics Lab. UW was recently awarded a grant to help advance robotics prosthetics. Bottom: UW researchers are working to integrate the pictured hand prosthesis with the human nervous system.

Photos: Courtesy of Walter Reed Army Medical Center

Walter Reed Hospital Closes

Walter Reed Hospital, which closes September 15, treated about 875 amputees from the Iraq and Afghanistan wars.

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O&P ALMANAC SEPTEMBER 2011

Walter Reed Army Medical Center, the U.S. Army’s flagship hospital located in Washington, DC, has shut its doors after 102 years of service. The medical facility treated numerous O&P patients—including about 875 amputees from the Iraq and Afghanistan wars.

The hospital officially closes on September. 15. The new facility will be called the Walter Reed National Military Medical Center and will have campuses in Bethesda, Maryland, and Fort Belvoir, Virginia.

Photo: M. Levin, University of Washington

The National Science Foundation provided an $18.5 million grant to establish an Engineering Research Center for Sensorimotor Neural Engineering at the University of Washington in Seattle (UW). Scientists at the center aim to further neurological research with the hopes of creating robotic devices that are synchronized with the body’s nervous system.

“Our center will use sensory and neural feedback to give [prosthetic] devices much more flexibility and control,” says Yoky Matsuoka, a UW associate professor leading the effort.

“It will combine advances in robotics, neuroscience, electromechanical devices, and computer science to restore or augment the body’s ability for sensation and movement.”

Researchers will develop new technologies for amputees, stroke victims, and people with spinal cord injuries, cerebral palsy, Parkinson’s disease, or age-related neurological

Photo: University of Washington

University of Washington Leads Effort to Advance Robotic Prosthetics

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All coding opinions expressed herein are based upon information provided by the manufacturer. Regardless of

© 2011 SPS. SPS and Experience Our Commitment are trademarks of SPS. the source of the information provided, the final responsibility for correct coding within all established laws, rules, All other trademarks are properties of their respective owners. All rights reserved. standards and practices is the sole responsibility of the practitioner submitting the claim.

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In the News Scientists Developing New Method to Repair Damaged Nerves Blood vessels and supporting cells appear to be pivotal partners in repairing nerves ravaged by diabetic neuropathy, and nurturing their partnership may aid in re-growing damaged nerves.

Findings from Johns Hopkins University research may provide new options for treating neuropathy, which affects about 20 percent of diabetics, and other vascular problems.

By promoting growth of blood vessels and Schwann cells—both integral parts of nerve cells—researchers may increase nerve cells’ long extensions, axons, in regeneration and reparation of damaged nerves and blood vessels.

Previous research shows that axons regenerate slowly in diabetics. Results from the study, which were published in the June issue of the

TRANSITIONS

PEOPLE IN THE NEWS

Otto Bock HealthCare hired Joshua Bomar and Irina Powers as territory sales representatives in technical orthopedics. Bomar is responsible for Arizona, New Mexico, and Southern Nevada, and Powers is responsible for Indiana and Kentucky.

Physiotherapy Associates promoted Andrew DeVoe to CEO. DeVoe most recently served as the company’s chief financial officer.

He assumes the CEO position from Dan Connors.

WillowWood hired Wayne Fichtel, CP, as its national account manager.

Fichtel will visit patient-care facilities nationwide and educate personnel on the latest WillowWood products and fabrication techniques.

Hanger Prosthetics and Orthotics Inc. hired the following new practitioners: • Leslie “Ronn” Bell, CO, joined its West Monroe, Louisiana,

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O&P ALMANAC SEPTEMBER 2011

scientific journal Brain, showed that blood cells were the first to grow into healing skin, followed

by Schwann cells, and then axons. The axons appeared to use the blood cells to bolster their growth. The entire healing process was significantly delayed for those with neuropathy. Not only was axon growth slower than those of healthy individuals, but the rate of blood vessel growth was decreased, and fewer Schwann cells were found in the axons.

Neuropathy is a burning, tingling sensation caused by nerve damage that sometimes leads to infections and amputation of the toes, fingers, hands, and feet. Current treatments for diabetic neuropathy focus on alleviating symptoms, but don’t address the root cause by repairing nerve damage.

patient-care facility as practice manager.

• Jillian Elwart, CP, joined its Little Rock, Arkansas, patient-care facility.

• Virginia Farney, C.Ped, joined its Springdale and Rogers, Arkansas, patient-care facilities.

• Eric Forster, CP, BOCP, joined its Butler, Pennsylvania, patient-care facility.

• Kate Horner, CO, joined its Michigan City, Indiana, patientcare facility.

• Bradley Intres, CPO, C.Ped, joined its Englewood, Colorado, patient-care facility as practice manager.

• Seamus Lawler, CP, joined its Torrance, California, patient-care facility.

• Daniel Savloff, C.Ped, joined its Philadelphia patient-care facility.

• Greg Zschaschel, CPO, joined its Los Angeles patient-care facility as practice manager.

Össur promoted Amanda Miller to director of sales, prosthetics, and government accounts. Previously, Miller served as director of national accounts and new business development.

The Greater New York Council of the Boy Scouts of America honored Steven Mirones, president of the prosthetics firm Arimed, with the Silver Beaver Award for his “countless contributions to the youth of Brooklyn and as an outstanding example of entrepreneurial spirit.”

The organization honored Mirones at the Brooklyn Council’s Annual Recognition Dinner on June 16.

Mike Schuch, CPO, FAAOP, FISPO, joined the SPS management team as director of clinical and technical services.

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In the News

BioBolt wirelessly transmits the brain’s neural signals to control a computer and could be used to transmit neural signals directly to muscles.

A minimally invasive, low-power brain implant that wirelessly transmits the brain’s neural signals to control a computer may eventually be used to reactivate paralyzed limbs.

The device, called BioBolt, could be used to pick up neural signals from the brain’s cortex and transmit them directly to muscles, researchers say.

Developed at the University of Michigan located in Ann Arbor, Michigan, the BioBolt has the appearance of a bolt and is about the circumference of a dime. The device, which is implanted in the skull beneath the skin, includes a film of microcircuits that is placed on the brain.

The microcircuits function like microphones that are listening to the pattern of firing neurons and recognize them as a specific command from the brain. Those signals are amplified, filtered, and then converted to digital signals and transmitted through the skin to a computer.

Most brain interfaces require high power to transmit data wirelessly from the brain to another source; whereas BioBolt uses the skin as a conductor to transmit data.

Researchers hope that in the future the signals can be transmitted through the skin and collected by a device on the body, such a watch. This would eliminate the need for an off-site computer to process the signals. a

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O&P ALMANAC SEPTEMBER 2011

BioBolt is a minimally invasive brain implant, placed beneath the skin of the skull, that may be used to reactivate paralyzed limbs. The device is about the circumference of a dime.

TRANSITIONS

BUSINESSES IN THE NEWS

AmpSurf’s 2011 Northeast program took place August 15-19.

The program is designed to give disabled veterans and other members of the disabled community in the northeast the opportunity to participate in AmpSurf’s rehabilitative surfing program.

The Amputee Coalition celebrated its 25th year at its national conference held in Kansas City, Missouri, from June 2-4. More than 900 people with limb loss and exhibitors from around the world attended educational seminars, peer and support group training, and athletic and social events.

During the conference, the Amputee Coalition honored AOPA with a “Spirit of Collaboration” award, celebrating the close relationship AOPA and the Amputee Coalition have fostered for supporting amputees and protecting the O&P patient-care community.

OPGA entered into a new partnership with DeRoyal, a provider of orthopedic soft goods.

Physiotherapy Associates acquired Rehabilitation Consultants Inc. This acquisition builds on Physiotherapy Associates’ growth initiative, which includes acquisitions, joint ventures, and 35 new clinic openings in 2011.

Photos: Sun-Il Chang, University of Michigan

Wireless Implant May Restore Movement to Paralyzed Limbs

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Reimbursement Page

By Joseph McTernan, AOPA government affairs department

Common Myths in O&P Billing Don’t be fooled by some prevailing schools of thought

“J

ust because you hear something all the time, doesn’t mean it’s true.” While parents usually give this piece of advice to their children, it certainly is sound guidance for the O&P industry as well. This month’s Reimbursement Page will explore the facts associated with some common myths about O&P billing that are repeated so often they are believed to be true.

Myth: Bilateral amputees are not subject to prosthetic functional level restrictions.

Reality: According to the Lower Limb Prosthesis Local Coverage Decision (LCD), “It is recognized, within the functional classification hierarchy, that bilateral amputees often cannot be strictly bound by functional level classifications.”

The secret to obtaining proper reimbursement for miscellaneous codes is persistence.

While this allows some leeway for coverage of components that are outside of a bilateral amputee’s functional level classification, it by no means suggests an opportunity to provide bilateral amputees with components that do not benefit them medically.

It is the exception, rather than the rule, that Medicare will cover prosthetic components typically reserved for patients with a higher functional level. If a provider expects Medicare to cover K3 components for a K1 or K2 bilateral amputee, it must be able to prove the advanced componentry benefits the patient in a way that components covered under his or her existing functional level cannot. This usually involves several

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O&P ALMANAC SEPTEMBER 2011

levels of appeal and specific documentation showing the benefit to the individual patient must be present.

Myth: Not accepting assignment relieves the provider of financial responsibility for a claim.

Reality: The decision to accept assignment has no bearing on a provider’s financial liability for a Medicare claim. The assignment decision only addresses the amount that the provider may collect from the patient at the time of delivery or service.

If a provider does not accept assignment for a Medicare claim, it may collect its full, usual, and customary charge from the patient at the time of delivery. If Medicare subsequently deems the claim as not medically necessary, and the provider did not obtain a properly executed Advanced Beneficiary Notice, the provider is financially liable for the claim and must refund any payment previously collected from the patient.

Regardless of whether they accept assignment or not, all Medicareenrolled providers must submit claims on behalf of their patients.

Myth: Miscellaneous codes are never reimbursed.

Reality: In 2009 alone, Medicare paid more than $2 million dollars in claims for miscellaneous procedure codes.

The secret to obtaining proper reimbursement for miscellaneous codes is persistence. Remember, you are

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Reimbursement Page

asking Medicare to pay for something that is not identified other than by what you provide. If you expect to be reimbursed, you must provide a detailed description of the item or service and a full breakdown of the cost and labor associated with providing it to the patient.

Another effective tactic is to use consistent descriptors. If you are providing something more than once, describe it the same way each time you submit your claim to Medicare.

At the very least, it will provide the DME MAC with a reference point from a previous claim. At most, it may lead to the development of a designated procedure code. If the DME MACs receive multiple claims with identical descriptors, a need for a new procedure code may be recognized.

The worst thing you can do is not bill for miscellaneous codes because they are not worth the fight. When you do this, you are giving up hard-earned reimbursement dollars for services you have provided.

Myth: Medicare will not cover a prosthesis if a patient has a power wheelchair.

Reality: The days of conflicting medical policy regarding power wheelchairs and prostheses are long behind us. Many years ago, the main criteria for coverage of a power wheelchair was that the patient was non-ambulatory. Medicare’s lowerlimb prosthetic policy has always required a patient to be ambulatory for a prosthesis of any kind to be covered. In the past, these conflicting medical policies prohibited Medicare coverage of a power wheelchair and a lower-limb prosthesis for the same patient.

The Medicare power wheelchair policy has been completely re-written and currently ties the medical necessity of a power wheelchair to its ability to assist a patient in performing activities of daily living. While the decision to provide a prosthesis to a Medicare patient should be based on

18

O&P ALMANAC SEPTEMBER 2011

the patient’s ability to meet Medicare coverage criteria without consideration of other covered items or services, medical policy no longer prohibits patients from obtaining coverage for a prosthesis and power wheelchair.

The worst thing you can do is not bill for miscellaneous codes because they are not worth the fight.

Myth: Including a KX modifier on your claims guarantees that they will be paid.

Reality: The purpose of the KX modifier is to inform Medicare that all coverage criteria have been met and documentation supporting the medical necessity of the item is available. While failure to include the KX modifier on Medicare claims for AFOs, KAFO, knee orthoses, diabetic shoes, and orthopedic shoes will result in an automatic denial of the claim, including it is no guarantee that the claim will be paid. As with any claim, Medicare reserves the right to perform a pre-payment review to ensure the claim meets medical necessity guidelines and should be paid. While the KX modifier streamlines the automated claim payment system used by the DME MACs, using it does not guarantee payment.

Myth: All prosthetic services are exempt from the Skilled Nursing Facility Prospective Payment System (SNF PPS) and may be billed directly to the DME MAC. Reality: CMS publishes an annual list of HCPCS codes that are not subject to SNF PPS and may be billed directly to the DME MACs. If a code is not on this list, it remains subject to SNF PPS payment rules and must be provided by the SNF directly or by a

vendor of the SNF’s choice. If you are selected as a vendor by the SNF, you must negotiate payment directly with the SNF. While most prosthetic codes are included in the list, some notable codes that are not exempt from SNF PPS are those that describe immediate post-surgical prostheses, partial hands and feet, labor and repair codes, and prosthetic feet described by L5987.

For a complete list of codes that are exempt from the SNF PPS payment system, follow this link and click on “File 1”: www.cms.gov/SNFConsolidated Billing/02h_2011Update.asp#TopOfPage.

Myth: As long as I handle all of my Medicare billing out of a single office, I can operate multiple locations under a single PTAN number.

Reality: Medicare regulations clearly mandate each location where you deliver services have its own NPI and PTAN number. While you may consolidate billing operations at a single location, you must bill for services using the PTAN associated with the physical location where the service was provided. For purpose of this discussion, a location is defined as a dedicated space where you provide regular services to Medicare patients. While there is some grey area regarding what constitutes a location, as a general rule, if you are regularly seeing patients at a site that is dedicated for your use, it should have a separate PTAN number.

The myths addressed in this month’s Reimbursement Page are a small sample of the many rumors prevailing in the O&P industry. By highlighting the reality a few of the larger myths, we encourage you to consider what is truth and what is reality when deciding how best to operate your business. a

Joe McTernan is AOPA’s director of coding and reimbursement services.

Reach him at jmcternan@ AOPAnet.org.

Man and Machine Homayoon Kazerooni, PhD, a leading expert in robotics human augmentation, is a man with a mission: harnessing affordable technology to help the mobility impaired

W

hat if robots could help people walk? What if people with mobility problems could trade their wheelchairs for state-of-the-art exoskeletons that would give them back the strength and agility they have lost due to stroke, spinal cord injury, or other medical conditions? What if they could say good-bye to the sheer inconvenience of using wheelchairs and to the dangers of such secondary diseases as muscle and joint deformity and reduced heart and circulatory function?

It might sound like science fiction, but all that will soon be possible, if Homayoon Kazerooni, PhD, a leading expert in robotics human augmentation, has anything to say about the matter.

Kazerooni, director of the Robotics and Human Engineering Laboratory at the University of California at Berkeley (UC Berkeley), has spent 25 years conducting research on robotics, control sciences, exoskeletons, human-machine systems and augmentation, bioengineering, mechatronics design, artificial locomotion, intelligent assist devices, and power and propulsion. Since receiving his doctorate in mechanical engineering from the Massachusetts Institute of Technology in 1985, he has authored and co-authored more than 180 articles and given presentations at numerous conferences on exoskeleton systems, robotics, and control sciences. He has created many devices that augment people’s capabilities in industrial and military settings, as well as in the medical field.

20

O&P ALMANAC SEPTEMBER 2011

COVER STORY

BY TORA

CE L A E!

