August 2010 O&P Almanac

Almanac OP The American Orthotic & Prosthetic Association

AUGUST 2010

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WWW.AOPANET.ORG

THE MAGAZINE FOR THE ORTHOTICS & PROSTHETICS INDUSTRY

INNOVATION AND OUTCOMES High-tech devices achieve new levels of mobility but challenge practitioners to weigh outcomes and expectations

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O&P Almanac CONTENTS

AUGUST 2010, VOLUME 59, NO. 8

COLUMNS

COVER STORY

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Reimbursement Page PECOS deadline update and tips for managing the rules

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Facility Spotlight American Prosthetics & Orthotics Inc.

16 Innovation and the Real World

By Kim Fernandez As technologies come to market with lightening speed, O&P professionals must devise new ways of measuring outcomes as they match the right devices with the right patients. How do they find middle ground?

[16] FEATURES

DEPARTMENTS

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AOPA Contact Page How to reach staff

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In the News Updates and company announcements

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24 Answers from the Hill

Edited by Josephine Rossi At the 2010 AOPA Policy Forum, Rep. Jason Altmire (D-Pennsylvania) spoke to participants about the effects of health-care reform on small business, the upcoming elections, and more.

34 An All-Star Cast of Speakers

Seasoned veteran speakers as well as several new faces highlight the 2010 AOPA National Assembly clinical and business education sessions.

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

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AOPA Membership Applications

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Marketplace Products and services for O&P

56

Jobs Opportunities for O&P professionals

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Calendar Upcoming meetings and events

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Ad Index

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; e-mail: 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, e-mail: dmather@mrvica.com.

AUGUST 2010 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 ext. 26, jrossi@strattonpublishing.com

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

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

Ann Davis, office, meetings administrator, and associate editor, AOPA in Advance, 571/431-0876, adavis@AOPAnet.org

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

AOPA Bookstore: 571/431-0865

Steven Rybicki, production manager, 571/431-0835, srybicki@AOPAnet.org Ann Davis, staff writer, 571/431-0876, adavis@AOPAnet.org

DESIGN & PRODUCTION Marinoff Design, LLC PRINTING United Litho Inc.

BOARD OF DIRECTORS OFFICERS President James A. Kaiser, CP, Scheck & Siress, Chicago, IL President-Elect Thomas V. DiBello, CO, FAAOP, Dynamic O&P, LLC, Houston, TX Vice President Bert Harman, Otto Bock Health Care, Minneapolis, MN Treasurer James Weber, MBA, Prosthetic & Orthotic Care, Inc., St. Louis, MO

Kathy Dodson, senior director of government affairs, 571/431-0810, kdodson@AOPAnet.org

Executive Director/Secretary Thomas F. Fise, JD, AOPA, Alexandria, VA

Devon Bernard, reimbursement services coordinator, 571/431-0854, dbernard@AOPAnet.org

OP Almanac Online &

Reading the O&P Almanac has never been easier!

DIRECTORS Kel M. Bergmann, CPO, SCOPe Orthotics and Prosthetics Inc., San Diego, CA Rick Fleetwood, MPA, Snell Prosthetic & Orthotic Laboratory, Little Rock, AR Russell J. Hornfisher, Becker Orthopedic Appliance Co., Troy, MI Alfred E. Kritter, Jr., CPO, FAAOP, Hanger Prosthetics & Orthotics Inc., Savannah, GA Anita Liberman-Lampear, MA, University of Michigan Orthotics and Prosthetics Center, Ann Arbor, MI Mahesh Mansukhani, MBA Ossur Americas, Aliso Viejo, CA John H. Reynolds, CPO, FAAOP, Reynolds Prosthetics & Orthotics Inc., Maryville, TN Lisa Schoonmaker, CPO, FAAOP, Tandem Orthotics & Prosthetics Inc., Sartell, MN Frank Vero, CPO, Mid-Florida Prosthetics & Orthotics, Ocala, FL

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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.

O&P ALMANAC AUGUST 2010

ADVERTISING SALES M.J. Mrvica Associates Inc.

Immediate Past President Brian L. Gustin, CP, BridgePoint Medical Inc., Suamico, WI

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EDITORIAL MANAGEMENT Stratton Publishing & Marketing Inc.

GOVERNMENT AFFAIRS

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

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PUBLISHER Thomas F. Fise, JD

Copyright 2010 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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In the News

BOC Revises Requirements for Orthotic Fitter Certification After a recent review and analysis of assessment and testing procedures for certification as an orthotic fitter (COF), the Board of Certification/ Accreditation International (BOC) has updated its COF requirements.

TRANSITIONS

O&P ALMANAC AUGUST 2010

enhancing their value to patients and to other health-care providers.”

“Just as technology and healthcare needs drive changes in scopes of practice, the needs and demands in our field will drive changes in the ways we evaluate skills,” notes Sharon Nichelson, CMOF, chairwoman of BOC’s board of directors. “Most practitioners begin their careers in one specialty. I believe this change will encourage people in two ways: First, it will encourage people to earn orthotic fitter certification because it makes the process clearer and more affordable. Second, it will encourage people who already hold certification in fitting one type of device to consider adding an additional credential.

“For all of us who fit O&P devices, patient care is a bedrock skill,” Nichelson continues. “When we expand our ability to help patients, not only is it satisfying and rewarding, but it expands our ability as members of the health-care team to work toward overall wellness. It also increases our value to our patients and to our employers, which makes it a triple win.”

BUSINESSES IN THE NEWS

Louisville Prosthetics has opened a second location at 1404 Browns Lane in Louisville to accommodate doctors in hospitals on Louisville’s East End. The facility has office hours on Tuesday and Thursday. The company’s primary location at 742 E. Broadway, has both fitting rooms and a production area.

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Like the BOC mastectomy fitter and BOC pedorthist credentials, the COF designation will be awarded based on three requirements: completion of a required course of study, experience in patient care under appropriate supervision, and passing a threehour multiple-choice examination.

The decision “retires” the formerly mandatory video practical examination in the orthotic fitter certification process, according to a BOC press release.

“The demand for certification in orthotic fitting is growing,” says BOC president Claudia Zacharias, MBA, CAE. “Through the review and analysis process, we have been able to establish a certification level that allows practitioners whose work focuses on fitting the most-in-demand devices—orthotic, mastectomy, and pedorthic—to follow similar qualification stages in education, experience, and examination requirements. This will streamline the certification process and encourage practitioners to consider learning to fit multiple devices,

RSLSteeper launched bebionic, a fully articulating myoelectric hand, at the ISPO World Congress/ ORTHOPÄDIE + REHA-TECHNIK tradeshow, which was held in Leipzig, Germany on May 12-15, 2010. Users demonstrated the device’s capabilities at RSLSteeper’s booth, where amputees also were able to try the device.

Workshops allowed attendees to learn more about the device, including its advanced features and software system, which allows the device to be customized for individual users.

Touch Bionics unveiled its new i-LIMB Pulse, also at the ISPO World Congress/ORTHOPÄDIE + REHA-TECHNIK tradeshow.

The i-LIMB Pulse uses pulsing technology to provide increasing and controllable grip strength. With an aluminum chassis, the i-LIMB Pulse’s design is sturdier than previous versions of the device and can carry up to 90 kg. The new technology also features BioSim, a Bluetooth-enabled software that both prosthetists and users can control.

Practitioner Creates DVD for New Amputees Todd Norton, CP, FAAOP, has developed a DVD to address the problems he has most commonly seen among new amputees in his 17 years as a prosthetist.

“Over and over they came in wearing their prostheses improperly and over and over, they were doing the little things wrong. Most commonly, they were not wearing the correct number of socks,” says Norton.

Norton suspected that his patients didn’t understand the printed literature commonly sent home with them.

That suspicion was confirmed in the Journal of Prosthetics and Orthotics (Vol. 21, No. 4, 2009), which reported that

the reading level of the average patient fell far short of what is needed to understand the literature.

Norton’s answer to this problem is contained on a new DVD called Prosthetics 101—Using a Below Knee Prosthesis.

“A DVD made so much more sense than a brochure because people seem to understand better when they see it,” says Norton.

Prosthetics 101—Using a Below Knee Prosthesis demonstrates what to expect as a new amputee, including how to put on and remove a prosthesis,

Global Community of Practice for Rehabilitation Now Online

how to care for a prosthesis, and how to ensure a good fit by sock management. It is not meant as a substitute for face-to-face patient instruction but as a supplement that patients can take home and refer back to as often as needed. For more information, visit www.prosthetics101.com.

DYCOR

The Global Community of Practice for Rehabilitation online recently posted archived Web casts from the May 2010 ISPO World Congress/ORTHOPÄDIE + REHA-TECHNIK tradeshow in Leipzig, Germany.

A joint effort of the World Health Organization and the Scottish Executive, the Web site originally launched in June 2009 featuring a week-long discussion of the issues facing providers of community-based rehabilitation around the world. The site is open to all health professionals with an interest in rehabilitation, including clinical leaders, researchers, expert practitioners, policy makers, support workers, and key stakeholders.

Visit http://my.ibpinitiative.org/public/rehabilitation to register and join the discussion on global rehabilitation issues and strategies with your colleagues from around the globe.

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In the News

Humboldt County, California, Reaches Out to Haiti Two doctors from Humboldt County, California, Asa Stockton and Nathan Shishido, were among the volunteers to visit Haiti after January’s devastating earthquake. They were deeply affected by the sheer number of amputees and the paucity of medical facilities.