P TO B

Editor’s Note: Prof. Kazerooni will kick-off the robotics clinical session at the AOPA 2011 National Assembly on September 20 at 10 a.m.

Photo: Kazerooni, University of California, Berkeley

E

TH

ESTEP

SEPTEMBER 2011 O&P ALMANAC

21

“The whole idea of using technology to create a better quality of life is gaining more and more momentum.

We are going to see a major revolution in orthotics and prosthetics.”

The mission of the laboratory Kazerooni currently directs is to develop fundamental scientific and engineering principles for robotic systems that augment human capability. One outcome of this research is the Austin project, which has developed a series of low-cost exoskeleton systems for people with mobility disorder. The Berkeley Robotics and Human Engineering Laboratory website describes the project this way: “The Austin project involves a series of accessible exoskeleton systems that have deliberately stripped-down clever design. Built with many off-theshelf parts, these exoskeleton systems have a limited range of motions.

They allow users to stand, walk forward, stop, and sit. We believe those few simple maneuvers will be game-changing. What is important to millions of people is to be upright, mobile, and independent through accessible technology.”

Kazerooni also is one of the founders and the chief scientist of Berkeley Bionics, a company launched in 2005 to commercialize innovative exoskeleton technology developed in partnership with UC Berkeley. The company’s earliest projects included BLEEX (Berkeley Lower Extremity Exoskeletons), ExoHiker, and ExoClimber, which were designed to help wearers walk and support heavy loads over long distances.

22

O&P ALMANAC SEPTEMBER 2011

In 2008, Berkeley Bionics introduced HULC (Human Universal Load Carrier), the first energetically autonomous, orthotic, lower-extremity exoskeleton, enabling users to carry 200-pound weights over any sort of terrain for an extended period of time without undue effort. People who wear these exoskeletons are less likely to become fatigued and reach their physiological endurance limit. HULC technology has since been licensed to Lockheed Martin.

Kazerooni has extended the knowledge and capability gained from these exoskeleton projects, which were designed for industrial and military use, to help people with mobility disorder. In October 2010, Berkeley Bionics launched the eLEGS exoskeleton system as a result of a project Kazerooni conducted with support from the National Institute of Standards and Technology. This device has received numerous awards and was named one of TIME magazine’s 50 best inventions of 2010.

“Creating an exoskeleton system for the price of an average wheelchair has become my passion.”

The eLEGS exoskeleton system is fastened over the user’s clothes with simple straps and backpack-style clips. The device gets its power from a battery and has superb knee flexion, resulting in the most natural gait currently available and allowing the user to travel over anything from level pavement to rutted or rocky terrain. It uses sensors to gather information, and a computer crunches the data to plan and choreograph each step.

O&P Almanac spoke with Kazerooni about why he became interested in robotic human augmentation, the impact that the eLEGS and Austin projects may have on the mobilitydisordered community, and where

he sees robotic human augmentation going in the future. Here are excerpts from that interview: O&P Almanac: Your career in robotic human augmentation and mechanical engineering has been long and distinguished.

How did you initially get involved?

I became interested in applying mechanical engineering and robotics to human augmentation more than 30 years ago. I was disappointed with the state of robotics, which focused solely on structured tasks that are often dangerous for humans, such as robotic welding, assembly, spray-painting, and so forth. These robots were incapable of completing unstructured tasks such as working in a warehouse or a construction environment—places that cannot replace people because people are smart, adaptable, and have decision-making capabilities.

I realized that the combination of human intelligence and robotic power could be optimal for many tasks— especially in manufacturing, factory, warehouse, and distribution settings.

The combination also could have many applications in the medical field and in the military.

I became interested in robotic devices that are actually worn by people. Humans wear and drive the devices, while the robots augment human mechanical ability. I became committed to the idea that humans would greatly benefit from robotic exoskeleton systems that would augment their strength and abilities, and I wrote and presented my first paper on the topic at the IEEE International Workshop on Intelligent Robots and Systems in Tokyo in 1988.

O&P Almanac: Two recent projects of yours focus on extending exoskeleton technology to aid people who are confined to wheelchairs to get them upright and mobile again: eLEGS and the Austin project. Can you tell me more about them? eLEGS is an assistive exoskeleton system for people with mobility

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UC Berkeley student Austin Whitney uses Kazerooni’s “Austin” exoskeleton system to walk during graduation.

disorder, including paraplegics, stroke patients, and others who are not able to walk. The eLEGS project started about three and a half years ago at Berkeley Bionics and was officially launched in October 2010 to create robotic exoskeleton systems that facilitate walking. The particular purpose of this device is for use in rehabilitation settings under the supervision of physicians. In therapy sessions, patients who have newly undergone stroke or spinal injury will be able to re-learn walking and prevent secondary diseases and atrophy resulting from being constantly seated.

Some of these secondary diseases include muscle and joint deformity, frequent urinary tract infections, spasticity, and reduced heart and circulatory function.

However, eLEGS and other exoskeleton systems on the market such as REX and ReWalk are very expensive machines. Most patients simply cannot buy these devices for their own personal use, so I went back to the drawing board to make inexpensive machines available to a

24

O&P ALMANAC SEPTEMBER 2011

“I want to see a young person, no matter what his or her disability, do any of the things a non-disabled person can do independently.” large number of people. This formed the foundation of the Austin project at the University of California, Berkeley.

My idea with the Austin project was to create accessible exoskeletons with acceptable performance and the lowest cost to end users. The aim of the Austin project is at-home accessibility, in contrast to the current expensive technology limited to a clinical rehabilitation setting. The whole idea is to create a technology for large numbers of people in their homes.

I feel my mission is not complete until these low-cost machines are made accessible to large numbers of people who have no access to rehabilitation

settings anywhere. Creating an exoskeleton system for the price of an average wheelchair has become my passion. However, it is actually a very difficult project because it necessitates overcoming the tendency to add rather than subtract technology, while maintaining performance. I want to rely more on computation rather than hardware, allowing an elegant design to compensate for mechanical components.

We named the Austin project after Austin Whitney, an undergraduate student at UC Berkeley and the first human test subject for the project.

Austin was paralyzed from the waist down in 2007 and has been confined to a wheelchair since. He was able to walk during his graduation with a low-cost exoskeleton to receive his degree, which was symbolic that it is time for young people to stand up, get their degree, and live independent lives. The Austin project not only changed Austin’s life but also changed my life and the lives of the others who work with me in the lab.

We are moving forward and are going to dedicate our knowledge and passion to bring this technology to people of any age who have limited mobility.

O&P Almanac: How are you solving the problem of keeping the costs down?

There are many ways to reduce cost.

As an engineer, innovator, and entrepreneur at the beginning stages of a promising technology, I want to create a different technology that is inherently less expensive to manufacture.

Engineering decisions and creativity contribute to this goal. For example, I want to use fewer sensors and actuators and make materials from lower-cost components. When designing these exoskeletons, I need a way to add power with the help of computers and actuators, but I need to use mechanical components sparingly.

Any time I see costly hardware, I consider if I can replace it with something less expensive or with slightly less performance, in order to compromise to find the best balance of performance and affordability.

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O&P Almanac: What are the broader implications of creating low-cost exoskeleton systems?

I support the availability of quality health care for everyone. This belief is embedded in my work to make exoskeletons affordable and suitable for all ages. I want to make sure people, even children, can use these devices instead of wheelchairs. People who are upright and mobile are healthier, live with fewer secondary diseases that result from wheelchair use, and live a longer life.

Exoskeleton users would fare better psychologically as well. For example, they could get more employment opportunities and not be isolated from the economic and educational mainstream. I want to see a young person, no matter what his or her disability, be able to effortlessly stand up, put the device on, go to the bathroom, go to work, go to lunch, or do any of the things a non-disabled person can do independently. I want to see people easily able to walk up

the narrow aisle of an airplane and thus be able to travel. Maybe using an exoskeleton will be a little bit slower, but it will not be nearly as restrictive as a wheelchair. Better access to the economic and educational mainstream, independence, the ability to travel— these are just some things that equate to a better quality of life and are obtainable through exoskeleton technology.

O&P Almanac: We’ve talked about where these technologies have been in the past and how they are affecting people with mobility disorder in the present.

Where do you see robotics human augmentation going in the future?

The whole idea of using technology to create a better quality of life is gaining more and more momentum, so I would say this is just the tip of the iceberg. Many researchers in the United States, Europe, and East Asia are developing similar technology. We are going to see a major revolution in orthotics and prosthetics. A lot of high-end devices—hopefully with

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lower cost—will be coming out as this technology progresses.

In the United States and Europe, our life is inundated with all kinds of technology, but we still don’t have high-end technology for people with mobility disorders. Wheelchairs, which have been around for years and years, are still the most common solution to mobility disorder. It’s really unacceptable to see young people coming back from conflict zones or with medical afflictions bound to wheelchairs, when the technology is out there to keep them upright and mobile a few hours a day at the very least.

I am really glad to contribute to this fight in terms of managing the eLEGS project and the Austin project.

I want to bring both of those to maturity as fast as I can, allowing the greatest number of people to benefit from this technology. a Tora Estep is a contributing writer for O&P Almanac. Reach her at tora. thurisaz@gmail.com.

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RACking Up Recoupment As RACs step up their policing of Medicare payments, take time to ensure your billing practices are compliant

T

he world of Medicare billing is one of acronyms. The alphabet avalanche starts at the top with DHHS, which stands for the Department of Health and Human Services, and CMS, which stands for the Centers for Medicare and Medicaid services. From there it flows down to Medicare contractors, who are described using terms such as MAC (Medicare Administrative Contractor), DME MAC (Durable Medical Equipment Medicare Administrative Contractor), PDAC (Pricing, Data Analysis, and Coding), and ZPIC (Zone Program Integrity Contractor).

One of the newer acronyms on the Medicare billing landscape is RAC, or Recovery Audit Contractor.

While RACs have only existed on the national stage since October 2009, they have already established themselves as a tour de force in the Medicare audit arena and continue to expand their influence.

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O&P ALMANAC SEPTEMBER 2011

What is a RAC? A RAC is a specialized contractor to CMS tasked with identifying and recovering improper Medicare payments. While that includes both overpayments and underpayments, audit activity has focused almost entirely on overpayments because they are easier to identify and more likely to result in recoupment—that is, return of funds to the Medicare system.

The legislative foundation for the RACs was established in section 306 of the Medicare Prescription Drug Improvement and Modernization Act of 2003. This law, which also established prescription drug coverage for Medicare beneficiaries, mandated a demonstration project to determine if recovery audits were a viable option for protecting Medicare from improper claim payments.

The demonstration project, which began in 2005 and ended March 27, 2008, operated in New York, Massachusetts, Florida, South Carolina, and California. In July 2008, CMS released its final report on the project, which was deemed a tremendous success. Almost $1 billion was returned to the Medicare trust fund as a result of overpayments discovered during the three-year demonstration.

Before the project ended, Congress authorized expanding the RAC program to permanent, national status. This

authorization, which was included in section 302 of the Tax Relief and Healthcare Act of 2006, required nationwide expansion no later than 2010.

The RAC program went into effect at the national level in October 2009.

In its first two years, the program recovered more than $150 million.

This year, the RACs stepped up their

RACs are paid on a contingency basis; that is, they receive a percentage of the dollars they identify as overpayments or underpayments. audit activity, racking up $162 million in overpayment recoveries in the first three months of 2011. No overpayment recovery has been reported since March, but it is reasonable to assume that recoveries will continue to expand exponentially.

From the perspective of CMS, the RAC audit program is a huge success and is responsible for the return of real dollars to the Medicare trust fund.

Unfortunately, it appears that RACs are here to stay.

Who Are the RACs? With the expansion of the program, CMS selected four insurance companies to serve as RACs. The companies are responsible for RAC functions within jurisdictions equivalent to the current DME MACs: • Jurisdiction A: Diversified Collection Services (DCS) • Jurisdiction B: CGI • Jurisdiction C: Connolly Inc. • Jurisdiction D: HealthDataInsights Inc. (See the table below for contact information.)

The RACs are authorized to hire subcontractors, but each bears ultimate responsibility for the correct performance of its duties.

How Are the RACs Paid?

RACs are paid on a contingency basis; that is, they receive a percentage of the dollars they identify as overpayments or underpayments. This creates an incredible incentive for them to find the low-hanging fruit that represents the easiest recoupment opportunities.

According to a recent report released

by CMS, RACs in Jurisdiction C and D report that their top recovery situation involves Medicare Part B payments that were made to DMEPOS suppliers for patients in a Medicare Part A Skilled Nursing Facility (SNF).

How to Reach Your RAC RAC

Website

Email

Telephone Number

Jurisdiction A: Diversified Collection Services

www.dcsrac.com

info@dcsrac.com

866/201-0580

Jurisdiction B: CGI

http://racb.cgi.com

racb@cgi.com

877/316-7222

Jurisdiction C: Connolly Inc.

www.connollyhealthcare.com/RAC

RACinfo@connollyhealthcare.com

866/360-2507

Jurisdiction D: HealthDataInsights Inc.

http://racinfo.healthdatainsights.com

racinfo@emailhdi.com

Part A: 866/590-5598 Part B: 866/376-2319

SEPTEMBER 2011 O&P ALMANAC

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involving a prosthesis in an SNF, use the discussion period that is part of the RAC process to explain the exemption to the RAC. If this is unsuccessful, use the appeal process to defend your claim.

How Can I Prepare for RAC Audits?

RAC audits are categorized as post-payment audits, which means they involve claims that have already been processed and paid by the DME MAC. There may not be much you can do to ensure that proper documentation exists to support claims that have already been processed. Still, a thorough internal review of your billing practices may help you avoid unnecessary recoupment on future claims. Given their success to date, RAC audits clearly are not going to stop anytime soon. Identifying and correcting poor billing practices today may help you avoid problems down the road.

O&P is just a small part of the DMEPOS universe, but it is squarely in the spotlight of the Jurisdiction C and D RACs. Based on feedback from AOPA members, the Jurisdiction C RAC, Connolly Inc., appears to be increasingly interested in O&P claims and has focused on SNF billing as well as payments that were improperly made for addition codes precluded by medical policy from being billed with preparatory base codes.

Examples of the second scenario include L5647 (below-knee suction socket), L5629 and L5631 (acrylic socket), and L5980 (flex foot or equal). The full list of addition codes that may not be billed with preparatory base codes may be found in the Lower Limb Prosthesis LCD published by each of the DME MACs. Many of the RAC recoupments are inappropriate, especially those

30

O&P ALMANAC SEPTEMBER 2011

surrounding the delivery of a prosthesis during a Medicare Part A SNF stay. Most prosthetic services have been carved out of the SNF Prospective Payment Service (PPS).

That means, even if the prosthesis is delivered during an SNF stay covered

by Medicare Part A, the provider of the prosthesis may submit a claim to the DME MAC for most of the codes that are billed.

Some codes are not exempt from the SNF PPS system and must be paid for by the SNF directly, but AOPA is hearing that the RACs are recouping all reimbursements made by the DME MACs for prostheses delivered in a Medicare Part A SNF setting. AOPA continues to try to educate the RACs about the prosthetic exemption and hopes that the improper recoupment will stop in the near future.

In the meantime, if a RAC attempts to recoup reimbursement

Given their success to date, RAC audits clearly are not going to stop anytime soon.