Their newly formed charity, Humboldt Helps Haiti, raised a total of $85,000 to provide Haiti with a sustainable supply of prosthetics. Working with the nonprofit group Prosthetika, which has constructed prosthetics labs in Armenia, Turkey, and elsewhere, Humboldt Helps Haiti built a prosthetic lab inside two shipping containers. The facility will arrive in Haiti ready to open with an assortment of supplies.

The doctors’ plan is to have a full-time coordinator of the unit for the first two years to train Haitians and organize volunteers. Their goal is for the facility to be staffed locally at the end of two years.

If you would like to assist with this effort, visit www. prosthetika.com.

TRANSITIONS

PEOPLE IN THE NEWS

Comprehensive Prosthetic & Orthotics Inc. in Peoria, Illinois, has appointed Jim Andreassen to the position of chief operating officer.

Andreassen has more than 20 years of experience in the O&P profession.

He previously served as president of the Orthotic & Prosthetic Group of America and as Hanger Prosthetics & Orthotics’ Midwest market leader, area practice manager for Iowa and director of operations for the Midwest Region. Andreassen began his career as business manager for Dale Clark Prosthetics in Iowa. He holds a bachelor’s degree in business management from Iowa State University.

Les Chubick has retired from Knit-Rite, Inc., after 30 years of service. Chubick had a role in many aspects of the company, including catalog development, advertising, marketing support, sales support, and exhibit management.

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O&P ALMANAC AUGUST 2010

Avery Hammonds, CO, has joined Hanger Prosthetics and Orthotics in its Gainesville, Georgia, patientcare center. Hammonds received her associate’s degree from Georgia Highlands and her bachelor of science degree from the University of Georgia. She also completed the orthotic and prosthetic certificate program at Northwestern University.

OrPro Prosthetics & Orthotics announced that Raghvendra Prajapati, BOCO, C.Ped, joined the staff of its clinical practice in Richmond, Indiana.

Prajapati has a background in O&P and hospital management and has healthcare experience in both India and the United States.

Ruben Rodriguez, C.Ped, is now with Hanger Prosthetics and Orthotics’ Encino, California, patientcare center. Rodriguez brings more than 20 years of patient care to his new position.

Rebecca Russell, CPO, has been named to the position of practice leader at OrPro Prosthetics & Orthotics’ Waldorf, Maryland, office.

Russell is a 2006 honors graduate from Eastern Michigan University in prosthetics and orthotics and earned her bachelor’s degree in biology at the University of Maryland. She completed her prosthetics residency in OrPro’s Dayton, Ohio, office and her orthotics residency in the Waldorf office.

Michelle Slider, CP, brings more than 15 years of patient-care experience to the Philadelphia, Pennsylvania, facility for Hanger Prosthetics and Orthotics. She received her bachelor’s degree from Wesley College in Dover, Delaware, and her prosthetic certificate from Florida International University.

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Reimbursement Page

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By Kathy Dodson, AOPA government affairs department

CMS Flip Flops—Again— on PECOS Ensuring all referring physicians are enrolled key to reimbursements

T

he Centers for Medicare and Medicaid Services (CMS) has done another about face on its Provider Enrollment, Chain, and Ownership System (PECOS). As of this writing, in early June, CMS has decided that PECOS will now go into effect on July 6, 2010; this after first saying it would become effective Jan. 1, 2010, and then changing the date to Jan. 3, 2011.

You probably already have a good idea of what PECOS is. In simple terms, it’s an automated system of Medicare enrollment for physicians— the electronic equivalent of the 855S form that you fill out to sign up with Medicare. Approximately six years ago, CMS created this system to allow physicians to enroll online as Medicare providers. It was an optional program that physicians could choose to use, or they could instead continue to submit paper applications.

Many physicians are still not in this database, and some are not even aware of its existence.

Once the system was created, any physician who enrolled either did it online, or a paper application was manually updated by CMS into the PECOS system. The net result was that any physician who sent in an application was put into the PECOS

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O&P ALMANAC AUGUST 2010

database. However, physicians are not required to reenroll—as suppliers are—meaning there were many physicians who had enrolled in Medicare before PECOS existed and were not part of the database.

In September 2009, CMS announced it would start enforcing the Medicare law requiring a referring physician to be enrolled in Medicare in order to refer or write a prescription for a Medicare patient. CMS felt that the PECOS database was the way to track compliance with this requirement. It said that from Oct. 1 through Dec. 31, 2009, remittance notices for any claim for a service ordered by a physician not in PECOS would carry a warning notice to let suppliers know that this physician was ineligible to refer, but the claim would still be paid. However, starting on Jan. 4, 2010, claims would be denied if the physician was ineligible.

In addition, CMS expected O&P

facilities to start “educating” their referring physicians about the need to reenroll. Of course this task should not have been put on facilities, since physician education is a CMS responsibility, and it proved very difficult to carry out. Physicians, even when they had been informed, saw no need to reenroll, especially since payment of their own claims would not be affected. This just seemed like one more thing that suppliers were expecting them to do, even though it was really a CMS mandate.

Another problem arose regarding new prescriptions. The only source for a facility to look up to see if a referring physician was in PECOS, and therefore eligible to refer, was a 12,000-page PDF document that had no search engine and was therefore extremely unwieldy to use. Since it wasn’t a real-time document, there also were concerns with how often it would be updated going forward.

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Reimbursement Page

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Warning Signs When warning notices started arriving in October, O&P facilities found that many of their physicians were not in PECOS and started complaining about the upcoming implementation of denials, especially since most of the physicians contacted

by O&P facilities about this issue had no idea about PECOS and the need to reenroll with Medicare. Facilities continued to try to educate their referral sources, including providing them with written information about PECOS and appropriate Web sites; however, success was limited since many physician’s offices had never heard of PECOS from CMS or their carriers.

What finally forced CMS to change the implementation date was the new healthcare reform legislation.

AOPA carried the field’s concerns to CMS, and eventually the implementation date of claims denials was postponed until Jan. 3, 2011. This meant that there would be much more time for CMS to educate physicians about reenrolling.

In addition, during this same time, CMS proactively put physicians’ 14

O&P ALMANAC AUGUST 2010

National Provider Identifier (NPI) numbers into PECOS for any physician that was already in this database. Lack of an NPI in the PECOS database also had been causing warnings on claims.

Of course they could not do this for any physician who was not already in the database.

When the deadline was delayed until January 2011, the field relaxed a little, thinking that CMS would now put more resources into physician education and that by January, the situation would be better. What they had not counted on, but what finally forced CMS to change the implementation date, was the new health-care reform legislation.

Legislative Effects According to CMS officials, there is a requirement in the health-care reform act that mandated better controls on physician identification to ensure that only eligible physicians are able to make referrals. So CMS decided to use the PECOS system to monitor physician eligibility and therefore changed the implementation date from Jan. 4, 2011, back to July 6, 2010.

As of this date, according to James Bossenmeyer of CMS, facilities are expected to submit only compliant claims—those for care ordered by physicians in PECOS. Of course, this presents a number of problems for O&P facilities. Many physicians are still not in this database, and some are not even aware of its

existence. For those who are aware and are trying to reenroll through PECOS, there will be a lag time for CMS to process their application, which will affect when O&P claims can be successfully submitted. CMS has indicated that as of July 6, the edits that would prevent payment to ineligible physicians will not yet be in effect.

This means that you will get paid for services that should have been denied but will possibly face recoupment activities once the edits are turned on. AOPA will be lobbying strongly to see that retroactive recoveries are not allowed; however, there is no guarantee that this will happen. CMS has announced that the edits to reject ineligible claims will go into effect on Jan. 3, 2011.

AOPA will be lobbying strongly to see that retroactive recoveries are not allowed.

Here are several steps to help your practice deal with this situation: 1. For any new prescriptions, check the PECOS database (see box) to find out if you can proceed to treat the patient. When searching, remember to use the physician’s full name or NPI. Do not use nicknames, titles, credentials or punctuation (other than the hyphen between hyphenated names).

2. If the physician is not in PECOS, contact his/her office to let them know that they need to go through this process. AOPA has put together a draft letter that you can use for this purpose. You can access it by going to the AOPA Web site, www.

AOPAnet.org, and scrolling to the bottom of the homepage. In the letter is a Web site that the physician can use to better understand what PECOS entails and how to sign up, as well as a MedLearn Matters article for more information. Because physicians may not immediately see the impact on their patients, make

sure to tell them that without a record in the PECOS database, they will not be able to write prescriptions for O&P, Durable Medical Equipment (DME), clinical lab tests, or radiology.

Make sure your business is enrolled in PECOS today!

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3. If you choose to treat the patient knowing that the prescription is not valid due to PECOS problems, you may decide to not submit the claim until you are certain that the physician has enrolled properly. Check the physician registry occasionally, and once he/ she is enrolled, you can submit the claim for payment. The Medicare processing system will not key on the date of service but will only look at the date of receipt. As long

as the physician is in the database before the DME MAC receives the claim, it should not be denied as an ineligible referral.

4. If you decide to submit an ineligible claim, for now you will be paid.

However there is a chance that CMS may attempt recoupment of such payments once the edits are turned on. But there is certainly a strong argument to support the inappropriateness of such actions.

5. If you choose not to treat the patient, you can explain that the physician is currently not able to prescribe for Medicare patients. The patient would then have the option of contacting the physician or obtaining a new prescription from a different, eligible physician.

6. For services that have already been rendered, research before you submit the claim to make sure the physician is in the database. If not, contact the office and offer the information in item 2 above. Again, you may want to hold the claim until the physician is in compliance.

SAVE thE DAtE

At this writing, CMS staff has told AOPA that they are developing their own search engine, which should be available shortly. In addition, Medicare Part B carriers should have sent out letters by the end of June to all physicians who are not enrolled through PECOS to direct them to enroll. a Kathy Dodson is AOPA’s senior director of government affairs.

Reach her at kdodson@ aopanet.org.

REIMBURSEMENT TIP To help alleviate the problem of no searchable database, Paul Prusakowski, CPO, FAAOP, developed a search engine that he has shared with the field to make verifying your physician’s status much easier. You can reach it from the AOPA Web site, www.AOPAnet.org, by scrolling to the bottom of the homepage, or at www.oandp.com.

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We look forward to seeing you at the AOPA 2010 National Assembly September 29–October 2, 2010, at the Rosen Shingle Creek Resort in Orlando, Florida!

For more information, visit our Web site at www.AOPAnet.org.

AUGUST 2010 O&P ALMANAC

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INNOVATION and the

Photo: Martin Barraud/OJO Images/Getty Images

Real World

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O&P ALMANAC AUGUST 2010

By Kim Fernandez

TECHNOLOGY EVOLVES AT LIGHTENING SPEED, but outcomes and patient limitations challenge practitioners to look beyond the hype

B

roadcasting student Van Phillips lost his left leg just above the ankle in a waterskiing accident in 1976, at just 22 years old. Shortly after the accident, he was fit with a clumsy and uncomfortable prosthesis that allowed him to walk, but he was unable to run or play sports that he loved.

Seeking to regain his active lifestyle, Phillips dumped broadcasting and enrolled in the biomedical engineering program at Northwestern University. He devoted himself to developing a leg that would flex and bend so its user could jump and run.

The rest is history: Phillips launched Flex-Foot in 1984, introducing a revolutionary device inspired by the shape and function of a cheetah’s leg. At the time, the leg was like nothing anyone had seen, and

it made national news as each new athlete donned one.

For amputees, it was a seemingly unreachable dream finally realized.

Today, of course, amputees are fit with prosthetics, including a long list of Flex-Foot options, taught to use them properly, and encouraged to continue their sports and hobbies.

They compete in athletics, fly airplanes, and even summit Mount Everest, and the news has become so commonplace it rarely makes headlines anymore.

But the same devices that offer unprecedented mobility also require intensive training and dedication by users to reap their full benefits—not to mention the care of practitioners who can assess outcomes and mitigate unrealistic expectations.

AUGUST 2010 O&P ALMANAC

17

The Latest Technologies Still, the new developments coming down the pike will make a world of difference for patients, and for practitioners who stay on the cutting edge.

“We’re seeing a greater national awareness [of new advancements] that’s being driven politically.”

—M. Jason Highsmith, PT, DPT, CP, FAAOP

18

O&P ALMANAC AUGUST 2010

Two years ago, prosthetic legs that use Bluetooth technology to “see” each other made the national news.

They were inherently reactive to each other and improved the gait and performance of double-leg amputees, who found they didn’t have to work so hard for even steps or appropriate reactions to movements. What one leg did, the other imitated, in gait and force. Originally developed for the military, these Bluetooth devices are expected to trickle down to civilians in the next few years. And there are even more advances on the horizon.

“We’re seeing more of the myoelectric technology being used in combination with targeted muscle reinnervation (TMR) surgery,” says Kelly M. Lee, CP, Rehabilitation Institute of Chicago. “That originated in the research labs here, and we’re starting to apply it clinically. It’s no longer just research, but being used as a clinical tool.”

“We’re seeing a greater national awareness [of new advancements] that’s being driven politically,” says M. Jason Highsmith, PT, DPT, CP, FAAOP, assistant professor at the School of Physical Therapy & Rehabilitation Sciences, University of South Florida College of Medicine. “It’s happened with the war on terror.

Funding is still very much moving toward prosthetic and amputee advances. And those technological advances are driving rehabilitation advances.

We’re all being forced to take a closer look at how we categorize these things, how we maximize component usage, and what the recreational options and pursuits might be for them.”

Highsmith currently is working on prosthetic hands designed to let wearers play golf or baseball. The golf hand is being developed with lots of input from avid golfers. “We’re partnering with TRS Inc. to do this golf hand,” he says. “We’re finding that regardless of your dominant side, it

can work. It’s pretty novel.” He’s also working with baseball coaches on a hand for that sport.

Touch Bionics, makers of the i-LIMB line of hands, is also working on advancing that technology, which uses Bluetooth to help with grip and functionality. “You’re going to see that hand and other devices become stronger, faster, and more capable, and more able to perform a wider range of functions,” says Mark Ford, vice president of North American operations.

Lower limbs will see improvements as well. “There are also some newer technologies coming out for the lower knees that we can’t talk about quite yet,” says Highsmith, “but we’re starting to see improvements with the new power knees coming out of military settings.

“There are control strategies that are unique [to the new knee design] that can help people sit down much more symmetrically than any other product out there. Our thought is that control strategy should be something that’s considered for other knee products and other functions.

If you’re an amputee at 40 and you start to get arthritis in your 50s, and we can improve your load symmetry for something you do 50 times a day, that’s important.”

Other technologies Highsmith points to as revolutionary are a Vari-Flex foot design and a new design from Bioquest that claim improved shock absorption and more natural gait and movement, including uphill and downhill. A new shell from Flex-Foot, he says, will help users who’ve resorted to having custom build-ups made for their frames.

“Microprocessor knees are still extremely exciting,” adds David Rotter, clinical director of prosthetics for Schenck & Siress in Chicago. “We think of a young active person using those to do incredible things, but they’re more exciting for the traditional patient who’s older and not quite as healthy, who needs something stable and balancing for them.”

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While device developers and practitioners say it’s a thrilling time to be part of the industry, new devices don’t come without challenges. Simply put, they’re not right for everyone, and measuring success isn’t always black and white.

As the mainstream media cover product research and development, patients don’t always understand why a promising new device might not be appropriate for their own day-to-day use. Further, the devices usually are not simple to fit and use, so practitioners also find themselves needing to forge partnerships with surgeons and therapists, and then navigate a whole new minefield of patient frustration when new “intuitive” technology proves difficult to master.

Devices that work with TMR, for example, require patients to participate in extensive post-surgical training to use the device. That process can be long, and patients often don’t realize that it’s not as simple as just thinking about the movement, as some news reports lead them to believe.

“It’s very challenging for patients,” says Lee. “It’s not cut and dried. They spend a lot of time with us, and a lot of time with our occupational therapy team, working toward the best outcome. There’s more frustration 20

O&P ALMANAC AUGUST 2010

because there’s more the patient has to do.”

“It helps to have a good understanding of the now-existing products,” says Rotter. “When something new comes along, you can make a comparative assessment based on what’s currently available. You have a baseline understanding of where things are.”

Reliability is another big concern with brand-new products. “You don’t know what’s going to happen in terms of service and follow-up,” he continues. There are devices coming from existing companies that we know, but also new companies are introducing products to the market; those are complete unknowns.”

That means a lot of testing and measuring are necessary to determine

who each device might work best for, and—just as importantly—which populations it might not.

“We get a lot of feedback from patients and practitioners,” says Ford, who adds that the company’s latest software communicates with devices directly, providing information about how they’re used, how often they’re used, and in some cases, how well they’re working.

“We are able to quantitatively see how a hand is being used and how impulses are coming through

electrodes,” he says. “We get a good feel of things from the entire socket, from the electrode socket to the terminal device, and that gives us a very interesting picture of how people are using the devices,” he adds, noting that interactive devices are part of an emerging trend in the field.

Patients also have to be aware of and on-board with the work involved in wearing a state-of-the-art prosthesis. “We try to be very up front with patients,” says Lee. “We tell them about how much time and effort they’re going to have to dedicate to be successful users. And we spend a good bit of time identifying good candidates who can put in the time and focus, and who understand this isn’t like buying a pair of shoes. This is a tool they’re going to have to learn to use.”

Then, she says, the partnerships kick in, with different professionals from different specialties working with the patients as appropriate. It’s frequently no longer as simple as fitting and adjusting and a bit of practice.

“You need a tight interaction between the prosthetist and an experienced occupational therapist as well has having a physician to guide you through medical issues that may arise post-surgery,” she says. And that’s not always simple. But the partnerships are critical to ensuring good outcomes for patients.

“Once we begin to fit patients, we work very closely with an occupational therapist,” Lee continues. “A typical scenario involves very intensive prosthetic and therapy appointments.

They might see me twice a day and see the occupational therapist twice a day for several weeks at each occasion of some change.”

Tracking those changes also is critical to measuring outcomes. “If we have someone who was previously using a hand and is now using a powered hook, we evaluate those changes,” Lee says. “Can he or she turn the prosthesis on? Can he or she open and close the terminal device cleanly, without mistakes? Can he or she operate the elbow? We’re not looking for perfection, but we’re tracking any improvement and changes.”

Equally important, she says, is ensuring patients will accurately report back with anything they notice at home—good or bad—once they leave the rehab center and return to everyday life.

“We put a lot of effort and work into getting patients to apply what they’ve learned here at home and report back to us with issues that may crop up there,” says Lee. “We keep track of them through phone calls and e-mails. And honestly, some people come in and say they were very busy with work and family and children and did nothing for the past month, and that’s fair. You can’t stop life.”