If you have not done so already, you should immediately appoint a compliance officer for your company. A compliance officer—usually a member of your company’s senior management team—has overall responsibility for ensuring that your company operates within the coding and billing guidelines established by Medicare and other payers. The compliance officer should develop your company’s compliance plan and have the authority to implement policies and procedures that protect the company from accusations of improper practices.

An important part of any such

plan is an effective self-audit process that allows for the correction of improper billing practices and the education of clinical and administrative staff. Depending on the size of your organization, self-audits may be performed by the compliance officer directly, by a designated team of employees, or by outside consultants.

Regardless of who audits your own files, that person or persons must be given the authority to take corrective action—even if that means voluntarily refunding payments that were made improperly. Regular internal review of your files may result in small refunds in the short term but significant savings in the long term as you to identify and correct issues before they get out of hand.

Another strategy in preparing for RAC audits is focused education on billing practices that are most likely to spawn RAC activity. As part of their contractual requirements, RACs

are required to publish the issues they have identified as areas of vulnerability.

RACs typically focus their efforts on these issues, because they represent high potential for recoupment with minimal effort. Because the RACs are paid on a contingency basis, an efficient

audit process is key to maximizing their profits.

Educating your staff about the areas the RACs are focusing on will help ensure that all required documentation is obtained and that policy requirements have been met before submitting claims.

W NE IGN S DE

SEPTEMBER 2011 O&P ALMANAC

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Many RAC recoveries have nothing to do with the actual medical need for the service or device you provided, but rather your ability to properly document the medical need in the patient’s medical record.

Remember, the RACs are looking for any reason to declare that a claim should not have been paid.

A third strategy involves how you respond to a RAC audit. It is extremely important to properly prepare information that will be used to appeal an

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O&P ALMANAC SEPTEMBER 2011

audit decision. The omission of a single piece of documentation may result in the denial of your appeal and loss of any reimbursement. Remember, the RACs are looking for any reason to declare that a claim should not have been paid.

The appeal process is in place for a reason and allows you the opportunity to defend your claim. Make sure the documentation you submit as part of your appeal is legible, accurate, and complete. If your first appeal is denied, appeal again, all the way through the administrative law judge (ALJ) if necessary. Often, the ALJ will rule in your favor even if previous appeals were unsuccessful.

Looking Forward With more than $300 million recovered through RAC audits in just 18 months, it’s a safe bet that the

RACs will continue to be a part of the Medicare program—and that RAC activity will increase. While the RACs represent another layer in the Medicare audit maze, they also represent an opportunity for you to stop and examine how your business operates.

Nobody likes to refund money to Medicare—especially for devices and services that are truly needed by the patient. Still, rules exist to make sure Medicare pays only for services that are reasonable and necessary. Taking the time to make sure your billing practices are compliant today should help you avoid any negative impact from RAC audits in the future. a Joseph McTernan is AOPA’s director of coding and reimbursement services.

Reach him at jmcternan@ AOPAnet.org.

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Ask the Expert

By Devon Bernard, AOPA government affairs department

Prescriptions and Written Orders Learn the ins and outs of ordering orthotics and prostheses

This month’s Ask the Expert will focus on some of the more common questions about prescriptions—both initial prescriptions

Q:

A:

Yes. NPs, or clinical nurse specialists, and PAs are eligible under Medicare guidelines to order O&P items or services and sign the detailed prescriptions. However, some criteria must be met first.

For NPs to prescribe an item and sign the detailed prescription, they must • treat the patient for the condition for which the item is needed • practice independent of a physician • bill Medicare for other services under their own provider number • be allowed to do the above in the state in which the item is being delivered.

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O&P ALMANAC SEPTEMBER 2011

What information should be included on the detailed prescription?

A:

and detailed written orders.

Can nurse practitioners (NPs) and physician assistants (PAs) write a dispensing order and sign the detailed prescription?

Q:

For PAs to prescribe an item and sign the detailed prescription, they must • meet the definition of a PA in the Social Security Act • treat the patient for the condition for which the item is needed • practice under the supervision of a physician, either a doctor of medicine (MD) or a doctor of osteopathy (DO) • have their own NPI number • be permitted to perform services in accordance with state law.

Even though NPs and PAs are eligible to write prescriptions and sign detailed prescriptions for orthotic and prosthetic services, they may not sign the certifying statement for diabetic shoes and inserts.

At a minimum, three core components must be included on your final detailed prescription: • the name of the patient.

• the signature of the physician or ordering entity and the date that person signed the prescription.

• a complete breakdown and description of all the individual components for which you are billing. This description can consist of a list of the relevant HCPCS codes and descriptors, or it can be a narrative description. If the item is prefabricated or off-the-shelf, you also may include the brand name and model number of the item.

You may want to include some additional information on the detailed prescription even though it is not required and may not always be needed. First, you may want to include the ICD-9 diagnosis code or a description of the patient’s condition. Second, you should indicate on the detailed prescription

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if you are providing supplies that must be replaced on a regular basis. Note the quantity of supplies being provided, how often you plan to provide the patient with a reorder, and for how long you will provide reordered supplies.

Finally, it is always a good idea to review the medical policies to make sure you have included any additional information that is required on the prescription. For example, the Knee Orthoses Policy requires that written orders for custom KOs must clearly state “custom” or specify a brand name and model that is only available as a custom fabricated device.

written document—it may be simply a verbal request from the physician treating the patient. If you receive a verbal order, document in your records that you received the order verbally and document all the information that is required on a dispensing order. The dispensing order should contain at least the following: • a description of the item requested (this does not need to be detailed; it can be as basic as just stating AFO) • the name of the patient and the physician ordering the item • the date the item was ordered.

Q:

Q:

Does the dispensing or starting order have to be written? What type of information should be included on the starting order?

A:

Can we deliver an item solely based on a dispensing/ initial order?

A:

Yes. The initial or dispensing order allows you to see the patient, treat the patient, and deliver an item to the patient. However, you may not bill for the item until you have received a signed detailed prescription.

No. An initial or dispensing order does not need to be a

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O&P ALMANAC SEPTEMBER 2011

If you deliver an item based solely on the initial order, you must make sure that the final detailed prescription specifies the start date.

Q:

Do we need both a dispensing order and a detailed written prescription?

A:

Typically the answer is yes, but there is one instance when it is OK to have only one of the documents on file before you bill. This is when the initial/dispensing order meets all the criteria of a detailed written order.

For example, if you receive an initial order from a physician that includes the name of the patient, the physician’s signature and date, and a detailed description of the item to be provided, you may dispense the item and bill for it with only the initial order.

Q:

Once an item has been delivered to a patient, when is a new prescription required?

A:

A new prescription is required if you provide a replacement item due to a change in the patient’s condition, or if the original item is lost or stolen. A new prescription is not required, however, if you are only repairing or adjusting an item you provided. A new prescription also is not required when you are replacing items that are considered supplies, as long as you noted on the original detailed prescription that you would be replacing the supplies on a frequent basis.

If you are uncertain whether you need a new prescription, review the medical policies. Each policy outlines when a prescription is required.

If you have any more questions about prescriptions and orders, contact AOPA or review Chapter 5 of the Medicare Program Integrity Manual at www.cms.gov/Manuals/IOM/list.asp. a Devon Bernard is AOPA’s manager of reimbursement services. Reach him at dbernard@aopanet.org.

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Facility Spotlight

By Deborah Conn The Snell staff in front of the company’s Memphis office, circa mid-1950s.

Beginning with one small shop in Memphis, five generations of the Snell family have served the O&P population

All in the

Family FACILITIES:

CFI P&O, Snell’s O&P, and Snell P&O Laboratory

LOCATIONS:

Facilities in Mississippi, Tennessee, Louisiana, and Arkansas

OWNERS:

Ted Snell, CP; Clint Snell, CPO; and Frank Snell, CPO, FAAOP

HISTORY:

100 years in business

38

O&P ALMANAC SEPTEMBER 2011

“M

om and pop” orthotics and prosthetics facilities are nothing new, but it’s rare that one endures for a century—and was founded by someone actually called Pop. That would be R.W. “Pop” Snell, who started Snell’s Artificial Limbs, Braces & Trusses in Memphis in 1911.

Today, Pop’s legacy is continued by his great grandson, Ted, grandson Clint, and great-nephew Frank, who own O&P facilities throughout Mississippi, Tennessee, Louisiana, and Arkansas. All three are celebrating the Snell centennial this year.

Pop Snell entered the field by fitting trusses in a Memphis pharmacy, eventually purchasing the artificial

limbs and braces portion of the company. Business thrived, and Snell’s soon expanded into Nashville and Little Rock. In the late 1930s, Pop’s son Jim opened his own facility in Shreveport, Louisiana, while R.D. “Ralph” Snell, Jim’s brother, took over the Nashville operation. A few years later, G.E. “Ed” Snell, Pop’s nephew, purchased the Little Rock portion of the business from his uncle.

In time, the second generation of Snells produced a third: Ralph’s son Ralph R. “Ronney” Snell; Jim’s son Clint Snell, CPO; and Ed’s son Frank Snell, CPO, FAAOP, all joined their fathers and eventually assumed control of the family businesses.

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Uplifting the Profession Ralph R. Snell, better known as Ronney, played a major role in the development of the orthotics and prosthetics profession in the United States. “He was a dynamic man in a very quiet way,” says his son, Ted Snell, CP. “He helped a disjointed business of craftsmen become a profession, and he felt passionately that it needed to be a profession.”

Ronney Snell served as head of all three major O&P organizations: • president of the American Board for Certification in Orthotics and Prosthetics (ABC) in 1969 • first president of the American Academy of Orthotists and Prosthetists (AAOP), an organization he helped to create, in 1971 • twice president of AOPA, in 1974-1975 and in 1998-1999.

He believed strongly in education as a way to uplift the profession, serving as a clinical instructor at the University of Tennessee’s Department of Physical Therapy, an assistant professor of orthopedics for the University of Tennessee’s rehabilitation engineering program, and an O&P instructor at Northwestern University.

Snell was closely connected to St. Jude Children’s Research Hospital in Memphis, where he was instrumental in developing a rehabilitation program that has grown into a state-of-the-art department today.

He received AOPA’s Lifetime Achievement Award in 2001 and the Academy’s Titus-Ferguson Award in 2002. On his death at the age of 70, in 2003, former Rep. John Tanner of Tennessee extended his remarks in the Congressional Record to commemorate Snell’s life and achievements.

“He was always available if there was a need for him.” says Ted Snell.

“What I learned from him was the conviction that we have the ability to make a difference in the lives of the people we serve. It’s not just a job, it’s a responsibility.”

Third-generation family members, Ronney Snell, CPO, (left) and his son, Ted Snell, CP, (right) in front of the U.S. Capitol attending an AOPA Policy Forum.

40

O&P ALMANAC SEPTEMBER 2011

Ralph and Jim Snell, sons of R.W. “Pop” Snell (circa 1920s).

Growth in Tennessee Ronney Snell grew up literally above his father’s facility, which was located in the basement of their Nashville home. “He found it difficult to say just when he began in O&P,” says his son, Ted Snell, CP, a member of the family’s fourth generation. “The business had always been there.”

In the early 1960s, Ralph sent Ronney to the Memphis branch to address some management problems.

While there, Ronney developed a strong working relationship with Dr. Robert Toombs, who ran the children’s amputee clinic in Memphis, and the two teamed up in an effort to enhance the professionalism of O&P through local and national O&P associations.

Through the years, the Memphis and Nashville offices flourished, and Snell’s expanded into Jackson, Tennessee, and Lexington, Paducah, and Owensboro, Kentucky. The company ultimately attracted the attention of Durr-Fillauer Medical Co., based in Chattanooga, Tennessee.

(Hanger Orthopedic purchased Durr-Fillauer in 1991.)

“At the time, none of the kids knew what they wanted to do. I was 13 or 14 years old,” says Ted Snell. “So Dad sold.” In 1972, Durr-Fillauer purchased

E

TH

E AC PL BE! TO

Editor’s Note: Join the Snells at their 100th Anniversary Celebration on September 21 at 5:30 p.m. in the expo hall of the AOPA 2011 National Assembly.

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Ronney’s five offices and took over the Snell name. Ronney assumed an administrative position with the parent company, and in 1977 Ted went to work for Durr-Fillauer/Snell’s.

In 1980, Ronney took a position with Florida Brace. Ted joined him in Winter Park and started a central fabrication facility next door called CFI (Central Fabrication, Inc.) Prosthetics and Orthotics. Ronney and Ted moved CFI back to Memphis in 1982, changing the focus back to patient care, and the two worked together until Ronney’s death in 2003. CFI now stands for Custom Fit Innovations.

Today, CFI P&O has two offices in the Memphis area, with a staff of 28, including nine practitioners and eight technicians. Both sites offer complete O&P services, but fabrication takes place in the main office. The facility serves a broad demographic and recently opened a new division devoted to high-tech devices.

“We realized that a high-tech practice needed to operate a little differently from our mainstream business, so we funnel things like microprocessors, stance control

Ed Snell (far left), Ralph Snell, (third from left), Jim Snell (third from right), and other O&P professionals at an AOPA National Assembly in the 1940s.

orthoses, and electrical stimulation devices into AI Bionics,” explains Ted. AI Bionics is a separate entity, with its own website, and is physically located adjacent to the main CFI office.

Ted Snell has been active on the national O&P scene, serving on many AOPA committees and as president during 2006-2007. In 2008, his son Sean, 30, left another career in sales and finance to join the company as CFO, representing the fifth generation of Snells in the family business.

Innovation in Louisiana

Fourth-generation family member, Ted Snell, CP, in the laboratory.

42

O&P ALMANAC SEPTEMBER 2011

About 10 years after Jim Snell opened Snell’s O&P in Shreveport, he became one of the first practitioners in the country to qualify as a certified prosthetist orthotist after the first standards were established. An innovator, Jim developed a process for stamping out aluminum stirrups that allowed for lighter and faster production than his competitors could match.

Twenty years later, in 1968, Jim’s son Clint joined his father’s company, after completing his O&P studies at University of California Los

Angeles and the Rancho Los Amigos Rehabilitation Center. He assumed full ownership of the Shreveport company in 1976 when his father retired.

Clint, a CPO, became an examiner for the American Board for Certification in Orthotics & Prosthetics and helped write the National Certifying Exam for practitioners.

He was instrumental in forming the Louisiana Association of Orthotists and Prosthetists in 1991 and served as its first president. He also served a stint as president of the Louisiana Rehabilitation Association Board.

Today, Snell’s O&P has four offices. The headquarters remain in Shreveport, along with a two-year-old branch office. Two other branches are in Monroe and Alexandria, Louisiana.

The practice has 30 employees, including 10 practitioners and seven technicians.

Snell’s O&P’s patients range in age from children to the elderly, and the facility handles the full gamut of orthotic and prosthetic services. “We do a lot of trauma work,” says Clint Snell, “and we have an on-call arrangement with local hospitals.”

Clint’s son Chris did odd jobs around the office Snell’s P&O Lab has when he was 15 years old, a strong commitment to and he soon began working community service. In in the shop as an orthotic 2006, it celebrated its 95th technician. After receiving anniversary with a “More his business degree from than 9-5” campaign, which Louisiana State Universityencouraged employees Shreveport, he turned to the to donate 9,500 hours of administrative side of the community service over practice. He plans to attend the course of the year. The school for both orthotics and company continues to prosthetics in the near future. give annual recognition One of the ways Clint to the employee who has Snell is commemorating contributed the most hours the 100th anniversary is by of volunteer service. In creating an oral history. He addition, it is sponsoring its (From left to right) Cousins Clint Snell, CPO; Ted Snell, CP; and Frank Snell, CPO, FAAOP, at a recent AOPA meeting. has interviewed members of own Legacy Tree community the family, former employees, giving program. and former patients who have had a Frank Snell was actively involved in of the American Academy of Orthotics longstanding relationship with the the O&P community’s successful 2007 and Prosthetics. company. The video segments will campaign to pass a state licensure law Snell’s P&O Laboratory has be used to produce a short DVD on in Arkansas, and he fought for a state expanded to include eight branch the company’s history for the general insurance parity law for orthotics and offices across Arkansas. The offices public, with an extended version prosthetics that passed in 2009. have from two to five full-time documenting the family’s history.