Know Thy Patient Before determining what device might work the best for a patient, the practitioner needs to have a true understanding of that patient’s real life. Knowing what he or she needs and wants a device to do is the first step toward properly measuring outcomes, and requires honesty on everyone’s part.

“You have to really understand your patients’ lives,” Rotter says. “Someone will come to you and say they saw this really cool hand on television and it has this amazing elbow, and you have to tell them it’s experimental, and we can maybe expect to see this outcome and maybe not.”

Confronting the limitations of a patient’s current device from the 22

O&P ALMANAC AUGUST 2010

standpoint of comfort and wearability often can open up the line of dialogue.

“That’s really the best starting point: have handouts, listen to what they have to say, and do the best job you can of explaining the realistic points of where and what these devices are.”

That same honesty applies when practitioners discuss how new products will benefit a patient. “You see someone on the news running a myoelectric hand and the reporter says it’s completely intuitive,” Rotter points out. “But you have to learn how to fire one muscle and not the other. It takes work and training, and it’s heavy and takes time to get it just right.

We’re often debunking the mythology of what a person has been exposed to and trying to give them a real sense of what a device can and can’t do. The worst thing we can do is set unrealistic expectations for them.”

Ford agrees. “Our device is not for every patient,” he says. “There are limitations in every product, and it doesn’t do us any good to try to force a device on a patient that might be contra-indicated. Nobody’s going to benefit from that.”

As technology moves forward, companies also may find that individual devices just aren’t working for some patients, and they need to go back to the drawing board entirely. ”Not every idea works flawlessly,” he says. “You can have an amazing

idea, but when you put it into the real world, it doesn’t work as well as you thought. Invariably, when you put a product out there, along come things you didn’t anticipate. You can’t anticipate everything that will occur when you put a new product on patients in the field.

“We’re seeing a new way for manufacturers to work, and it’s a much more integrative approach,” he says. “We’re not just selling a piece of hardware and that’s all we have to do.

We have to make sure each patient gets the most out of it.”

More to Come With the relentless pace of new technologies coming to market, it can be difficult to determine which new ones work for patients, but experts say that a little homework and a lot of patience and determination can get practitioners there.

One important step is to develop relationships with doctors and therapists. Lee enjoys having all of those professionals in-house, but says even small practices can get there with minimal cost or aggravation.

“You absolutely can develop those relationships even if you’re not hospital based,” she says. “You need to have a team, but they don’t need to be in the same place or the same building.

You can get that same interaction and communication, and you need it once you know what the moving target is.”

Highsmith says he’s encouraged that technology is moving forward, particularly for upper-limb amputees, who’ve not historically been at the forefront of R&D allocations.

“There are about 250,000 upper-limb amputees in the United States right now,” he says, referring to the need for new technologies for upper-limb amputees. “It’s a small problem for a government agency, but it’s huge for those people.” a

Kim Fernandez is a contributing writer for O&P Almanac. Reach her at kim@ kimfernandez.com.

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Answers

from the Hill

Rep. Jason Altmire answers members’ questions at the 2010 AOPA Policy Forum

California Senate Chamber Desks 24

O&P ALMANAC AUGUST 2010

Edited by Josephine Rossi

A

t the 2010 AOPA Policy Forum, participants gathered on Capitol Hill to educate members of Congress on the role O&P plays in restoring quality of life to patients. In addition to receiving training on AOPA’s federal policy objectives, attendees participated in briefings from key congressional lawmakers, the AOPA lobbying team, and other experts about critical issues confronting the O&P profession.

This year’s Policy Forum included an audience discussion with Congressman Jason Altmire (D-Pennsylvania) who is serving his second term in the U.S. House of Representatives, where he represents six counties in western Pennsylvania. Prior to his election to Congress in 2006, he spent 15 years working in health-care policy as a congressional staffer, a hospital association executive, and for the University of Pittsburgh Medical Center. At the Forum, Altmire fielded questions about the effects of health-care reform, what to expect from the 2010 mid-term elections, and more.

Excerpts from his session follow:

H QUESTION: Recent polls say 63 percent of the American people want health-care reform repealed, and prognosticators are saying that after the November elections, the House is going to turn over. If that happens, what is the realistic possibility of defunding some or all of these programs? And, how might that affect our industry?

H ALTMIRE: That is a good question. A number of attorney generals have filed lawsuits challenging the health-care reform bill. In my opinion, these lawsuits are a very long-term prospect, and it is unlikely that they will succeed.

Although the idea of repealing this law is certainly out there, I do not support doing that. Instead, I want to focus on how we can improve this law over time. President Obama is

going to be in the White House after November’s election for two more years. Even if the Republicans retake the House and/or the Senate, they will not have a majority that can override a Presidential veto.

The Republicans will have to win 40 seats to regain control of the House. There are at least a couple of Republican-held seats that are almost certainly going to flip, meaning that in reality Republicans need to win a minimum of 42 seats. Given the seats that are in play, Republicans will have to win every race that they possibly could. In the Senate, the Republicans would have to win 10 seats to effectively take the majority.

If the Republicans win eight seats in the Senate and 35 seats in the House this November, that should be viewed as a reprimand for the Democrats and as a tremendous victory for the

AUGUST 2010 O&P ALMANAC

25

Republicans. But instead, that will be viewed a win for the Democrats: They will have kept the House and kept the Senate. Republicans have made a strategic error in defining success as retaking both chambers of Congress.

My decision to vote against the health-care bill was well received in my district for a number of reasons.

Ninety-three percent of my constituents already have health insurance, and they were concerned about the impact this bill would have on the role of government in our health-care system. They also were concerned about the lack of cost-containment in this bill. As a Representative, I took the fact that my constituents were overwhelmingly opposed to this bill very seriously.

Additionally, my district has one of the highest numbers of Medicare Advantage recipients of any district in the country. To some extent, you can debate whether this bill will increase or decrease Medicare premiums and how it will impact the Medicare Trust Fund’s solvency.

However, there is no question that if you’re on Medicare Advantage, under this bill you will pay more and get less.

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O&P ALMANAC AUGUST 2010

While it is unlikely that the healthcare bill will be fully repealed, it is possible that some of its provisions will be defunded, especially its pilot projects.

This bill is 2,400 pages because it is full of demonstration projects, pilot studies, commissions, and boards. As is often the case with authorization bills, many of the health-care bill’s initiatives may not be funded through the appropriations process. However, I do believe that the major elements of the health-care bill will likely be implemented.

H QUESTION: The services that we provide enable people to live full and active lives. When we’re on the Hill, what do you think we can do better to get that message of quality of life across?

H ALTMIRE: I have two main suggestions. First, be sure to address the following issues: quality of care, cost, the patient’s wishes, and customer service. Oftentimes, cost is the only issue discussed. Second, deliver your message in a way that will make a lasting impact on the member of Congress that you’re meeting with.

For you, your meeting on Capitol Hill with a member of Congress will

be the most important meeting of your day. You will have 20 minutes or half an hour to make your pitch and tell your story. You need to remember, however, that just before your meeting, somebody else met with this member of Congress to discuss Iraq. Right after you, somebody else will meet with this member about education issues. Then, someone else will come in to discuss veterans’ affairs. Then, someone else will come to in talk about the oil spill.

The list goes on and on.

I have a pretty good memory, and when I first got elected to this seat, I used to play a mental trick with myself. At the end of every day, I would think back through my day to try to remember everything that I did.

More often than not, I couldn’t do it.

You have to work to make a lasting impression on a member. Otherwise, you will just be one of 10 scheduled meetings that he or she had over the course of the day.

The way to make an impact is to tell a personal story—don’t just focus on the bottom line. I had an interview once with a man who was an amputee.

He had an incredible life story and was one of the most impressive people I’ve ever met. That meeting left an impression on me. Your goal should be to do the same. To do this, try to talk about your customers, your patients, and the life-changing moments you have seen. If you can bring a constituent of the member that you are meeting with, all the better. You have a great story to tell. You really do change people’s lives. Focus on telling your unique story, because that’s what a member of Congress will remember at the end of a long day.

H QUESTION: What are the positives of the reform bill, and what aspects will have an immediate impact on small businesses such as ours?

H ALTMIRE: The health-care reform bill has many good provisions; it’s not all bad. There’s a lot that was left out that should have been included, and there’s a lot that was included

because I’ve been heavily involved in this issue every step of the way, but that is the reality we are facing.

H QUESTION: What is it like be a Democratic member of Congress and on multiple occasions to have one-on-one conversations with the Democratic president and then tell him “no”?

H ALTMIRE: Since I was a member

(Left) James A. Kaiser, CP, AOPA President, and (right) Tom DiBello, AOPA President-elect with Rep. Altmire

that should have been left out. On the positive side, if you are a small business who already offers health insurance, this bill’s tax credits could help to lower costs for you.

Our country as a whole is already paying to treat the 30 million Americans who do not have health insurance. The uninsured go to the emergency room, get treatment, and we pay the bill. The health-care reform bill rationalizes that by getting everyone into the insurance market, you can spread the risk pool and, in theory, make costs more manageable over time. If that does in fact happen, employers would benefit.

Another positive aspect of this bill is its insurance reforms prohibiting both lifetime health-insurance caps and denial of coverage for pre-existing conditions. Both of these reforms will benefit American families.

H ALTMIRE: I appreciate that and

H QUESTION: There have been

your prospects for that bill?

significant efforts to repeal competitive bidding of durable medical equipment. But to the extent that there needs to be something to offset the cost of repealing that bill, our concern is that orthotics and prosthetics are not used to pay for something that ultimately does not impact the field.