The fourth generation of Snells at employees, some with on-site Another centennial project at Snell’s the P&O Lab is represented by Frank’s fabrication and repair services that is the Legacy Giving Tree. Visitors to daughter Melissa Snell, who joined complement the company’s central each office may choose from several the company in 1999 and is the vice fabrication facility at the main office. listed charities and vote for their president of business development The company normally has between favorite by adding a leaf to the tree. and marking, and by his son Brant 50 and 55 employees, including 15 to 18 Each quarter, Snell’s picks the most Snell, RPT, LP, who joined the business practitioners and five or six technicians. popular charity and makes a financial in 1997.

The main Little Rock facility houses donation.

Each of the three Snell cousins— all administrative functions, although “This is a way for us to emphasize Frank, Clint, and Ted—has made his satellites are encouraged to do their our legacy of giving back to the own mark on the family business, own marketing with local referral community,” says Clint Snell. but they all take pride in tracing their sources. Every office has at least one history back to Pop Snell 100 years ago. customer service representative, and “It’s one thing for a family to stay in some have two.

Expansion in Arkansas the industry,” says Ted Snell, “but it’s As a whole, practitioners treat about Ed Snell, the son of Pop’s brother even better to have three branches who 60 percent orthotic and 40 percent Benson, purchased the Little Rock all do a good job at what they do and prosthetic patients. The offices in towns business, Snell Artificial Limb, from his for the right reasons. It’s a great thing with a large retirement population uncle in 1945. In 1952 he added bracing for the profession to have that kind of do more geriatric work, and satellite to the line of services. legacy to bring a historical perspective offices tend to do more pediatric Ed’s son Frank Snell, CPO, FAAOP, to what we’re doing. work than the headquarters in Little began working alongside his father “When I started 34 years ago, all Rock, which boasts the sixth-largest at age 14 and joined the company I made was wooden legs,” he says. children’s hospital in the nation. full time in 1972 after graduating “Now I’m on computers, programming Each spring, Snell’s assembles from Northwestern University. He knees. I expect that what we’re doing employees from all its branches for changed the company name to Snell today will seem archaic when our a day-long training event called Prosthetic & Orthotic Laboratory and children have been in the business as “Team Snell.” Participants hear from became president and sole owner of long as we have.” a industry speakers on new technologies the company when his father retired in and techniques and earn continuing 1984. Fourteen years later, in 1998, he education credits from accrediting Deborah Conn is a contributing writer to O&P became one of the first seven practiboards in the field.

Almanac. Reach her at dconn@cox.net. tioners to earn recognition as a Fellow

44

O&P ALMANAC SEPTEMBER 2011

n

AOPA Headlines AOPA WORKING FOR YOU

Facts and Figures on the Nuts and Bolts

Profits remain steady, according to 2011 Operating Performance and Compensation Report

K

nowing where you stand compared with others is an important tool for benchmarking business progress.

Most big business decisions revolve around revenue, expense, and profit numbers, and the components of those numbers will drive many other decisions.

From what products and from what services revenue flows is a key marker. The typical O&P patient-care facility participating in the 2011 Operating Performance and Compensation Report study, which is based on 2010 data, generated $2.2 million in revenue.

Here’s how those revenues broke down by each segment of product or service compared with prior years.

Source of Revenue

2010

2009

2008

2007

Prosthetics

49%

49%

48%

53%

Orthotics

42%

40%

45%

36%

DME

1%

5%

1%

2%

Pedorthics

5%

4%

4%

6%

Other

3%

3%

2%

4%

These and a myriad other facts are gleaned from the recently concluded Operating Performance and Compensation Report survey of 135 member companies representing 1,050 full-time locations and 68 part-time locations.

Payment source is another benchmark to watch closely.

Taken together, Medicare and Medicaid still top the list of

46

O&P ALMANAC SEPTEMBER 2011

payers for the typical O&P patient-care facility. Here’s the trending on payer sources for the past three years.

Source of Payment

2010

2009

2008

Medicare

28%

31%

32%

Contracted Private Insurance

31%

30%

28%

Medicaid

16%

13%

12%

Non-contracted Private Insurance

4%

5%

5%

Hospitals & Nursing Homes

7%

5%

8%

Veterans Administration

3%

4%

4%

Workers Compensation

5%

5%

4%

Vocational Rehabilitation

1%

1%

1%

Self Pay

3%

4%

3%

Other

2%

2%

1%

Expenses, even more than revenue, can be the key to increased profitability. How expenses are controlled and managed can separate the profit leaders from the rest of the pack. Three major expense components—cost of goods sold, production and labor costs, and general administrative expenses—drive the profit picture, which looks like this over a four-year period.

All Respondents Expense

2010

2009

2008

2007

Sales/Billings

100%

100%

100%

100%

Cost of Goods

27.5%

28%

29%

28%

Production/Labor

17.8%

19%

21%

22%

General and Administrative

45.5%

42%

42%

38%

9.2%

11%

8%

10%

Operating Profit

Profit Leaders Only (Top 25% of Respondents) Expense

2010

2009

2008

2007

Sales/Billings

100%

100%

100%

100%

Cost of Goods

25%

26%

30%

28%

Production/Labor

14%

14%

15%

22%

General and Administrative

42%

42%

39%

30%

Operating Profit

19%

19%

18%

21%

Whether looking at data from the profit leaders or all respondents, one can’t help but be struck by the basic stability that the multi-year comparisons suggest, which only shows a modest swing in the bottom line for both.

In addition to the highlight information presented here on the operating performance data, the report also breaks down performance data by revenue size and the location by major metro, moderate-size city, or small city or town to get more relevant comparisons.

AOPA, in conjunction with Industry Insights, conducts the survey on operating performance and compensation every two years on odd-numbered years. In the evennumbered years, only the operating performance survey is conducted. The 140-page data report is priced at $185 for members (hard copy) or $95 for the electronic version.

Nonmembers may purchase the hard copy report at $325 or $185 for the electronic version. To order online, visit the AOPA Bookstore at www.AOPAnet.org.

Participants in the survey not only receive a free copy of the survey results but also a company performance report, which shows their company’s results in comparison to a peer group of companies with similar size and location.

Those responding also are eligible to reserve a time slot for a personal consultation from Industry Insight.

Information on the compensation part of the report will appear in a future issue of the O&P Almanac. a

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It is our privilege to work in an industry that gives selfsufficiency, mobility, and self confidence back to those with amputations and birth defects. For more information, call 800/775-5501 or visit www.artechlab-prosthetics.com.

SEPTEMBER 2011 O&P ALMANAC

47

n

AOPA Headlines

AOPA’s Third Coding and Billing Seminar October 24, 25 The third Advanced Coding and Billing Seminar of 2011 will be held October 24 and 25 at the Sheraton Inner Harbor in Baltimore. At this seminar, AOPA experts will provide the latest information to help O&P practitioners and officebilling staff learn how to code complex devices, including repairs and adjustments, through interactive discussions with AOPA experts, colleagues, and others.

Designed for practitioners and office staff alike, this advanced two-day event will feature break-out sessions tailored for both groups, to ensure material is appropriate to each.

Register for the seminar at https://aopa.wufoo.com/ forms/2011-mastering-medicare-baltimore/.

AOPA has reserved a block of rooms at the Sheraton Inner Harbor. Attendees must make all hotel reservations through the hotel by calling either 800/325-3535 or 410/962-8300. Mention the AOPA seminar to receive our group rate of $159 per night for single or double occupancy.

You will learn • medical policies to improve your reimbursement • tips for documenting your interaction with patients • best practices for a successful compliance plan • strategies for performing self-audits of charts and resolving problems.

Practitioners will cover • general coding principles • hands-on coding of specific devices • proper coding for repairs and adjustments • reimbursement for unlisted codes • mutually exclusive codes that should not be billed together.

Administrators will cover • updated Quality and Supplier Standards • strategies for handling appeals and denials • strategies for handling unique billing situations • documentation requirements • Medicare as secondary payer.

48

O&P ALMANAC SEPTEMBER 2011

Mastering Knee Orthoses Reimbursement Rules Obtaining Medicare reimbursement for knee orthoses can be a challenging and frustrating experience. Medicare drastically changed the rules that govern its coverage with the publication of the knee orthosis LCD and Policy Article in 2008. Join AOPA on September 14 for an AOPAversity Mastering Medicare Audio Conference that will focus on the nuances of the knee orthosis LCD and Policy Article, and help you understand the rules.

Attendees will learn • what documentation must exist to use the KX modifier on claims • ways to interpret the specific diagnosis codes required for coverage • when addition codes are appropriate • which codes require PDAC approval • lifetime restrictions for knee orthoses.

The cost of participating is always just $99 for AOPA members ($199 for nonmembers), and any number of employees may listen on a given line.

Listeners 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/2011-telephone-audio-conferences/.

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AOPA Headlines

AOPA to Host 2013 World Congress of Orthotics & Prosthetics AOPA is proud to announce that it will be hosting the World Congress of Orthotics & Prosthetics from Sept. 18-21, 2013, at the Gaylord Palm Resort in Orlando.

During meetings with various international groups at the 2008 Reha-Teknik show in Leipzig, Germany, AOPA expressed interest in hosting a World Congress of O&P in 2013. The response was so encouraging that AOPA proceeded to solidify plans for this globally significant event.

AOPA President Thomas V. DiBello, CO, FAAOP, says AOPA is looking forward to the event. “We are tremendously grateful for this opportunity and look forward to exceeding the expectations of the international partners whom we have invited to participate.

“AOPA offers advanced educational programs and the most extensive exhibit hall in North America at our annual National Assembly. With the addition of international partners for 2013, this guarantees that the 2013 World

Congress of Orthotics & Prosthetics will be the premier event of the decade for the O&P community.”

AOPA selected the Gaylord Palm Resort as the site for the 2013 World Congress for its location and size. It boasts approximately 400,000 square feet of educational and exhibit space and enjoys year-round warm weather. Orlando also is easily accessible to the international community.

For more information or to learn how to present at the 2013 World Congress of Orthotics & Prosthetics, contact Tina Moran at tmoran@AOPAnet.org or call 571/431-0810.

To learn how businesses can advertise or reserve space in the exhibit hall, contact Kelly O’Neill at koneill@AOPAnet.org or call 571/431-0852.

AOPA Supports Texas in Fight Against Medicaid Cuts AOPA has been alerted to another threat to cut Medicaid payments to O&P in Texas. The Texas state legislature is holding a special session to finish passing a state budget and is considering a 12.5 percent cut to O&P reimbursements within the state’s Medicaid budget throughout fiscal years 2011 and 2012.

AOPA has been supporting the Texas Orthotic and Prosthetic Association by crafting an ad for placement in newspapers and distributing a letter notifying O&P patient-care providers of possible Medicaid cuts and ways they can contact their state representatives to express their opposition.

50

O&P ALMANAC SEPTEMBER 2011

AOPA will continue to update members about potential O&P cuts in Texas. These threats to O&P Medicaid reimbursements spurred AOPA and the Amputee Coalition to launch a 30-second television public service announcement, available at www.LimbsAreEssential.org.

AOPA also created a “Take Action” advocacy page where interested parties may send letters urging their state and federal legislators to join the fight to protect citizens with mobility impairments. AOPA encourages members to take advantage of these resources.

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800.574.5426 800.574.5426 www.easyliner.com www.easyliner.com info@easyliner.com info@easyliner.com

n

AOPA Headlines

PAC Update The O&P PAC recently made contributions to Sen. Olympia Snowe (R-Maine) and would like to thank the following AOPA members for their recent contributions to and support of the O&P PAC*: Rick Allen, CO Robert Arbogast Thomas DiBello, CO, LO, FAAOP David Edwards, CPO, FAAOP David Falk, CPO Rick Fleetwood, MPA Sam E. Hamontree, CP Steve Hamontree, CPO James Kaiser, CP Jon Leimkuehler, CPO, FAAOP Stephen Rinko, BS, CPO Terry Lee Shaw, BOCPO, CPO, FAAOP Rick Stapleton, CPO H.E. Thranhardt, CPO(E) Loretta Thranhardt John Wall, PT, CPO, FAAOP Thomas H. Watson, CP

The O&P PAC advocates for legislative or political interests at the federal level that have an impact on the orthotic and prosthetic community. The O&P PAC achieves this by working closely with members of the House and Senate to educate them about O&P issues and helps elect individuals who support the O&P community. For example, AOPA contributed to Sen. Snowe, who co-sponsored the Insurance Fairness for Amputees Act (S.773) with Sen. Tom Harkin (D-Iowa), also a recipient of PAC support.

To participate in the O&P PAC, federal law mandates that you must first sign an authorization form. To obtain an authorization form, contact Devon Bernard at dbernard@AOPAnet.org.

*Due to publishing deadlines, this list was created on July 20, 2011, and includes only donations received between June 14, 2011, and July 20, 2011. Any donations received or made after July 20, 2011, will be published in an upcoming issue of O&P Almanac.

The American Orthotic & Prosthetic Association

PDAC Updates Verification Requirement for Cervical Orthoses The Pricing, Data Analysis, and Coding (PDAC) contractor announced that, as of August 31, all products classified under L0174 must undergo a coding review to be eligible for Medicare reimbursement.

Any existing products that have been classified

by PDAC under L0174 will be end dated as of August. These products must be resubmitted to PDAC for a new and independent review.

After August 31, Medicare will deny any orthosis billed using L0174 that PDAC has not reviewed and approved. a

proudly congratulates the following companies on their high achievements:

150th

Anniversary

100th

Anniversary

20th

Anniversary

www.AOPAnet.org

52

O&P ALMANAC SEPTEMBER 2011

For Better Outcomes, Reach for ShearBan®

e v i t a r e c l U e Pr ”Hot Spot” First Consultation Diagnoses* 10+ yr. history of recurring ulceration on right foot;Multiple ray amputations due to ulcers

After n a B r a e h S t n e m t a e r T Ulcer healed within 11 weeks of treatment with ShearBan; Patient remained ulcer-free over 2 years later.

Friction management technology proven to protect skin against friction blisters, calluses and foot ulcers.

Apply directly to footwear, insoles or orthotic devices – wherever skin is susceptible to damage from friction & shear. Choose from 8” x 12” sheets for custom trimming, or Pre-cut ShearBan Oval patches for easy peel & stick installation.

Visit shearban.com to download & watch the presentation, “Friction Management for Neuropathic Foot Problems” Upon completing a short online self-assessment, qualifying O&P practitioners, assistants and technicians will receive 2 PCE units. * Case study courtesy of Charles Kuffel CPO, FAAOP • Arise Orthotics and Prosthetics, Inc.

For more information about ShearBan®, contact Becker Orthopedic: Phone (248) 588-7480 • Toll free (800) 521-2192 To locate an O&P distributor worldwide, visit BeckerOrthopedic.com © 2010 ShearBan is manufactured in the USA by Tamarack Habilitation Technologies

Design is the difference

EXITS

On the following pages is an advance look at the companies that will be exhibiting at the 2011 AOPA National Assembly. You’ll find website information and booth numbers for each exhibitor—use this guide and floor plan to organize your visit to the exhibit hall. Better yet, check out their websites now and plan ahead!

+

Companies with are Supplier Plus Partners. Companies in BOLD are AOPA Members. Exhibitors as of 8/15/11.

AIN PLASTICS.................................... 513 www.ainplastics.com

+ ALLARD USA INC.......................... 713

www.allardusa.com

FE/ FS

120 118

FE/ FS

ADVANCED O&P SOLUTIONS LLC... 517 www.aopsolutions.com AETREX WORLDWIDE INC................ 413 www.foot.com

O&P ALMANAC SEPTEMBER 2011

329

429 528

325

24' Freedom Innovations Inc

223

20'

119

20'

318

20'

111 210 16' Vorum Research Corp 20'

101

205

311

SPS

Trulife

16'

ALPS 50'

40'

30' 20'

301

201 300

1

20'

413

306

2 6' Table

FHC/ FS

16'

Aetrex Worldwide Inc

24' 20'

16' Steeper USA 20'

20'

211 310

107

FE

419

Optec USA, Inc 30'

113 212

20'

16' DAW Industries Inc 20'

420

16'

215 314

20'

20'

319 418

217 316 20'

20'

425 524

323 422

30'

AOPA would like to extend a special thank you to our Diamond, Platinum, Gold and Silver Sponsors.

DIAMOND ❯

433 532 431 530

30'

Fillauer Inc 60'

ALTERNATIVE PROSTHETIC SERVICES INC.................................. 1225 www.alternativeprosthetics.com

Sponsors

16' Vibrant Commercial Technologies

ALPS................................................... 401 www.easyliner.com

Sponsors

54

104

VIDEO WALL

ADN - EXTREMITY GAMES....................1439 www.adnpage.org

16'

FE/ FS

114

SLO MACH

FE

18

327 426

102

ADAPTEC PROSTHETICS LLC..............16 www.adaptecprosthetics.com

19

HALF MO CARPE

FE

106

ACSYS ORTHOPEDIC......................... 111 www.acsysortho.com

FE/ FS

20

PPT

112

ACOR ORTHOPAEDIC INC................. 824 www.acor.com

20'

FE

SEATING FOR 150

STAGE

❯❯

2011 Exhibit Directory

FHC FS

FE

3 6' Table

4 6' Table

FE/ FS

401 5

FE

6

FHC7

FS

FE

SEPTEMBER 19-22, 2011 MIRAGE - EVENT CENTER LAS VEGAS, NV

2011 EXHIBIT DIRECTORY FLOOR PLAN SEPT. 19-22, 2011

EXITS FS

FHC 3'

EXIT EXIT

6'

CYBERFS SPACE

OT HINE

6'

EXITS

3'

FHC FE

17

20'

FE/ FS

16

FS

FE

14

6'

3'

•

THE MIRAGE RESORT & CASINO

32'

16'

531

733 832 20'

833 932 16'

FS

SNACK SHACK

6'

FHC

FS

1425 1427

FE

1431 1433

FE/ FS

827

60'

30'

16' AOPA 16'

20'

Comfort Products

820

821

925 1024 16' Arizona AFO 20'

921

719 818

20'

16'

517 24'

513

20'

30'

1029

30'

814

713 812

32'

16'

Otto Bock HealthCare

Ossur Americas Inc

1129 1228

50'

30'

1123 1222

1223 1322

1121

1221

1021

501

50'

1119 1218

16' Orthomerica Products Inc

20'

1115 1214

1013

701

801 9 6' Table

FS 8

FS FS

ENTRANCE

FHC

FE

Bulletin 10 Board 6' Table (4'x8')

FE/ FS

OrthoCare Innovations

POSTERS POSTERS POSTERS POSTERSFS

1217 1316

1213

20'

1211 1310

50'

12

FE

16' PEL Supply Co 20'

1101

FHC 13

FE/ FS

FE/ FS

1209 1308

ENDOLITE

1001

11

EDUCATIONAL SESSIONS EXHIBIT HALL C2

1215 1314

16'

16'

20'

1219 1318

FE/ FS

20'

1107

901

FE

20'

1302

1201 1300

EDUCATIONAL SESSIONS

POSTERS POSTERS POSTERS

50'

20'

30'

16'

FS

1440

1225 1324

30'

College Park Industries Inc 30'

EXHIBITOR SERVICE AREA

1424 1426 1428 1430 1432 1434 1436 1438

909 Ohio Willow Wood

30'

1229

1125 1224

30'

16'

1443

FOOD SERVICE AREA

Amfit 30'

Cascade Orthopedic Supply Inc

16' Euro International Inc

813

613

1131 1230

16'

1018

917 1016

20'

POSTERS POSTERS POSTERS POSTERS

Becker Orthopedic Otto Bock Healthcare

20'

Townsend

927 1026

20'

725 824 OPGA Supplier Partners

20'

20'

POSTERS POSTERS POSTERS POSTERS

20'

AOPA 40'

FE 6' Table 6' Table 6' Table 1435 1437 1439

16'

20'

931 1030

830

729 828

40'

20'

LAS VEGAS

EXITS FHC

OON ET

SureStep 20'

•

EXHIBIT HALL C1

FHC/ FS

FS

POSTERS POSTERS POSTERS

FE

FE/ FS

FE FHC

FS

FE

EDUCATION ENTRANCE FS

FHC

FE

special thanks

Sponsors PLATINUM ❯

GOLD ❯

SILVER ❯

SEPTEMBER 2011 O&P ALMANAC

55

2011 EXHIBIT DIRECTORY

AMERICAN ACADEMY OF ORTHOTISTS AND PROSTHETISTS....................... 1435 www.oandp.org

ANATOMICAL CONCEPTS INC........ 1125 www.anatomicalconceptsinc.com

BIONESS............................................. 517 www.bioness.com

AON O&P INSURANCE PROGRAM.....1129 www.insurance4op.com

BIOQUEST PROSTHETICS LLC........ 1428 www.bioquestpros.com BIOSCULPTOR CORP......................... 217 www.biosculptor.com

AOPA GOVERNMENT RELATIONS... 821 www.aopanet.org AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS, PROSTHETICS & PEDORTHICS (ABC)........................................12 www.abcop.org AMERICAN CENTRAL FABRICATION..................................... 420

APIS FOOTWEAR CO......................... 314 www.bignwideshoes.com ARGO MEDICAL TECHNOLOGIES....................................18 www.rewalk.com

AMERICAN ORTHOPEDICS MANUFACTURING CORP................. 1217 www.americanomc.com

AMERICAN PLASTICS.................................530 www.americanoandp.com

BMI INTERNATIONAL...................... 1318 www.orthobmi.com

BOARD OF CERTIFICATION/ ACCREDITATION, INT’L (BOC)...............5 www.bocusa.org ARIZONA AFO.................................... 921 www.arizonaafo.com

AMERICAN ORTHOTIC & PROSTHETIC ASSOCIATION (AOPA)....................... 827 www.aopanet.org

BLEDSOE BRACE SYSTEMS............ 1300 www.bledsoebrace.com

ARTECH LABORATORY INC............ 1431 www.artechlab-prosthetics.com ASPEN MEDICAL PRODUCTS......... 1214 www.aspenmp.com ATLANTA INTERNATIONAL P&O.... 1030 www.aibracing.com

+ AMERICAN PROSTHETIC

BORT-SWISS ORTHOPEDIC SUPPLY............................................. 1121 www.bort-swissortho.com BOSTON BRACE INTERNATIONAL INC...................... 1310 www.bostonbrace.com BRACEMASTERS INTERNATIONAL LLC...................... 1436 www.bracemasters.com

COMPONENTS......................................20 www.apcomponents.com

ATLANTIC RIM BRACE MFG CORP... 327 www.spinalbraces.com

AMFIT INC........................................ 1229 www.amfit.com

ATLAS INTERNATIONAL................. 1440 www.atlasortho.com

AMPUTEE COALITION..........................13 www.amputee-coalition.org

BADER PROSTHETICS & ORTHOTICS/ KINETIC RESEARCH INC.................... 814 www.kineticr.com

BRANIER CUSTOM MOLDED SHOES................................ 820 www.branier.com

BAUERFEIND USA.....................................1314 www.bauerfeindusa.com

BREG INC.......................................... 1219 www.breg.com

BECKER ORTHOPEDIC APPLIANCE CO................................... 813 www.beckerorthopedic.com

THE BREMER GROUP COMPANY..... 931 www.bremergroup.com

BIO-MECHANICAL COMPOSITES INC............................ 1302 www.phatbraces.com 56

O&P ALMANAC SEPTEMBER 2011

BRIGHTREE LLC................................. 517 www.brightree.com

2011 EXHIBIT DIRECTORY

BSN MEDICAL...................................................14 www.bsnmedical.com

CYBERTECH MEDICAL.................... 1201 www.cybertechmedical.com

BULLDOG TOOLS INC....................... 425 www.bulldogtools.com

DAW INDUSTRIES INC....................... 419 www.daw-usa.com DELCAM........................................... 1230 www.delcam-healthcare.com DEROYAL INDUSTRIES INC............. 1026 www.deroyal.com

CAILOR FLEMING INSURANCE...... 1024 www.cailorfleming.com CANADIAN ASSOCIATION OF PROSTHETICS & ORTHOTICS (CAPO)........4 www.pando.ca CASCADE DAFO INC......................... 927 www.cascadedafo.com

DJO..................................................... 210 www.djoglobal.com DME MEDICARE ADMINISTRATIVE CONTRACTORS..........................................1211 www.ncsmedicare.com DR. COMFORT.................................... 725 www.DrComfort.com

+ CASCADE ORTHOPEDIC

E TH CE A PLTO BE!

+ FILLAUER LLC - A FILLAUER COMPANY.......................................... 223 www.fillauercompanies.com FLORIDA BRACE CORP...................... 925 www.flabrace.com

+ FLO-TECH® ORTHOTIC & PROSTHETIC SYSTEMS INC............ 1308 www.1800flo-tech.com FREEDOM INNOVATIONS LLC.......... 119 www.freedom-innovations.com FREEDOM MACHINE TOOL...................1425 www.Freedomcnc.com FRIDDLE’S ORTHOPEDIC APPLIANCES INC............................... 517 www.friddles.com FUTURA INTERNATIONAL INC......... 832 www.futuraintl.com

SUPPLY INC...................................... 1021 www.cascade-usa.com

DREW SHOE CORP.......................................418 www.drewshoe.com

+ CENTER FOR ORTHOTICS DESIGN -

+ EMOTIS – A FILLAUER COMPANY... 223

www.e-motis.com

GRACE PROSTHETIC FABRICATION INC............................. 422 www.gpfinc.com

+ ENDOLITE.................................... 1001 www.endolite.com

HOPE ORTHOPEDIC.......................... 319 www.hopeortho.com

ESP LLC.........................................................1224 www.wearesp.com

+ HOSMER DORRANCE CORP. -

A FILLAUER COMPANY..................... 223 www.centerfororthtoicsdesign.com

+ CENTRI – A FILLAUER COMPANY... 223 www.centri.se CIR SYSTEMS/GAITRITE.................... 433 www.gaitrite.com COLLEGE PARK INDUSTRIES INC..... 901 www.college-park.com COMFORT PRODUCTS INC............... 719 www.comfortoandp.com COMFORT SLEEVES......................... 1438 www.kneedabrace.com

EURO INTERNATIONAL INC.............. 909 www.eurointl.com FABRICA MACHINALE....................... 113 www.fabricamachinale.it FABTECH SYSTEMS LLC.................... 205 www.fabtechsystems.com

A FILLAUER COMPANY..................... 223 www.hosmer.com HUTNICK REHAB SUPPORT SERVICES INC.................................. 1213 www.thehutnickcenter.com INNOVATIVE NEUROTRONICS INC..... 212 www.walkaide.com JUZO..............................................................1426 www.juzousa.com

COMPLETE BUSINESS SOLUTIONS........................................ 833 www.oandp-solutions.com

KISS TECHNOLOGIES LLC................. 818 www.kiss-suspension.com

COYOTE DESIGN................................ 517 www.coyotedesign.com

KLM LABS.....................................................1018 www.klmlabs.com

CSUS LLC............................................ 106 www.csusmed.com

+ FILLAUER COMPANIES INC.......... 223 www.fillauercompanies.com

KNIT-RITE INC.................................... 517 www.knitrite.com SEPTEMBER 2011 O&P ALMANAC

57

2011 EXHIBIT DIRECTORY

OPTEC USA INC................................. 311 www.optecusa.com

LADON SYSTEMS OF LAWTON BRACE & LIMB CO INC..................... 1432 www.ladonsys.com

ORFIT INDUSTRIES AMERICA.......... 318 www.orfit.com

LANGER BIOMECHANICS INC.................112 www.langerbiomechanics.com

ORTEN................................................ 830 www.orten.fr

LEVY & RAPPEL............................... 1322 www.LevyandRappel.com

ORTHOCARE INNOVATIONS.......... 1107 www.orthocareinnovations.com

LIBERATING TECHNOLOGIES INC.... 517 www.liberatingtechnologies.com LIFE-LIKE LABORATORY LLC............ 932 www.lifelikelab.com

NATIONAL COMMISSION ON O&P EDUCATION (NCOPE)..................................11 www.ncope.org

LINKIA - A HANGER ORTHOPEDIC GROUP COMPANY............................. 323 www.linkia.com

NEARLY ME TECHNOLOGIES INC..... 528 www.nearlyme.org

MARSHFIELD CLINIC....................... 1443 www.marshfieldclinic.org

NEW OPTIONS SPORTS.................. 1123 www.newoptionssports.com

MAXIMUM MOBILITY....................... 118

NEW STEP ORTHOTIC LAB INC...... 1434 www.newsteporthotics.com

M. J. MARKELL SHOE CO. INC........... 104 www.markellshoe.com MD ORTHOPAEDICS......................... 431 www.mdorthopaedics.com MED SPEC (ASO).............................. 1119 www.medspec.com

MEDI USA........................................... 211 www.mediusa.com

O&P BUSINESS NEWS/SLACK INC......19 www.oandpbiznews.com

MICA CORP........................................ 517 www.micacorp.com

O&P EDGE/WESTERN MEDIA LLC.... 114 www.oandp.com/edge

+ MOTION CONTROL INC -

O&P ENTERPRISES INC..........................8 www.oandpenterprises.com OANDP.COM.................................... 1115 www.oandp.com OANDPDIRECT.COM......................... 517 www.oandpdirect.com OPPO MEDICAL INC.......................... 828 www.oppomedical.com

58

O&P ALMANAC SEPTEMBER 2011

ORTHOPAEDIE + REHA-TECHNIK (O+R 2012)............................................................3 www.ot-leipzig.de OPAF & THE FIRST CLINICS...................9 www.opfund.org

OF AMERICA (OPGA)........................ 517 www.opga.com

NORTH SEA PLASTICS................................120 www.northseaplastics.com

MEDFORCE TECHNOLOGIES...................426

NATIONAL ASSN FOR THE ADVANCEMENT OF O&P (NAAOP).........................1 www.naaop.org

ORTHOMERICA PRODUCTS INC.... 1013 www.orthomerica.com

+ ORTHOTIC & PROSTHETIC GROUP NORA SYSTEMS GMBH, SHOE COMPONENTS................................. 1223 www.nora-shoe.com

O&P 1 CENTRAL FABRICATION........ 517 www.oandp1.com

A FILLAUER COMPANY..................... 223 www.UtahArm.com

ORTHOFEET..................................... 1228 www.orthofeet.com

ÖSSUR AMERICAS INC...................... 701 www.ossur.com

+ OTS CORP. A FILLAUER COMPANY..................... 223 www.ots-corp.com

OTTO BOCK HEALTHCARE................ 501 www.ottobockus.com OTTO BOCK HEALTHCARE - PLANNING & EQUIPPING DIVISION.................... 613 www.ottobock.com

SLIM Designed to fit a wider selection of shoes.

call our custom-fab department for more info

877-737-8444 visit our web site for a video demonstration orthomerica.com /spectrum

Visit us at AOPA! Booth 1013

©2011 Orthomerica Products, Inc. All Rights Reserved.