28

O&P ALMANAC AUGUST 2010

I am aware of your position. I am a cosponsor of the legislation that Congressman Kendrick Meek introduced last October, which would not require your field to pay for competitive bidding’s repeal.

However, I am somebody who believes that we need to pay for what we spend. In your own businesses, you all follow the pay-as-you-go principal: You have to have money on one side of the ledger if you want to spend money on the other side of the ledger. I agree with you that it would be inappropriate to look to orthotics and prosthetics to make up the difference, to pull somebody into the argument who is not involved in the first place. However, we do have to find the money to fill in the gap somewhere.

H QUESTION: Can you give us H ALTMIRE: As the clock ticks and as we get closer to the end of session, I think it becomes less and less likely that we will fully repeal competitive bidding. I don’t want to throw in the towel yet, but it’s going to be difficult to get that done. I don’t like to say that,

who was considered to be a swing vote and who had a background in health care, I received national coverage on this issue. Everyone was paying attention to how I would vote.

When I announced that I would vote no, I found that in my district, there were two groups of people. One group said that my decision was the most courageous act they had ever seen. They said that they couldn’t imagine the pressure that I was under, and they wanted to congratulate me for standing up to the President. The other group said I was a gutless coward for buckling to the Tea Party instead of representing my constituents. There were times when people would make these comments during that same town meeting and then start arguing with each other.

As background, I voted against cap and trade. I voted against the bailouts. I was a leader on combating illegal immigration, stressing the need for stronger enforcement measures instead of amnesty. So, I think it’s fair to say that I am not one of the Speaker’s favorite people in the Democratic Congress. However, we do continue to discuss different issues as various pieces of legislation come up for a vote.

It’s one thing to say “no” to the Speaker. It is another thing to say “no” to the President. I took very seriously the fact that the President paid a lot of attention to this issue. I had five meetings at the White House in the week leading up to the vote, and a couple of phone calls, including one after I announced that I would vote no, which did not go so well.

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The President is very persuasive, and he went out of his way to try to get every vote. In the end, the White House won. Although they did not get my vote, they persuaded enough people to win. This would not have happened if the President hadn’t been personally involved.

H QUESTION: So, what are your odds of re-election?

H ALTMIRE: Everyone has a different district, and I think that all representatives try to cast the best votes they can for their individual districts.

When deciding how to vote, I study what my role is as a representative verses the role of a Senator. The Founding Fathers did an amazing job in setting up Congress. In the House of Representatives, everything is set for action. Representatives have two-year terms and are immediately responsive to the people. Under House rules, the majority wins, every time. There are no impediments, and there are no road

blocks. Debate time is limited. Each of the House’s 435 seats represents the same number of people.

The Senate is very different.

Senators have six-year terms, so they can be more thoughtful and deliberate. In contrast to the House, Senators have every opportunity to obstruct legislation and put up road blocks. In the Senate, you need to have 60 senators agree to move forward before you can have a final vote on a bill. Another key difference is that no matter what a state’s population is, it has the same number of senators as any other state.

Rhode Island, Texas, Delaware, and California all have the same number of votes in the Senate. By design, that creates a very different dynamic from what we have in the House.

I view my role as a representative in two ways. First, it’s my job to make an informed and intelligent decision.

It is my job to make an effort to learn the details of every bill, which is why I listen to the insights of industry experts

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like you. I also have to draw upon my own personal experience. In the case of health-care reform, I did know something about the issue. Second, it is my job to represent my district, because that is what the Founders had in mind when they designed Congress.

When deciding how to vote, I balance my own knowledge and thoughts with my constituents’ views. If I am still undecided after doing this, then I will ultimately decide to vote in accordance with my district’s wishes. I think most members would do the same. There are some members whose vote on the health-care bill was unpopular in their districts. Many of these members will say, publicly, as well as privately: “I was willing to give up my seat because I thought voting the way I did was the right thing to do.”

On this particular vote, that was the decision that they made. a Josephine Rossi is editor of O&P Almanac.

Reach her at jrossi@strattonpublishing.com.

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Alignment and Fine Tuning of Pediatric and Adult AFOs: Utilizing the Strathclyde Approach and the Dynamic Response Ankle Foot

The Use of Balance Measures to Evaluate Outcomes in the Provision of Knee Ankle Foot Orthoses

Post-Mastectomy Care

Understand, Heal, and Protect the Diabetic

Walking Your Way Through Stance Control Orthoses (SCO) and Reciprocating Gait Orthoses (RGO)

Limb Prostheses: Tricks, Tips, and Creative Solutions

Soft Tissue Management for Prosthetics

Body Powered Upper

A Case Study of the Socket Forces Observed in Amputee

EDUC ATIONAL SESSIONS

Runners Differences in Internal Prosthetic Moment for Transfemoral Amputees Running With and Without a Knee Changes in Internal Prosthetic Moment with Walking Speed: A Case Study Unique Challenges of Hip Disarticulation and Hemipelvectomy Amputees Gait Analysis for Prosthetists and Orthotists Orthotic Management of the Hypertonic Foot FES Management: What It Can Mean to Your Practice International Track – Hosted by ISPO and BIV Safety in the Workplace Prosthetic Tricks of the Trade Innovative Suspension Methods for Disarticulation Amputees A New Hydraulic Foot/Ankle Prevalence of Shoulder Disarticulation Designs

Improving Outcomes for Bilateral Transfemoral Amputees: A Graduated Approach to Prosthetic Success

of Haptic Feedback for Improved Prosthetic Control

Evaluation of Locking Liner Suspension Control Mechanisms

Basics and Clinical Approach for TT, TF and HD Prostheses Biomimetic Limb – The Future Is Here

Application

Prosthetic Alignment: Biomechanical

Patient Benefit of the Multi Degree of Freedom Prosthetic Hand System “Michelangelo”

Cable Efficiency in Transradial Body Powered Prostheses

The

Analysis of Activities of Daily Life with a Polycentric,

Hydraulic Hip Joint System in Comparison to a Conventional Hip Disarticulation Style Prosthesis DynamicArm-TMR: A New Externally Powered Upper Limb Prosthetic System for those Undergoing Targeted Muscle Reinnervation (TMR) Symposium 34

Polymer Science – An Overview

O&P ALMANAC AUGUST 2010

Managing the Geriatric Spine: Degenerative Injury, Deformity and Pain

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ace The Pl !

To Be

An All-Star Cast of Speakers 2010 AOPA National Assembly raises the bar for clinical and business education

MARCUS BESSER, CONAL DOYLE is a

E

ach year, the AOPA National

Assembly planning committee strives to plan a program of

both business and clinical education

sessions to provide all levels of orthotic, prosthetic, and pedorthic professionals with valuable knowledge to advance their professional development. We recruit top experts from around the world to present at the Assembly, and this year is no exception. Read on to see this year’s lineup, which includes top-notch first-time presenters as well as seasoned Assembly favorites.

nationally recognized trial attorney and lower-limb amputee. With experience arguing before the U.S. Supreme Court, Doyle has been recognized as one of the Top 100 Trial Lawyers in California, and one of the Top 20 Lawyers under 40 in California. Doyle specializes in representing amputees and prosthetists in injury and insurance claims.

Doyle’s session, “How to Appeal Payer Denials for High Technology O&P Products,” part of the “Good Business $ense” panel from 2 to 5 pm on Friday, October 1, will cover the legal and practical ramifications of interacting with insurance companies during the claims process. Topics to be covered include: • how to package a claim to increase the chances of initial approval • how to deal with a claims denial, both during the appeals process and after final denial • what information you need from your patient • what information you need to provide to the insurance company • what actions to take when the initial claim is not approved.

PhD, graduated from the University of Michigan with a bachelor’s degree in mechanical engineering. He earned his master’s degree and PhD from Drexel University’s Department of Mechanical Engineering. Besser is a professor in the Department of Physical Therapy in the School of Health Professions and director of the Human Performance Laboratory at Philadelphia’s Thomas Jefferson University. His research focuses on gait analysis of children with cerebral palsy, changes in gait indicative of fall risk in the elderly, and the development of instrumentation for analysis of slip-and-fall risk.

Besser’s presentation, “Gait Analysis for Prosthetists and Orthotists,” from 10:30 am to 12:30 pm on Friday, October 1, will include: • techniques for integrating quantitative gait analysis into your practice • a brief overview of qualitative and quantitative gait analysis • specific examples of outcome measures that have been shown to be relevant for prosthetic delivery • the collection and evaluation of temporal and spatial parameters of gait.

AUGUST 2010 O&P ALMANAC

35

JOHN MARKUS, JD, served as execu-

Registration is now open— visit www.AOPAnet.org for updates and more information. Call us anytime at 571/431-0876 if you have any other questions.

BRUCE TULGAN, speaker and best-selling author of It’s Okay to Be the Boss, has delighted audiences around the world in organizations as diverse as Aetna, Wal-Mart, the Army, and the YMCA. Recognizing his expertise on the different management strategies needed in today’s multi-generational workforce, last year, Tulgan was awarded Toastmasters International’s most prestigious honor, the Golden Gavel. Annually presented to a single person who represents excellence in the fields of communication and leadership, the award’s past winners include Marcus Buckingham, Stephen Covey, Zig Ziglar, Deepak Chopra, Tony Robbins, Ken Blanchard, Tom Peters, Art Linkletter, Dr. Joyce Brothers, and Walter Cronkite.

On Friday, October 1 at 7:30 am, join this year’s keynote speaker for a compelling blend of insight, laughout-loud humor, and concrete best practices that can be put to work immediately in your practice. You won’t want to miss this one!