EASILY HEAT ADJUSTED

2011 EXHIBIT DIRECTORY

E TH CE A PLTO BE!

PEL SUPPLY CO................................ 1101 www.pelsupply.com

RX TEXTILES INC ............................. 1218 www.rxtextiles.com

THE BARR FOUNDATION.......................1437 www.ti-med.com

PHYSIOTHERAPY ASSOCIATES...... 1427 www.physiocorp.com

SILIPOS INC...................................... 1324 www.silipos.com

TiMed................................................ 1430 www.medgroup.com

+ PILGRIM SHOES DBA HOOPOE

SOLETECH INC................................... 729 www.soletech.com

THE MED GROUP............................. 1215 www.medgroup.com

FOOTWEAR........................................ 325 www.pilgramshoes.com

TOUCH BIONICS................................ 917 www.touchbionics.com

PINE TREE ORTHOPEDIC LAB INC. 1433 www.pinetreeorthopedic.com PMT CORPORATION.................................1222 www.pmtcorp.com

+ TOWNSEND DESIGN................... 1029 www.townsenddesign.com + SPINAL TECHNOLOGY INC.......... 524 www.spinaltech.com

+ PROFESSIONAL TECHNOLOGIES INTERNATIONAL INC........................ 733 www.protech-intl.com

SPS...................................................... 301 www.spsco.com

PROSTHETIC DESIGN INC................. 215 www.prostheticdesign.com

SPS - NATIONAL LABS...................... 306 www.spsnatllabs.com

PROSTHETICS LABORATORIES INC.................................................... 1424 www.optable.com

ST&G USA CORP................................ 201 www.stngco.com

PROTEOR............................................ 310 www.proteor.com PROVEL INC..................................... 1316 www.provel.us QUALITY OUTCOMES........................ 517 www.qualityoutcomes.org

STEEPERUSA...................................... 101 www.rslsteeper.com SURESTEP.......................................... 531 www.surestep.net SYMMETRY PROSTHETICS............... 429 www.symmetryprosthetics.com

+ TAMARACK HABILITATION RENIA GMBH. CHEMISCHE FABRIK.............................................. 1221 www.renia.com RESTORATIVE CARE OF AMERICA INC................................... 1131 www.rcai.com ROYAL KNIT INC...................................17 www.royalknit.com

TECHNOLOGIES INC.......................... 812 www.tamarackhti.com TECHMED 3D INC...................................7 www.Techmed3d.com TENSEGRITY PROSTHETICS..................6 www.tensegrityprosthetics.com’

+ TRULIFE......................................... 300 www.trulife.com USISPO AND ISPO INTERNATIONAL........2 www.usispo.org VERLAG ORTHOPÄDIE-TECHNIK.................3 www.ot-forum.de/index_eng.html VGM FINANCIAL................................ 517 www.vgmfs.com VGM FORBIN...................................... 517 www.forbin.com VGM INSURANCE.............................. 517 www.vgminsurance.com VIBRANT COMMERCIAL TECHNOLOGIES INC.......................... 329 www.vibrantcommerce.com VORUM RESEARCH CORPORATION................................... 107 www.vorum.com VQ ORTHOCARE........................................1209 www.vqorthocare.com

TEXAS ASSISTIVE DEVICES LLC....... 532 www.n-abler.org

+ WILLOWWOOD............................. 801 www.willowwoodco.com

FOR MORE INFO

AOPAnet.org 60

O&P ALMANAC SEPTEMBER 2011

❯❯

I N N OVAT E

responsive mobility Bringing College Park technology into the K2 market, the balanced design and natural motion of the Celsus provide smooth, stable transitions. It’s the perfect lightweight design to promote confidence and security for your lower impact patients.

300

MORE MOTION = BETTER FUNCTION

6.4

CENTIMETERS

LOW PROFILE

SANDAL TOE FEATURE

[ SHOWN ACTUAL SIZE 26CM ]

SMOOTH TRANSITIONS

individualized solutions. thousands of possibilities.

800.728.7950

I

www.college-park.com

VIS AT BOOIT US TH 901

AOPA 2 0

11

NATIONA L AS to see o SEMBLY K2 innour latest vation

n

AOPA Applications Active Life 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 statelicensed 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

124 Alvarado Drive SE Albuquerque, NM 87108 505/266-1700 Fax: 505/266-1705 Category: Patient Care Facility Spencer Doty, CPO

Align Orthotics & Prosthetics

Complete Business Solutions

Georgia Orthotics & Prosthetics

26 S. Martin Road Amesbury, MA 01913 978/835-3084 Category: Supplier Level 1 Erin Cammaratta

135 N. Crest Boulevard Macon, GA 31210 478/745-8623 Fax: 478/ 745-9859 Category: Patient Care Facility Mike Wilder, CPO

Dynamic Orthotics & Prosthetics

45040 Albion Street Mendocino, CA 95460 707/937-3003 Fax: 707/937-6267 Category: Patient Care Facility Jessica Grinberg, CPO

1830 W. Olympic Boulevard, Ste. 123 Los Angeles, CA 90006 213/383-9212 Fax: 213/383-6421 Category: Patient Care Facility Peter Sean, CPO

Argo Medical Technologies Ltd

First Step Prosthetics LLC

P.O. Box 161 Kochav Yokneam Bldg.

Yokneam, 20692 Israel 949/293-6177 Fax: 949/502-0778 Category: Supplier Level 1 Ami Kraft

1136 US 31 W. Bypass Bowling Green, KY 42101 270/904-6130 Fax: 270/904-6132 Category: Patient Care Facility Jeremy Harris, BOCP

Clark’s Orthopedic 816 9th Street S. Great Falls, MT 59405 406/452-8428 Fax: 406/452-8741 Category: Patient Care Facility Richard Clark, CPO

First Step Prosthetics LLC 1406 East Broadway, Ste. D Gallatin, TN 37066 615/461-8557 Fax: 615/461-8581 Category: Affiliate Parent Company: First Step Prosthetics LLC, Bowling Green, KY

O&P Almanac Online

Reading the O&P Almanac has never been easier!

• Access advertiser Websites by simply clicking on the hotlinks • Access content with the click of a mouse or the touch of a smart phone • Easily email your favorite articles to colleagues • Save articles as PDFs! Go to www.AOPAnet.org, click on ‘O&P Almanac Online’ today!

For more information, contact Steven Rybicki at 571/431-0835 or srybicki@AOPAnet.org.

For advertising information, contact Dean Mather at 856/768-9360 or dmather@mrvica.com.

62

O&P ALMANAC SEPTEMBER 2011

Kormylo Orthopedic Inc. 175 Benjamin Lane Boise, ID 83704 208/377-4024 Fax: 208/375-8522 Category: Patient Care Facility Mark Kormylo, CPO

Maximum Mobility Inc. 69 Winfield Street San Francisco, CA 94110 415/642-0242 Fax: 415/641-0242 Category: Supplier Level 1 Peter Herzstein

Precision Orthotics & Prosthetics 500 S. Rancho Drive, Ste. 8B Las Vegas, NV 89106 702/293-5502 Fax: 702/259-7671 Category: Patient Care Facility Jimmy Colson, CO

n

Marketplace

APIS FOOTWEAR COMPANY Apis is devoted to offering our customers high-quality, genuine leather, diabetic/ therapeutic footwear off-the-shelf or custom-made, comfortable, accommodating orthotics made for your patient using top-quality materials. Value-added services include: guaranteed fit for custommade shoes, shoe modification services, free foam boxes, free samples, a no-hassle return policy, large inventory, and quick turnaround.

Together with your support and our continuous efforts, Apis Footwear Company is striving to become the one-stop shop for all your therapeutic footwear needs.

Please call our friendly customer service at 888/937-2747 or visit www. bignwideshoes.com.

INTRODUCING THE NEW CELSUS K2 FOOT FROM COLLEGE PARK Brand new for 2011!

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 lowerimpact patients.

Key features include: • Smooth proportional response with integrated spring technology (iST) • Low-profile design • High weight limit of up to 136 kg (300 lbs) • Maintenance-free design 64

O&P ALMANAC SEPTEMBER 2011

• Sandal toe feature • Same-day, custom built-to-order.

For more information, call 800/7287950 or visit www.college-park.com.

EURO INTERNATIONAL’S EURONET Euro International debuts another add-on to its already extensive line of exciting materials: the EURONET. This 100-percent PVC material with dynamic features is perfect for your custom work, and can be used as top layers and bottom layers for insoles, braces, prosthetic devices or wheel chair coverings. EURONET has a variety of extraordinary characteristics such as stretchability, washability, and abrasion resistance besides being antibacterial, antifungal, easily bondable, breathable, and moisture resistant—attributes all combined in one material. EURONET black/silver will give your custom insole or brace the sleek carbon-technology appearance you are looking for. But for other projects and purposes you may also select from custom color sheets or original rolls.

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

SEE DEMONSTRATIONS OF THE BT-4 OVEN AT AOPA BOOTH 223 The BT-4 oven from OTS Corp. is the latest addition to the PDQ Infrared Oven equipment line. The eight 1000 watt emitters along with the dual electric fans allow bubble forming plastics to be heated evenly and efficiently. The BT-4 Infrared Oven is big enough to heat most of your KAFO sheet plastic and has enough drop for even the biggest check socket, but it only takes up a corner space in your lab.

• Eight 1,000 watt emitters; four on top and four on bottom • Programmable digital temperature controller • Dual electric fans for air circulation • Four interior lights and large viewing window • Access point for vacuum line • Tray with fitted Teflon® cover for sheet plastic • 18 in clearance for bubble forming.

Save up to $400 toward freight charges domestically on any PDQ oven purchased between Sept. 19 and Dec. 31, 2011.

Contact OTS Corp. at 800/221-4769 or www.ots-corp.com.

ELEGANT SCIENCE FROM HOPE ORTHOPEDIC

The Ninja is a spinal system built upon a comfortable yet supportive belt with a 6X mechanical advantage, single pull strap. One easy pull securely conforms the Ninja to the patient’s torso.

Best of all, the Ninja is a progressive orthosis—as your patient heals, the support and control can be progressively diminished.

The Ninja is just one in a robust line of spinal, hip, and cervical orthotics from Hope Orthopedic. Hope delivers the form that fits with the results you demand.

For more information, contact us at 800/613-8852 or visit www.hopeortho.com.

KISS TRAINERS––DYNAMIC FLEXIBLE KEEL STUBBIE FEET BOOTH #818 KISS Trainers combine phenomenal balance and ease of use. Patients feel stable while confidence training using these flexible keel “stubbie” feet.

Constructed of highly durable, flexible material that dynamically stores energy, these feet are of professional quality and ready to use. Bilateral above-knee amputees especially save time and energy while training, and all patients can use KISS Trainers for in-home ambulation. KISS Trainers: Part #: CMP27/A. For more information, call 410/663-KISS (5477) or visit www.kisssuspension.com.

MOTION CONTROL—MOTION FOOT The Motion Foot is a unique hydraulic foot and ankle system with a natural-range of ankle movement. Fully adjustable for nearly all levels of activity, the manual lock prevents unwanted movement in situations like driving, climbing ladders, or putting on shoes.

Features include • Independent plantarflexion and dorsiflexion hydraulic resistance adjustments to match patient preferences • Adjustable toe stiffness • Ankle locks at neutral for convenient driving and dressing • Adjustable toe lift (dorsiflexion stop) for those who want an easier time going up hills • Sizes 22-30 cm; weight limit of 220 lbs (100 kg) • Two-year warranty.

For more information, contact Motion Control at 888/696-2767 or visit www.utaharm.com.

VERTAMAX- PDAC APPROVED L0627 VertaMax is designed and manufactured utilizing dense elastic material that 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 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 www.optecusa.com. Don’t forget to visit us at AOPA Booth 311!

INTRODUCING OPTEC USA’S NEWEST PRODUCT 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.

Find out more about this and our many other products online at www.optecusa.com, or call us today at 888/982-8181! Don’t forget to visit us at the AOPA Booth 311!

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Marketplace

INNOVATIVE STRETCHABLE MARY JANES Orthofeet is introducing unique stretchable Mary Jane shoes, which integrate chic design with stretchy fit and exceptional comfort features: • Heel-strap allows the adjustment of the grip around the heel for a precise, comfortable fit.

• Two-way padded strap enables fastening on either side of the shoe, and an easy adjustment of the length of the strap.

• Stretchable design offers customized fit at the forefoot, and pressure relieve for bunions and hammer-toes.

• Seamless lining provides exceptional protection and ultimate comfort.

Contact Orthofeet Inc. by visiting www.orthofeet.com or calling 800/524-2845.

innovative orthotic solution for the management this condition.

Features of the Combo: • Uprights easily shaped and adjusted to optimum height for patient • Modular components accommodate variances in thigh and calf circumferences • Low profile • Lightweight • Easy to don and doff • Easily removed when wearer is relaxing (watching TV, etc.)

• Sold individually.

For more information on the Combo, and other quality products from Allard USA, call your friendly PEL Customer Service Rep at 800/3211264, fax your order to 800/222-6176, email customerservice@pelsupply.com, or order online at www.pelsupply.com.

NEW WATERPROOF PROSTHESES FROM OTTO BOCK

FABRICATE A CUSTOM KAFO IN LESS THAN AN HOUR! PEL Supply offers a low profile, functional orthotic solution for management of genu-recurvatum combined with footdrop.

ToeOFF®, from Allard USA, has proven to be an effective gait rehabilitation orthosis for the management of footdrop and ankle instability. Too often, however, footdrop is accompanied by genurecurvatum, or chronic knee instability.

The new Combo, available from PEL Supply, is a lightweight, removable knee brace attachment for ToeOFF® (or BlueRocker™) that creates an 66

O&P ALMANAC SEPTEMBER 2011

Just in time for the beach or pool, Otto Bock launches a line of waterproof components! Designed specifically for use in the water, the Aqualine® waterproof prostheses provides 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.

To learn more, call your local sales representative at 800/328-4058.

ÖSSUR’S FLEX-FOOT® BALANCE™ NOW AVAILABLE FOR LOW ACTIVITY PATIENTS UP TO 300 LBS Booth 701.

Flex-Foot Balance by Össur, which provides the optimum balance of light weight and stability, is now available for K2 patients weighing up to 300 lbs.

Designed especially for household or low-impact users, Flex-Foot Balance features an integrated multi-axial ankle for a comfortable, smooth rollover, and increased confidence. Now, more low-activity patients can benefit from the ideal balance of light weight and stability offered by Flex-Foot Balance!

For more information, visit our website at www.ossur.com or call 800/233-6263. *Please note product shown without its accompanying foot cover.

On rare occasions, a product emerges which redefines its category.

This is such an occasion.

DYCOR ' S Dynamically Alignable ENERGY STORING LISFRANC/CHOPART LCD PROSTHETIC FOOT is the product .

In 2009, Dycor redefined energy storing Syme feet by combining advanced carbon fiber-epoxy composite technology and diffused leaf spring technology* with ADL biomechanical engineering. By combining this same light weight, functional and cost effective** technology with a removable adjustable adaptor, Dycor has added a dynamic dimension to Lisfranc/Chopart prosthetic restoration.

LCD shown without carbon fiber attachment straps

Dycor’s adjustable Lisfranc/Chopart LCD foot (L-5981) is designed for assisted and unassisted independent ADL (K2-3).

It is subject to the same keel deflection chart as our popular FDS energy storing feet and is available in sizes 22-30 cm.

The strength and number of diffused carbon fiber leaf springs depends on the size and weight of your client, and range from 6-20 individual springs, each spring supporting between 17-30 pounds. With the adjustable adaptor removed for foot and socket integration, floor clearance is ⁵⁄₁₆˝ including foot shell, minimizing height discrepancy.***

®

DYCOR …

Renewing Independent Lifestyles

Anatomical support of the foot with minimal floor clearance

For additional specification and purchasing information, visit our web site at www.dycormfg.com or call toll-free 800 -794-6099.

Available through Dycor, SPS, Pel Supply Co. & OrtoPed

Take this occasion to give your clients the care and products they deserve. Specify

DYCOR'S LCD Alignable Lisfranc/Chopart Prosthetic Feet as the best solution for their individual and unique restoration and rehabilitation. *Patented **$480.00 for the light and medium duty, $674.00 for the heavy duty (includes adaptor mounting, keel and integrated foot shell) ***Contact Dycor's tech support prior to casting.

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Marketplace

THE NEW RE-FLEX SHOCK™ BY ÖSSUR: WORK HARD. PLAY HARD. Booth 701. Össur announces the new Re-Flex Shock, the ultimate in vertical shock absorption and dynamic energy return for active patients.

With a design originating from Össur’s Re-Flex VSP, the original and unparalleled vertical shock foot, Re-Flex Shock offers all the benefits of its predecessor, and much more! Featuring increased energy return, improved durability, easier fitting and finishing, and the EVO feature for smoother walking, this foot takes vertical shock feet to the next level and is the ideal solution for amputees who demand the ultimate in performance and comfort.

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

LIMBGUARD: POST-OP RIGID DRESSING Developed by a team of experienced prosthetists, the Limbguard™ is an alternative, post-operative, rigid dressing for trans-tibial amputation. The idea was to create a device that would allow practitioners to administer immediate and effective treatment of post-operative amputees. Volume fluctuation is accommodated via the floating pretibial section and our proprietary distal Gills™, which help provide the perfect fit.

Limbguard is available from Friddle’s Orthopedic Appliances.

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O&P ALMANAC SEPTEMBER 2011

Please visit www.friddles.com or call 800/528-9339 for information regarding ordering and pricing. For additional information, visit www.limbguard. info. And see us at the AOPA National Assembly: Booths 5171 E1 and E2.

SPS INTRODUCES BIONICARE® KNEE SYSTEM TO O&P BioniCare is a patented system with FDA approval (2003) as an adjunctive therapy for the treatment of pain, symptoms and overall improvement of the osteoarthritic knee.

The BioniCare system, distributed solely by SPS, delivers an imperceptible pulsed electrical signal that was designed to supplement the body’s endogenous electrical impulses required to maintain joint health.

Published clinical studies demonstrate patients using the BioniCare system are two-thirds less likely to have total knee replacement surgery. Clinical studies show that most patients will see significant improvement after 750 hours of use, with the greatest improvements achieved after 2,250 hours. BioniCare’s clinically proven system is delivered through advanced technology electrodes that avoid the need for conductive gel. It is available with the OActive® brace to reduce pain in the knee by offloading pressure on the knee and a Night-Wrap System to facilitate nocturnal treatment.

Contact SPS Customer Service at 800/767-7776, x3, for additional information.

FUSION FOOT WITH TORSION: A NEW TWIST ON FUNCTION WITHOUT COMPROMISE Amputees continually strive for more natural movement in their prostheses. A Torsion Receiver for the Fusion™ Foot now exists that can help users attain this goal. The Torsion Receiver provides a sense of natural movement.

The receiver is designed to provide 24 degrees rotation internally and 24 degrees rotation externally. This rotation lets wearers turn in or out as they do on their sound side. The patient weight limit for a Fusion Foot with a Torsion Receiver is 300 lbs.

For more information, contact WillowWood at 800/848-4930 or www.willowwoodco.com. Visit us at AOPA Booth 801 for a product demonstration! a

DAW’s SLK beats all other MPKs for most K 3’s. in -w nd n i w ua t

A yo ien for r pat you

OPEN FORUM WELCOME... Call Stuart at 1-877-242-2423

NO OTHER

Microprocessor Knee

can match the SLK

www.daw-usa.com

Copyright © 2011 DAW Industries, San Diego, CA 92121. All rights reserved.

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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

Southeast Certified Prosthetist or Certified Prosthetist/Orthotist (licensed or eligible) Memphis Ready for a change! Memphis is the second-largest city in Tennessee boasting blues, gospel, and rock ‘n’ roll music roots; the Memphis Zoo; Carnival Memphis; and arts festivals to mention a few. While considered the South, Memphis has four distinct seasons and sits on the eastern bank of the Mississippi River. It offers several professional sports teams; and, who could forget famous Beale Street! We offer a very competitive salary and benefit package accompanied by relocation assistance and sign-on bonus plus much more! If, interested, please contact, in confidence:

- 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.

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O&P ALMANAC SEPTEMBER 2011

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

Certified Prosthetist/Orthotist, Certified Orthotist Nashville Nashville is the largest city in Tennessee featuring country and bluegrass music roots, Tennessee Titans, Nashville Predators, and multiple parks and festivals. Now is your chance to work with an energetic practice, with multiple locations in Middle Tennessee. We are seeking five years’ experience, self-motivated practitioners, and offer a competitive salary and benefit package. If interested, send resume to:

Restorative Health Services Inc. Phone: 615/890-2160 Fax: 615/890-2361 Email: lmrrambo@gmail.com

Southeast Certified Orthotist, Certified Prosthetist/Orthotist South Carolina Seeking experienced CO/CPO for a privately owned, multilocation company with a reputation for excellent patient care.

Candidates must be self-motivated, team players and have a passion for providing quality patient care. We are centrally located in scenic upstate South Carolina, which offers convenient access to mountains, beautiful lakes, and coastal regions. Competitive salary and benefits package offered.

Send resumes to:

Certified Prosthetist or Certified Prosthetist/Orthotist (ABC/BOC licensed) Florida Start immediately! Privately owned, established O&P office in south Florida is seeking a CP or CPO. Florida licensure REQUIRED. ABC/BOC prosthetist who is a board-eligible orthotist also accepted.

Just 20 minutes from the beach or Ft. Lauderdale, this is the place to be! We offer a competitive salary and benefits package. This position will go fast, so apply today!

Email: cfpljob@hotmail.com

Fax: 864/855-9331 Email: scot@advancedpro.biz

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Jobs Pacific

Certified Orthotist Northern California Do you dream of earning six figures? Receiving a significant sign-on bonus and to work for the oldest and one of the most respected orthotic and prosthetic patient-care companies in the world? Are you looking for security? In addition to the above, we offer competitive benefits, worldclass education fair, latest technology, and a family of over 1,000 practitioners in addition to the support of HR, sales/ marketing, accounting, etc. Our core values are • Integrity • Clinical and operational excellence • Unsurpassed customer satisfaction • Flexible and entrepreneurial operations • Creativity and innovation • Shared success.

If you have the skills, drive and ambition…let’s talk!

Contact, in confidence:

Inter-Mountain Certified Orthotist, Certified Prosthetist (licensed or eligible) Houston Energy capital of the world; voted first in Texas and third in the United States for “Best Places for Business and Careers”; known for the youngest population in the nation; the Houston Livestock Show and Rodeo; ZZ Top, Lyle Lovett, Clint Black, Hilary Duff, Blue October; NASA’s Lyndon B. Johnson Space Center; many parks and outdoor venues!

Considered by many to be one of the premier practices in the country, this position will challenge the successful applicant with a broad exposure to a diverse patient population. 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

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

Northeast

North Central

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, O&P Almanac 330 John Carlyle St., Ste 200 Alexandria, VA 22314 Fax: 571/431-8099

Entry-Level Opportunities and Experienced Technicians Chicago Area Advanced O&P Solutions Central Fabrication is looking for technicians to strengthen its TEAM! We are accepting applications for entry-level positions all the way to highly qualified experienced technicians. All applications will be held confidentially. We offer competitive compensation as well as a very generous benefits package. Advanced O&P Solutions is a nationally respected Cfab with more than 40 technicians on staff. We are located just outside of Chicago.

Please send resumes to:

Email: mangelico@aopsolutions.com

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O&P ALMANAC SEPTEMBER 2011

North Central

Mid-Atlantic

Certified Prosthetist

Certified Prosthetist/Orthotist

Upper-Peninsula/Marquette-area, Michigan Wright & Filippis, a leader in the rehabilitative health-care field, currently has an opening in the Upper Peninsula/ Marquette area of Michigan for a dedicated, serviceoriented prosthetist. The ideal candidate will have a high school diploma, completion of residency program, or an equivalent combination of education and experience with certification (ABC or BOC), or equivalent combination of education and experience depending on level of education.

We also offer a competitive benefits package.

To learn more about a career with Wright & Filippis, please visit our website at:

Philadelphia Culture, arts, history, and architecture…not to mention cuisine! Philly has it all! It is the country’s fifth-largest city comprised of art museums and galleries, serious shopping, all four major sports, University of Pennsylvania. And, can’t forget the Philly cheesesteak! 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. If interested, please contact, in confidence:

www.firsttoserve.com/careers/

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

AVAILABLE POSITIONS Orthotist

Why do I work for Hanger?

“

I like working for a company that cares for its employees as much as they care for their patients. That’s why I’ve been with Hanger for the past 28 years.

When Hurricane Katrina hit my hometown of New Orleans, Hanger was there for me. They gave me as much time as I needed—with pay—and helped me relocate to Atlanta.

By working at the largest prosthetic and orthotic company in the nation, I have more than just career opportunities.

I have an employer that treats me like family.

”

Tony Thaxton Jr., CPO, LPO, Certified Practitioner, Orthotist-Prosthetist

To apply for any of these positions, visit www.hanger.com/careers Hanger Orthopedic Group, Inc. is committed to providing equal employment to all qualified individuals. All conditions of employment are administered without discrimination due to race, color, religion, national origin, sex, age, disability, veteran status, citizenship, or any

other basis prohibited by federal, state or local law. Residency Program or Certificate Primary Education Program Info, contact: Robert S. Lin, CPO/Dir. of Academic Programs. Hanger P&O/ Newington O&P Systems, Ph. 860.667.5304; Fax 860.667.1719

Springdale, AR Tucson, AZ Frisco, CO Belleville, IL Urbana, IL Indianapolis, IN Wichita, KS

Columbia, MO Tulsa, OK Philadelphia, PA York, PA Spartanburg, SC Houston, TX Parkersburg, WV

Prosthetist American Canyon / Fairfield, CA Port St. Lucie / Melbourne, FL Jackson, MS

Elmira, NY Oneonta, NY Pittsburgh, PA Austin, TX San Antonio, TX

Prosthetist/Orthotist Springdale, AR Tucson, AZ American Canyon / Fairfield, CA Long Beach, CA Hollywood, FL Orlando, FL Naples, FL West Palm Beach, FL Griffin, GA Indianapolis, IN Baltimore, MD

Denver, CO Belleville, IL Columbia, MO

Bangor, ME Olivette, MO Meridian, MS Brooklyn, NY Elmira, NY Oneonta, NY Tulsa, OK Bend, OR Portland, OR Salem, OR Houston, TX San Antonio, TX

Certified Pedorthist

Roseburg, OR Pittsburgh, PA Tacoma / Renton, WA

CPO / Practice Manager

Hollywood, FL Naples, FL West Palm Beach, FL

Indianapolis, IN Bend, OR

SEPTEMBER 2011 O&P ALMANAC

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Calendar

2011 ■■

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

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 SEPTEMBER 2011

■■ SEPTEMBER 8-9 The Northern Plains Chapter AAOP Annual Meeting. Vadnais Heights, MN. Jimmy’s Conference & Catering Center. For more information, visit www.oandp. org/membership/chapters/ northern_plains/.

■■ SEPTEMBER 12-13 Allard USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

Norfolk, VA. Two courses: Concepts in Applied Biomechanics; Transferring CAB Principles into Customized Orthotic Solutions. Approved for 18 CEUs. Contact 888/678-6548 or email info@allardusa.com.

■■ SEPTEMBER 14 AOPA Audio Conference: “Don’t Run Afoul of the KO Rules.” To register, contact Stephen Custer at 571/4310876 or scuster@AOPAnet.org.

■■ SEPTEMBER 14 Ultraflex: Pediatric Spasticity Continuing Education Course, via WebEx, 5–6 pm 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. For more information, call 800/2206670 or register at www. ultraflexsystems.com.

■■ SEPTEMBER 17 Ultraflex: Pediatric UltraSafeGait™ Continuing Education Course, via WebEx, 9–10 am ET. Covers assessment of pediatric pathological gait and

influencing shank kinematics with the new Adjustable Dynamic Response™ (ADR™) technology. Presenter: Keith Smith, CO, LO, FAAOP. For more information, call 800/220-6670 or register at www.ultraflexsystems.com.

■■ SEPTEMBER 19 Bio-Mechanical Composites, Inc. AOPA National Assembly Technical Workshop. Las Vegas. Mirage Hotel. Custom Engineering of Energy Storing AFO’s and Partial Foot Prostheses Utilizing Pre-Preg Carbon Fiber.

SEPTEMBER 19 WillowWood AOPA Manufacturers’ Workshop: An Introductory, Hands-on Approach to OMEGA® Tracer®, 1–5 pm PT. Las Vegas. Learn the basics of the OMEGA CAD System for prosthetic applications.

Limited space is available for hands-on learning. Preregistration requested. Call 877/665-5443. Additional observation space available. www.willowwoodco.com.

■■

■■ SEPTEMBER 19–22 AOPA National Assembly.

Las Vegas. Mirage Hotel.

Exhibitors and sponsorship opportunities, contact Kelly O’Neill at 571/431-0852 or koneill@AOPAnet.org.

■■ SEPTEMBER 27 Ultraflex: Adult UltraSafeStep™ Continuing Education Course, via WebEx, 12–1 pm ET. Focuses on normalizing adult pathological gait with the utilization of Adjustable Dynamic Response™ (ADR™) knee and ankle technology.

For more information, call 800/220-6670 or register at www.ultraflexsystems.com.

■■ SEPTEMBER 29 Ultraflex: Complex Orthopedic Rehabilitation Continuing Education Course, via WebEx, 12–1 pm ET. Focuses on Ultraflex combination dynamic and static stretching orthosis for addressing complex orthopedic rehabilitation goals and restoring range and function. For more information, call 800/2206670 or register at www. ultraflexsystems.com.