36

O&P ALMANAC AUGUST 2010

tive vice president and chief compliance officer for HealthSouth Corp., one of the nation’s leading rehabilitation, surgery, and diagnostic services providers. Prior to joining HealthSouth, Markus served as senior vice president for corporate compliance at Fresenius Medical Care North America and designed and updated regulatory compliance programs at Oxford Health Plans Inc. and National Health Laboratories. In addition to his corporate experience, Markus has been in private law practice and has represented clients before Congress and federal health-care agencies on provider regulation and reimbursement, Medicare coverage policy, and regulatory compliance.

In his session, “The Implications of Health-Care Reform Legislation for Orthotics and Prosthetics” on Friday, October 1 from 10:30 to 11:30 am, Markus will discuss: • the short- and long-term implications for O&P reimbursement as a result of the recently enacted health-care reform legislation • the general environment for future technology innovation • how the expansion of health-care coverage to an estimated 32 million additional Americans will create significant new demands for a variety of medical items and services, including O&P • how productivity adjustments will restrain Medicare payment increases and new excise taxes will squeeze manufacturers’ margins across all markets • the intensified focus on comparative effectiveness research, broader payment bundles, and care coordination • value-based purchasing for hospitals and other Medicare providers.

MEHRSHEED SINAKI, MD, MS, is a professor of physical medicine and rehabilitation at the Mayo Clinic in Rochester, Minnesota. Sinaki is certified by the American Board of Physical Medicine and Rehabilitation and has developed various exercises for strengthening back muscles for management of osteoporosis, kyphosis, vertebral fractures, and risk of falls. She is the author of more than 400 scientific publications and associate editor of the first and second editions of Dr. Randall Braddom’s Textbook of Physical Medicine and Rehabilitation.

Sinaki will be part of the “Managing the Geriatric Spine: Degenerative Injury, Deformity and Pain Symposium” on Friday, October 1 from 2 to 5 pm.

Learn about “Developing a Stronger Back Despite Aging and Osteoporosis: The Spinal Proprioceptive Extension Exercise Dynamic (S.P.E.E.D.) Program.” This program will present a method for strengthening back extensors and reducing back and flank pain in osteoporosis-related spinal deformities. a

Registration for the 2010 AOPA National Assembly is now open at www.AOPAnet.org. Click on the Assembly logo to link to the registration form. If you have any questions, please contact Ann Davis at 571/431-0876 or adavis@AOPAnet.org.

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Facility Spotlight

n

By Deborah Conn

Centralized and On Target American Prosthetics & Orthotics’ extender business model improves efficiencies, patient visits

American Prosthetics & Orthotics Inc. (APO) headquarters building, located in Clive, Iowa.

American Prosthetics & Orthotics Inc. (APO) new building, located in Davenport, Iowa.

FACILITY: American Prosthetics & Orthotics Inc.

Rod Cheney, CPO, with a patient

LOCATION:

8 offices in Iowa, 1 in Moline, Illinois

OWNER:

Ron Cheney, CPO

HISTORY:

29 years in business 38

O&P ALMANAC AUGUST 2010

T

he origins of American Prosthetics & Orthotics Inc. (APO) date back to 1958, when Ron Cheney, CPO, FAAOP, began his career in the Des Moines, Iowa, office of the Minnesota-based Winkley Artificial Limb Co. Winkley spun off the Iowa branch in the mid 1960s, and in 1972, Cheney and three colleagues purchased the company, then called American Prosthetics Inc. Sole owner

since 1988, Cheney now presides over eight offices in Iowa and one in Moline, Illinois.

An 18,000-square-foot building in Clive, Iowa, houses the practice’s corporate offices and patient-care facilities. APO practitioners see a wide variety of orthotic and prosthetic patients throughout the practice.

The family-owned business employs Ron’s elder son and Executive Vice-President Rod Cheney, CPO; Brent Cheney, CO, Ron’s younger son, who is director of material management; Ron’s wife, Rikki, director of internal affairs; and Ron’s brother Gary Cheney, CPO, FAAOP, who is APO’s compliance director. They are part of a 65-member

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Facility Spotlight

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Gary Cheney, CPO, FAAOP, with a patient

staff encompassing 25 clinicians, 10 assistants, 15 technicians, and 25 administrative employees.

The focus for APO practitioners is seeing patients, and Rod Cheney describes what he calls an “extender” practice model that allows them to do so. “We have about 10 people who function as assistants to our practitioners,” he explains. “They help with fittings, deliveries, adjustments, and other tasks—all under the guidance of certified clinicians. This allows the practitioners to give their attention to the large volume of patients we see. I definitely see that as the direction of our practice.”

Creating Efficiencies In another effort to extend the reach of its practitioners, APO opened a new central fabrication facility in Davenport, Iowa, last October. Before that, each office had been responsible for its own fabrication. Cheney expects the shift to cut both the cost and the time involved in fabrication.

Another centralized function at APO is its internal insurance department, located in the Clive headquarters building. Each office collects insurance information from patients and electronically transmits it to the central department, which immediately verifies coverage. “In most cases, patients know what their financial obligation is before they leave the facility,” says Rod

40

O&P ALMANAC AUGUST 2010

Cheney. “The insurance department also handles our financing option, if patients need it, which is run through Care Credit, a health-care credit card.”

Cheney says APO launched the insurance department seven years ago to speed up receivables. “We were great at taking care of patients, but not so good at managing cash flow and receivables,” he says. “The eight employees in our insurance department make follow-up calls all day long, and they have built up good relationships with insurance carriers.

Creating this department really turned us around. In the past, APO’s accounts receivables ran 60 to 90 days, but now are about 30 days.”

APO is looking at other ways to make the practice more efficient, including standardizing care among the eight offices. “Costs have increased, and so have our overhead and wages,” says Rod Cheney. By standardizing care and many components, the business can get volume discounts and shipping agreements with certain suppliers. “The squeeze is on. It’s not business as usual,” says Cheney. “So we go over financials regularly with our managers and work to educate practitioners to stay on top of costs.”

APO participates in buying groups, such as OPGA (The Orthotic and Prosthetic Group of America), to take advantage of volume discounts, and it works with nearby distributors who can provide next-day delivery, thereby reducing APO’s inventory costs.

an arcane field to those without a direct connection, Johnson highlights APO’s expertise and commitment to the community through news releases, training seminars, and shared sponsorship of such events as the annual Iowa amputee golf tournament. Johnson puts out a newsletter three times a year that describes patient success stories, new products and services, and employee and facility news. Referral sources, including doctors and therapists, receive the newsletter via first-class mail, and patients can pick up a copy at each APO office.

Spreading the Word

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

Want your facility to be considered

For the past 14 years, APO has contracted with Ron Sonntag Public Relations in Milwaukee, a company that specializes in O&P, to provide its marketing and public relations activities. The focus is on education, says Sonntag Executive Vice-President Patty Johnson. Because O&P can be

Brent Cheney, CO, with a patient

APO also is active in state and national industry organizations. Rod Cheney is a former board member of AOPA and past president of the Iowa Prosthetic, Orthotic, Pedorthic Association.

Looking ahead, Cheney believes the success of APO depends on how it responds to the new health-care legislation. “Only companies that are on top of their expenses and can move swiftly in this new marketplace will survive,” he says. “The O&P industry will not be the same.” a

for the next Facility Spotlight column? Contact the editor at jrossi@strattonpublishing.com.

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AOPA Headlines AOPA WORKING FOR YOU

RESEARCH

Takes a Front Seat

With the squeeze on reimbursement rates, AOPA makes research a top priority

I

n real estate, it’s all about location, location, location. However, in the world of patient care, it’s research, research, research. While O&P reimbursement is forever changing, two constants remain: Regulations surrounding the new health-care reform law will be written to reflect the government’s need to reduce Medicare and Medicaid’s growing cost burden, and comparative effectiveness research will increasingly drive reimbursement

44

O&P ALMANAC AUGUST 2010

levels flowing from Medicare, Medicaid, and third-party payers.

Answers are needed to demonstrate which treatment option, which device, or which surgical procedure is going to produce the most patient-centered and cost-effective outcome. And nobody is going to do that research for us. The O&P community must take the lead in producing quality research or forever take a back seat when it comes to payments.

AOPA has moved aggressively to encourage this kind of industry research. After issuing an RFP in four research areas early last year, AOPA, along with the Center for Orthotic and Prosthetic Learning and Outcomes/ Evidence-Based Practice (COPL), awarded three $7,500 grants funded by AOPA in June 2009. The COPL board of directors reviewed the submissions and recommended three research projects be funded The project areas selected were: “Comparison of Liner-Assisted Suspensions in Transtibial Prosthetics: A Pilot Study,” “Functional Outcomes of a Custom, Energy Harvesting ‘Bullfrog’ AFO,” and “Estimation of the Axis of Rotation Position in Non-Articulated Energy Storage and Return Prosthetic Foot-Ankle Mechanisms: Implications for Prosthetic Foot-Ankle Mechanism Efficiency and Motor Control Strategies in Unilateral Transtibial Amputees.”

The final reports are due Dec. 31, 2010, and the COPL board of directors will evaluate the findings and determine how to position these research results to secure further funding for expanded research.

Another set of pilot project research grants was awarded in June: • A Pilot Study—Outcomes Assessment of Vacuum-Assisted Socket Systems, submitted by Sam Phillips, PhD, CP, (Principal Investigator), Tampa Veterans Research and Education Foundation • A Pilot Project—Investigation of Prosthetic Socket Interface Pressure: Effects of Suspension Types and Socket Alignment, submitted by Fan Goa, PhD (Principal Investigator), University of Texas Southwestern Medical Center at Dallas • A Pilot Project—Exploiting Lower-Limb Orthotic Constraint of Movement as a Strategy for Neuromuscular Recalibration,

submitted by Christopher Hovorka, MS, CPO, LPO, FAAOP (Principal Investigator), School of Applied Physiology, Georgia Institute of Technology, Atlanta.

But there is more in the works.

Eight AOPA member manufacturers of energy-storing prosthetic feet and microprocessor prosthetic knees have agreed to invest an estimated $400,000 in research for measuring the comparative effectiveness in categories of various knees and feet. This research is envisioned as a cooperative effort under the AOPA/COPL research umbrella. The research is not a brand comparison within these categories, but rather a comparison of these more recently evolved technologies with their predecessors, such as sach feet and hydraulic knees.

The study will be conducted by

Don’t Delay!

REGISTER TODAY www.AOPAnet.org

independent third-party researchers.

COPL will have a key role in evaluating RFPs and recommending one or more researchers based on the RFP submissions. Neither AOPA, COPL, nor individual manufacturers will have any involvement once the researchers are selected other than that the manufacturers will supply sample products for the study and any necessary training.

The energy-storing foot RFP is expected to be issued around the time this issue of O&P Almanac is published, while the microprocessor knee RFP is expected to be issued shortly after the AOPA National Assembly, Sept. 29–Oct. 2, 2010, in Orlando at the Rosen Shingle Creek Resort.

Added to this mix is the patient registry framework developed for AOPA by the Thomas Jefferson School of Health Policy. About 20 AOPA

patient-care facilities participated in gathering data on randomly selected patients to document the validity of this instrument for measuring treatments and device outcomes across a range of needs for patients with limb loss or limb impairment.

It’s hard to fathom the incredible need for investment in research. But if the O&P community doesn’t muster the resources and the backing to move forward, the entire opportunity to continue delivering quality patient care may be thwarted by the ever increasingly sharp knives wielded by the payers. Adequate research is beyond the reach of a single company in the O&P field. That’s why AOPA must make an effort to provide leadership in urging collective and shared responsibility by all with a stake in the outcomes to aggressively pursue research now and in the years ahead. a

RegistR

Early Bird Deadline for 2010 AOPA National Assembly is August 20!

If you have not yet registered to attend the 2010 AOPA National Assembly, there’s no time to lose. Be sure to register

by August 20 to qualify for the early-bird rate of $565 ($935 for nonmembers). On August 21, the cost of registration increases to $665 ($995 for nonmembers).

Highlights of this year’s assembly include a motivational keynote address by Warren McDonald on the challenge of change, a special business keynote speech focusing on managing intergenerational workers by Bruce Tulgan, the first ever Award Winning Business Lecture, the Thranhardt Award Winning Lectures, the best clinical and business education sessions to be offered all year, Friday night complimentary bus transportation to Universal Studios’ CityWalk nightclub complex, and the opportunity to win $10,000!

August 20 also is the deadline for booking hotel rooms at the luxurious Rosen Shingle Creek for just $199 per night.

However, the hotel often sells out before the deadline. If you do not yet have a reservation, we advise you to call the hotel immediately at 866/996-6338.

ation is Visit www .AOPAnet.org now op for updates en and additiona re August l informati 20 and on.

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AOPA’s 2010 National Assembly will provide you with the opportunity to earn more than 34 continuing education credits; network with your colleagues, clients and suppliers; enjoy a fabulous luxury resort experience in Orlando, and more. Register today at www.AOPAnet.org.

AUGUST 2010 O&P ALMANAC

45

n

AOPA Headlines Don’t Delay!

Final Coding & Billing Seminar of 2010

REGISTER TODAY www.AOPAnet.org

October 14-15 in Las Vegas AOPA’s final “Mastering Medicare: Advanced Coding & Billing Techniques” seminar of 2010 will be held at the Mandalay Bay Hotel and Casino in Las Vegas, October 14-15. Hundreds of your colleagues already have benefited from this detailed, advanced seminar given by AOPA’s coding experts as well as members of the AOPA Coding & Reimbursement Committee. Join us in Las Vegas where you will:

• learn how to code complex devices, including repairs and adjustments, through interactive discussions with AOPA experts and your colleagues • join in-depth discussions on compliance with Medicare billing rules and documentation expectations • learn how to assess compliance risk areas and deal with them • learn successful appeal strategies and hints on avoiding claim denials • take part in break-out sessions for practitioners and office staff • receive detailed information on hot-topic issues in O&P • earn 14 continuing education credits in two days.

Seminar attendees stay at the Mandalay Bay Hotel and Casino for just $105/night! Cost of attending the seminar is $525 for members/$725 for nonmembers if you register

by September 14. (After the early-bird deadline, the cost goes up by $25 per person.) Any additional attendees from the same office get a $50 discount—just $475 for members and $675 for nonmembers. Join us in Las Vegas, bring your toughest coding questions, and spend an informative two days with AOPA’s experts and your colleagues.

Register at www.aopanet.org. Contact Ann Davis at adavis@ AOPAnet.org or 571/431-0876 with questions.

Register Now for August 11 Audio Conference:

How Good Is Your Compliance Plan?

The DME MACs and the Office of Inspector General • how and when to (OIG) are taking a closer look at the billing practices of perform self-audits O&P professionals. In today’s environment of increased • appropriate compliance provider scrutiny, a well-designed effective compliance training for your staff. plan is a necessity for any successful O&P business.

The cost of particiEnsuring your own billing practices are sound may prevent pation is just $99 per line unnecessary audits down the road. for members ($199 for Join AOPA on Wednesday, August 11, from 1 to 2 pm EST nonmembers). Any number for the latest AOPAversity audio conference, “Medicare’s of employees may listen on Knocking: How Good Is Your Compliance Plan?” Topics to a given line. Those needing be discussed during this call include: continuing education • how to establish and manage an efficient compliance plan can earn 1.5 credits by • the need for a dedicated company compliance officer returning the provided quiz • OIG guidance on the seven fundamental elements of an within 30 days and scoring effective compliance plan at least 80 percent.

• actions to take when compliance deficiencies are Register at www.aopanet.org. Contact Ann Davis at discovered adavis@AOPAnet.org or 571/431-0876 with questions.

46

O&P ALMANAC AUGUST 2010

n

AOPA Applications

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:

Fillauer Orthotics & Prosthetics 2710 Amnicola Hwy. Chattanooga, TN 37406 423/698-8971 Fax: 423/642-5160 Category: Affiliate Parent Company: Fillauer Companies Inc., Chattanooga, TN

Limbcare Prosthetics & Orthotics of Georgia Inc. 2925 Ledo Road, Unit 25 Albany, GA 31707 229/430-9778 Fax: 229/430-1347 Category: Patient-Care Facility John P. Rodman, Sr., CPO, FAAOP

OandPDirect.com 1111 W. San Marnan Drive Waterloo, IA 50704 800/532-6729 Category: Supplier Affiliate Parent Company: Orthotic & Prosthetic Group of America (OPGA), Waterloo, IA

Peachtree Prosthetic & Orthotic Fabricators P.O. Box 1934 Monroe, GA 30656 770/267-3711 Fax: 770/267-3522 Category: Supplier Level 1

Tindal O&P Associates 3244 Kimball Avenue Manhattan, KS 66503 785/537-8897 Fax: 785/5378893 Category: Patient-Care Facility Bobby Tindal, BOCO

Top Shelf Orthopedics 1851 E Paradise Road, Ste. A Tracy, CA 95304 866/592-0488 Fax: 209/834-8832 Category: Affiliate Parent Company: Pacific Medical Prosthetics & Orthotics, Tukwila, WA

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

OP Almanac Online &

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Access advertiser Web sites by simply clicking on the hotlinks Access content with the click of a mouse or the touch of a smart phone Easily e-mail 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.

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For more information, call 888/6786548, e-mail info@allardusa.com, or visit www.allardusa.com.

APIS

Apis is dedicated to providing our valued customers satisfactory solutions to many difficult problems, shoes that accomodate severe charcot, edema, and bunions. Our shoes are made of high-quality genuine leather with soft leather linings. Our shoes come in many different widths from AA to 14E and size from 4.5 to 20, all stock items for immediate delivery. We offer custom molded foot orthotics at a really low price, and our full line of service offering will make us the one-stop shop for all your pedorthic needs.

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Whether it is a custom shoe order, shoe mods or slit pairs, or orthotics materials order, call our friendly customer service at 888/937-2747 for detailed information about any of our products or programs.

THE ONYX® FOOT FROM COLLEGE PARK Integrating a dynamic pylon, the multi-axial Onyx® Foot allows active users to demand more. Highly customizable, the Onyx® has four degrees of plantar-dorsiflexion Angle Control and adjustable Stride Control™ for fine-tuning gait. The sleek Onyx® foot delivers balanced energy with ideal comfort and enhanced terrain compliance. Key benefits include: • Superior terrain compliance • The only Dynamic Pylon foot with four degrees of plantar-dorsiflexion Angle Control • Precision gait matched for out-of-the-box performance • Adjustable Stride Control™ to fine-tune foot stiffness from heel strike to heel off • Three-year warranty.

Check your mailbox: Special Customer Loyalty Savings on the Onyx during the third quarter of 2010!