■■ OCTOBER 3-5 The New England Chapter AAOP Continuing Education Seminar. Warwick, RI. Crown Plaza Hotel. For more information, visit www.oandp. org/membership/chapters/new_ england/.

■■ OCTOBER 3-6, 2011 Baltimore Four Points

by Sheraton Applied Technology Institute (ATi) Orthotic Fitter School.

Independent comprehensive course to prepare for certification exam. Approved entry level school by NCOPE and BOC, and for continuing education by ABC, BOC, and NATA. Contact Lois Meier at 888/265-6077, email lois@ kasseledu.com, or visit www. kasseledu.com.

■■ OCTOBER 5 Ultraflex: Pediatric UltraSafeGait™ Continuing Education Course, via WebEx, 5–6 pm ET. Covers assessment of pediatric pathological gait and influencing shank kinematics with the new Adjustable Dynamic Response™ (ADR™) technology. Presenter: Keith Smith, CO, LO, FAAOP. For more information, call 800/220-6670 or register at www.ultraflexsystems.com.

For over 50 years, PEL has offered practitioners a reasonable

Price

on the most popular products available from the O&P industry’s most respected manufacturers. As Director of Human Resources, Erin ensures that all PEL Customer Service Reps are qualified to meet customers’ needs and expectations, providing information on the newest, most innovative products available from PEL – at a competitive price.

Erin Sylvester • “Communication is the key.”

• Started as a CSR in 2005 • Understands the keys to complete customer satisfaction • B.F.A. from Kent State University • Loves hiking with her kids and dog • Hobby is making jewelry

ALPS Extreme Locking and Cushion Liner

Anatomical Concepts Inc. ABBY™ Articulating Ankle Foot Orthosis

Trulife Matrix Split Toe (ST) and Matrix Max Split Toe (ST)

The ALPS Extreme liner is engineered with GripGel to assist in donning and suspension • Specifically designed for transfemoral and active transtibial amputees • Limited vertical stretch reduces movement of redundant tissue

• Replicates biomechanical effects of semi-solid or PLS AFO • Positioning and offloading in the ICU • Rehab for functional weight-bearing activity • Adjustable dorsi and plantar flexion • Adjustable inversion and eversion • Compatible with all Anatomical Concepts liner variations

• Custom-fit, carbon composite AFOs • Improve patient balance and increase stability • Height adjustable anterior shells and trimmable footplates • Ideal for Hallux amputations • Matrix Split Toe (ST) for low activity patients with simple, unilateral drop foot • Matrix Max Split Toe (ST) for low to high activity patients with unilateral or bilateral drop foot

NEW!

Extreme Sleeve • Seals against skin without restricting circulation • GripGel helps prevent sleeve from rolling down patient’s limb

onary Revoluti late! tp o Split Fo ST

PEL Supply Co. Orthotic & Prosthetic Components

®

pelsupply.com

4666 Manufacturing Road Cleveland, OH 44135-2672 USA

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

®

Experience the Power of One.

Max ST

Simple As :

1.

PAGE 72 KISS Ad Materials to come

3.

2.

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

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Calendar

■■ OCTOBER 12 AOPA Audio Conference: “Developing Your Medicare Billing Compliance Plan.”

To register, contact Stephen Custer at 571/431-0876 or scuster@AOPAnet.org.

■■ OCTOBER 12-16 Skills for Life 3: Bilateral Upper Limb Loss Workshop.

Denver Renaissance Hotel.

US Member Society-ISPO, Amputee Services of America, and the Amputee Coalition.

For more information, visit www.usispo.org/skills_for_life. asp.

■■ OCTOBER 15 Arizona AFO Inc.: The Custom AFO Workshop.

San Jose, CA. Learn L-Coding, AFO selection, hands-on casting, footwear/ modification, and ideas for marketing to referral sources. The $150 fee includes lectures, handouts, and lunch.

Approved for 6.5 ABC/7 BOC CEUs. To register, call 877/780-8382, ask for the “Workshop” or email education@arizonaafo.com.

OCTOBER 20 WillowWood: LimbLogic® VS Applications Practitioner Course. Mt. Sterling, OH. Course covers various clinical aspects of LimbLogic VS applications: static and dynamic socket fitting, vacuum pump configurations, fob operation, system evaluation, liner options, alignment, and troubleshooting. Credits: 7.25 ABC/7.75 BOC. Registration deadline: September 29.

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

■■

■■ OCTOBER 20-21 Two-Day RCR Workshop.

Boise, ID. A comfortable hands-on format of the RCR Transtibial socket design.

The RCR socket increases patient comfort, rotational control, and range of motion.

Workshop features the fitting of suction pin suspension as well as vacuum pin suspension. Contact Miranda Johnson, Coyote Design & Mfg., at 208/429-0026.

■■ OCTOBER 20-22 The North Carolina/South Carolinia Chapter AAOP Annual Meeting. Charlotte.

Ballantyne Resort. For more information, visit www.oandp. org/membership/chapters/north_ carolina/.

OCTOBER 21 WillowWood: LimbLogic® VS Applications Technicians Course. Mt. Sterling, OH. Learn all aspects of fabricating LimbLogic VS for various applications: socket materials, controller configurations and care, fob operation, and troubleshooting.

Fabricate sockets following recommended techniques for airtight socket designs.

Credits: 9.75 ABC/9.75 BOC. Registration deadline: September 29. Contact 877/ 665-5443 or visit www.willowwoodco.com.

■■ OCTOBER 28-29 The Academy’s One-Day Seminar Certificate Programs, The Effect of AFOs on Balance AND Prosthetic Management of Multiple Limb Deficiency. Hilton Chicago O’Hare. For more information, visit www.oandp.org/education/ seminars/one-day/.

■■ NOVEMBER 9 AOPA Audio Conference: “Happy Holidays: Kickbacks and Gifts in O&P.” To register, contact Stephen Custer at 571/431-0876 or scuster@ AOPAnet.org.

■■ NOVEMBER 9-11 The New Jersey Chapter AAOP Meeting. Atlantic City.

Bally’s Hotel & Casino. For more information, visit www. oandp.org/membership/chapters/ new_jersey/.

NOVEMBER 10-11 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: October 20. Contact 877/665-5443.

■■

■■

OCTOBER 27-28 WillowWood: Existing OMEGA® Tracer® Users Orthotics and Prosthetics 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.

■■

Motion Control

SUPERCOURSE FALL 2011 OCTOBER 24 - 28, 2011

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

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

• CEUs: 34 (estimated) awarded by ABC.

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

The Fall 2011 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

SEPTEMBER 2011 O&P ALMANAC

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Calendar

■■ NOVEMBER 12 The Academy’s 6th Annual Golf Invitational. Scottsdale, AZ. Contact Manisha Bhaskar at 202/380-3663, x210, or mbhaskar@oandp.org.

■■ NOVEMBER 19 Arizona AFO Inc.: The Custom AFO Workshop.

Phoenix. Learn L-Coding, AFO selection, handson casting, footwear/ modification tips, and ideas for marketing to referral sources. The $150 fee includes lectures, handouts, and lunch.

Approved for 6.5 ABC/7 BOC CEUs. To register, call 877/780-8382, ask for the “Workshop” or email education@arizonaafo.com.

■■ DECEMBER 8-10 Rehabilitation Institute of Chicago: Pediatric Gait Analysis: Segmental Kinematic Approach to Orthotic Management.

Chicago. Featuring Elaine Owen. Application for 21.25 ABC Credits. Contact Melissa Kolski at 312/238-7731 or visit www.ric.org/education.

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.

For more information visit www.provel.us or call 509.857.2009.

O&P ALMANAC SEPTEMBER 2011

■■ 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.

■■

Provel offers cost effective, fast, easy to use, and reliable O&P automation. The D2 digitizer, C7 carver, and T7 thermoformer are appropriate for small clinics as well as large central fab's.

AOP file compatible and backed by a two year warranty. The D2 digitizer allows automated shape capture of prosthetic casts with unmatched accuracy. The C7 carver is not only fast and precise, its self contained dust collection system is extremely quiet. The T7 thermoformer consistently produces high quality thermoplastic sockets from industry standard preforms.

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2012

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

■■

■■ JUNE 15-16 PrimeFare East Regional Scientific Symposium 2012. Nashville Convention Center, Nashville. For more information, contact Jane Edwards at 888/388-5243 or visit www.primecareop.com.

■■ SEPTEMBER 6-9 AOPA National Assembly & AAOP 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

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Ad Index

COMPANY

PAGE

PHONE

WEBSITE

Advanced O&P Solutions Allard USA Inc. ALPS American Board for Certification in Orthotics, Prosthetics & Pedorthics Apis Footwear Arizona AFO ARTech Laboratory Becker Orthopedic The Bremer Group BOC International Cascade Dafo College Park Industries Inc. Complete Professional Office Services DAW Industries Dr. Comfort Dycor Euro International Ferrier Coupler Inc. Fillauer Companies Inc. Hope Orthopedic KISS Technologies LLC KNIT-RITE Med Spec Motion Control O and P Study Guide OPTEC Orthofeet Inc. Orthomerica Products Össur® Americas Inc. Otto Bock HealthCare PEL Supply Company Provel Spinal Technology Inc. SPS

47 17 33, 51

866/914 AOPS 888/678-6548 800/574-5426

www.aopsolutions.com www.allardusa.com www.easyliner.com

39 37, 63 43 47 53 13 41 26 61 79 1, 69 5, C3 67 11 32 35 49 27, 76 2 31 45 36 14, 15 19 23, 59 C4, 25 C2 75 78 7 9

703/836-7114 888/937-2747 877/780-8382 888/775-5501 800/521-2192 800/428-2304 877/776-2200 800/848-7332 800/728-7950 810/629-6424 800/252-2828 800/556-5572 800/794-6099 800/378-2480 800/437-8597 800/251-6398 800/613-8852 410/663-5477 800/821-3094 800/582-4040 888/696-2767

888/982-8181 800/524-2845 800/446-6770 800/233-6263 800/328-4058 800/321-1264 509/857-2009 800/253-7868 800/767-7776, x3

www.abcop.org www.bigwideshoes.com www.arizonaafo.com www.artechlab-prosthetics.com www.beckerorthopedic.com www.bremergroup.com www.bocinternational.org www.cascadedafo.com www.college-park.com www.oandp.office.com www.daw-usa.com www.drcomfortdpm.com www.dycormfg.com www.eurointl.com www.ferrier.coupler.com www.fillauercompanies.com www.hopeortho.com www.kiss-suspension.com www.knitrite.com www.medspec.com www.utaharm.com www.oandpstudyguide.com www.optecusa.com www.orthofeet.com www.orthomerica.com www.ossur.com www.ottobockus.com www.pelsupply.com www.provel.us www.spinaltech.com www.spsco.com

Increase Earnings, Claims Fully Paid Dont, Wait for an Emergency, Proven Turnkey Billing Services Make Your Practice More Profitable “ No Learning software” “Automatic Electronic Document Storage” “All Payment Checks Come Directly to You”

Our customers have seen these results, You can too!

Stop chasing claims collect 10% to 30 % more today

• Increased collections • Decreased valuable staff load • Important patient functions get done •100% of your billing needs handled • 30 + years guidance in O & P Industry

“30 years of O & P experience and 10 years as a billing agency has taught me how to get results and save you hours and hours of unnecessary management.

Call me directly, toll free (866) 925-0674, so I can show you how easy it is to have us do your billing today.”. ...John Dolza, President CPO Services We make it easy for you to transition your billing to us with complete Satisfaction.

Complete Professional Office Services p. (810) 629-6424 - f. (810) 629-6463

www.oandpoffice.com SEPTEMBER 2011 O&P ALMANAC

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AOPA Answers

Benefits and Audits Answers to your questions regarding SNF coverage and RAC preparedness 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.

When I am asked to see a Medicare patient in a Skilled Nursing Facility (SNF), I can submit my claim directly to the DME MAC provided the patient has been there for more than 100 days, correct?

A.

While the Medicare Part A SNF benefit is limited to 100 days of coverage per benefit period, just because a patient has been in a SNF for more than 100 days does not necessarily mean she has exhausted her Part A Medicare benefit. There are multiple scenarios in which a patient may remain eligible for Medicare Part A SNF coverage including, but not limited to, interruptions in Part A coverage during the stay, failure to qualify for Part A benefits, and periods of hospitalization during the SNF stay. The best way to determine who is responsible for paying your claim is to confirm, in writing, the individual patient’s Medicare coverage status with the business office at the SNF. AOPA PRESENTS

Q.

I keep hearing rumblings about RAC audits, but our company has yet to receive anything from a RAC. Should we be concerned?

A.

RAC audits are all performed on a post-payment basis. The job of the RAC is to identify claims that should not have been paid and recover the payment from the provider. If you wait for a RAC audit to examine your company’s preparedness, chances are you will be paying back some money. The time to prepare for RAC activity is now. You should complete a full internal audit of your company’s billing practices in order to make sure that they are sound. A thorough review now may save you thousands of dollars down the road.

Visit www.AOPAnet.org today!

Expert Coding Advice 24/7 at www.LCodeSearch.com

> > >

The O&P coding expertise you’ve come to rely on is now available whenver you need it.

Match products to L codes and manufacturers— anywhere you connect to the Internet.

This exclusive service is available only for AOPA members.

Log onto LCodeSearch.com and get started today.

Not an AOPA member?

GET CONNECTED 80

Contact Michael Chapman at (571) 431-0876, ext. 293 or mchapman@AOPAnet.org.

O&P ALMANAC SEPTEMBER 2011

Manufacturers: Get your products in front of AOPA members!

Contact Joe McTernan at jmcternan@AOPAnet.org or (571) 431-0876, ext. 211.

Create More Positive Outcomes For Your Practice

With Continuing Innovation and New Product Lines

Simply Beautiful.

Designed by physicians and biomechanical researchers for a superior fit.

NEW Urban Comfort Collection

From A Family of Comfort.

Each year millions of people will develop foot complications due to health problems. Properly fitted shoes, socks, inserts and compression wear are essential for reducing these risks. Dr. Comfort shoes are made from the finest leathers and are scientifically designed for various foot complications. Our footwear is extra depth with patented footbeds, our socks and compression wear are created by leading designers with attention to detail and our uniquely patented inserts are comfortable, beyond the “norm”.

Wellness is our business and our market, we care and pay attention to detail, with new products being developed all the time. “ Call now to experience exceptional quality and profitability with the finest “Total System” for your professional practice.

800.992.3580 www.drcomfort.com ®

©2011 Dr. Comfort All Rights Reserved

Visit us at AOPA 2011 Booth #725.

WORK HARD. PLAY HARD. RE-FLEX SHOCK.™ As a hard-working, hard-playing father of two young boys, Jim Bonney needs a prosthetic foot that can keep up with his active lifestyle.

Enter Re-Flex Shock with EVO™ by Össur.

Re-Flex Shock takes the proven design of the Re-Flex VSP,® the original vertical shock prosthetic foot, to the next level.

With dynamic energy return and the most vertical travel of any prosthetic foot, Re-Flex Shock can be used comfortably as an everyday foot, yet also protects Jim during sports and other recreational activities.

So whether he is working, rock climbing, or chasing his sons around the yard, Jim never loses a step.

To watch Jim's Re-Flex Shock video on your Smartphone: 1. Go to http://gettag.mobi 2. Get the free app 3. Scan the tag

CALL (800) 233-6263 OR VISIT OSSUR.COM TO LEARN MORE.

©2011 Össur. All rights reserved. Össur, Re-Flex Shock, Re-Flex VSP and EVO are trademarks of Össur.