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

SPECTRACARB STOCKINETTE & SPECTRACARB/ARALON STOCKINETTE

Wish there was a way to make minor adjustments to a socket without it delaminating? Tired of all the itching

when grinding a carbon socket?

Then check out Comfort Products’ two innovative tubular stockinettes: SpectraCarb Stockinette & SpectraCarb/Aralon™ Stockinette.

Both have the ability to be modified using a heat gun without delaminating.

No itching when grinding these stockinettes.

• Available in 5- and 25-yard rolls • Easy workability, wets out well, strength and fatigue resistant • Comes in 2-3-4-5-6 in. and 8 in. widths • Superb strength with some flexibility • Very lightweight.

For more information, call Comfort Products, the innovation leader in knitted Orthotic & Prosthetic products, at 800/822-7500 or email us at info@ comfortoandp.com.

LOOKING FOR SOMETHING COOL?

Summer is here and if the thought of wearing a piece of plastic around your leg on a 90° day is uncomfortable for you, imagine what your patients think.

For cool alternatives check out our nine different AFO’s and two styles of partial foot prosthesis. Minimal bracing for specific conditions along with high-tech materials allow us to reduce size and skin contact area while restoring and enhancing normal function.

For more information and a guide for selecting the right AFO for your specific patient’s physiology and lifestyle call 866/273-2230 or visit www.cc-mfg.com.

EURO JUNIOR ORTHOTIC IN STOCK AT EURO INTERNATIONAL! The Euro Junior Orthotic is the perfect solution for gently improving posture in children.

The orthotic improves bio-mechanical function without interfering with the foot’s natural growth.The top cover of the orthotic is a microfiber, and the bottom cover is slip resistant. The Euro Junior is heat moldable and grindable ensuring a perfect fit for children. It is available in double sizes from 22/23 to 40/41.

For more information, contact your account manager at 800/378-2480 or visit www.euroorthotics.com.

SFX WITH HOSMER KNEE TECHNOLOGY SPECIAL KIT PRICING The Weight Activated Locking Knee (WALK) and Single Axis Friction Knee (SAFK) are compact, durable options for patients requiring extra stability and performance. The independent friction and mechanical stance control adjustments make it easy to fine-tune the knee to each patient’s individual needs. Adding the Sfx to the WALK or SAFK provides adjustable stance flexion and greater stability at heel strike. The Sfx increases balance during initial weight loading and adds a moderate amount of shock absorption for a smoother gait. Weighing just 241g with a build height of 3.34 in., the Sfx comes in three adjustable load levels for optimized function. Kit provides a 15 percent savings.

For more information, call Hosmer at 800/827-0070 or visit www.hosmer.com.

KISS TRAINERS––DYNAMIC FLEXIBLE KEEL STUBBIE FEET

THE ALPHA SELECT LINER: CONTROLLED PISTONING

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 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 410/663KISS (5477) or visit www.kiss-suspension. com.

The Alpha Select combines many frequently-requested liner traits into one product. Controlled pistoning is one of the leading liner characteristics desired by wearers of locking liners. The one-way stretch fabric used in Alpha Select Liners effectively controls pistoning without the use of a traditional rigid distal matrix. The one-way stretch fabric provides tissue compression without uncomfortable pressure on the limb.

Additionally, the fabric stretches circumferentially allowing for easy donning of the liner for a variety of limb shapes.

For amputees who seek controlled pistoning, but are not due for a new socket, a retrofit option is available.

For information, call Ohio Willow Wood at 800/848-4930 or visit www. owwco.com.

DYCOR

TAKING THE NEXT STEP...

Introducing Dycor's Single and Double Ended Advanced Composite DRP Pylon System

Dycor's dynamic response pylon systems are available in 5 different wall dimensions to match strength and flexibility with weight and "K" level when used with Dycor's ADL AFP flexible keel, DR dynamic response and K SERIES feet. The single ended variant is used only with Dycor's AFP flexible keel feet and is available with integrated uni- and multi-axial ankles aligned in neutral. Custom single ended pylon systems are available to accommodate angular adjustments at the ankle during dynamic alignment with a loaner AFP foot. Simply call Dycor's Technical Assistance Dept. toll free number at 1-800-794-6099 with your specifications, and Dycor will provide the appropriate pylon system with pre-aligned foot and ankle components. Allow 4 working days for processing. Wt. limit is 286 lbs. and total installation weight of the single ended, single axis pylon system including foot and socket adaptor is 1.5 lbs. Custom single ended pylon systems are available at no extra charge with free ground shipping.

For more information please contact our Technical Support Dept. or visit our website at www.dycormfg.com

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Marketplace

OPTEC’S CUSTOM BRACES–– $50 OFF IN AUGUST For nearly 15 years, OPTEC has been a leader in custom spinal orthotic manufacturing. OPTEC provides the highquality products and services you need from your central fabricator.

With around-the-clock technical support, quality products at a fair price, and availability to take orders any time, you will find that OPTEC fits your needs. Further, you will get your custom brace when your patient needs it, just the way you want it. Plus, order a custom spinal brace now through Aug. 31, 2010, to receive $50 OFF the regular price! PDAC recently reviewed OPTEC’s custom spinal braces—see the L-Code determinations and letters online at www.OptecUSA.com.

For more information, contact OPTEC at 888/982-8181 or e-mail sales@optecusa.com.

STEALTH X––PDAC APPROVED L0637

Continuing in the tradition of excellence, OPTEC is pleased to introduce the Stealth X. The Stealth X, our newest and most revolutionary streamlined design, provides unmatched saggitalcoronal support. The closure system glides like butter and provides smooth compression which can be regulated by your patients. Our unique,

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durable, flexible, closure system with polymer straps provides additional reinforcement and support to the posterior for complete rehabilitation.

Stealth X combines the benefits of a post-op and rehab brace, all in one lightweight, innovative design. PDAC recently determined that L0637 is the appropriate HCPCS code for the Stealth X. Order yours today!

For more information, contact OPTEC at 888/982-8181 or e-mail sales@optecusa.com.

THE STEALTH TLSO––GLIDE TO WARP SPEED RECOVERY! OPTEC’s Stealth TLSO provides motion restriction for the thoracic and lumbar regions. The Stealth TLSO is available in 3 Panel and 4 Panel designs, which include a Dorsal Lumbar Kit (DLK) or a DLK with your choice of Anterior Thoracic Attachment (ATE). The Stealth TLSO allows you to restrict the thoracic vertebra with the ease of use and precise compression of our unique closure system. PDAC recently determined that L0462 and L0464 are the appropriate HCPCS codes for the Stealth TLSO with DLK and the Stealth TLSO with ATE, respectively.

For more information, contact OPTEC at 888/982-8181 or e-mail sales@optecusa.com.

OPTEC PRODUCTS WITH PDAC APPROVED CODES

OPTEC consistently offers cutting-edge products of the highest quality. Beyond offering innovative

orthoses at a fair price, OPTEC works to help your practice be successful by submitting braces to the Pricing, Data Analysis, and Coding (PDAC) Center.

PDAC recently reviewed many OPTEC products with the following decisions: VertaMax–L0627, Stealth PRO–L0631, Stealth Rehab–L0627, Stealth X–L0637, Stealth LSO LP–L0637, Stealth Xtreme– L0637, Stealth TLSO with DLK–L0462, Stealth TLSO with ATE–L0464, along with many custom spinal products.

Additionally, the Stealth LSO, Oasis LSO, and Oasis LSO LP continue to be L0637. For more L-Code determinations visit www.OptecUSA.com.

For more information, contact OPTEC at 888/982-8181 or e-mail sales@optecusa.com.

ÖSSUR LAUNCHES NEW RHEO KNEE® WITH MULTIPLE ADVANTAGES The new and improved RHEO KNEE, the latest addition to Össur’s innovative Bionic line, now offers a higher weight limit (275 pounds), increased torque, faster swing speed, and improved aesthetics. Thanks to its low build height, the RHEO KNEE is compatible with the entire Össur Flex-Foot line. Together they deliver maximum dynamics and a natural gait experience. As always, the Rheo Knee recognizes and responds immediately to changes in speed, load, and terrain, restoring the user’s ability to walk naturally, comfortably, and confidently at any speed.

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

Extreme Cushion

Liner & Sleeve

Providing more of what you want and need!

Extreme Advantage-Indicated for Transfemoral OR ACTIVE Transtibial amputees; Reduce on-hand inventory cost and space requirements through application on either TT or TF amputees.

Extreme Contact-- 80% Less Vertical Stretch As compared to other Alps gel liners, resulting in demonstratively increased contact while stabilizing movement of redundant tissue.

Extreme Suspension-New GripGEL™ is more tactile than EZGel to gently but firmly support the residual limb and sensitive tissues.

Extreme Versatility-Alps New Extreme Cushion Liner has limited vertical stretch to reduce movement of redundant tissue. Use appropriate for TT or TF applications.

Cushion liner available in 3 mm or 6mm Uniform profile to fit circumferences ranging from 1653 cm. Sleeve available in 3mm or 6mm in sizes 20 - 70 cm.

Alps New Extreme Sleeve seals against the skin without restricting circulation or causing shear forces. ALPS GripGel helps prevent the sleeve from rolling down the patient’s limb.

800.574.5426 www.easyliner.com info@easyliner.com

NOW IN STOCK: © 2009 ALPS. All Rights Reserved.

Experience Our Commitment

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Marketplace

NEW SOLUTION FOR HIP FLEXION CONTRACTURE

FINALLY!

A new lamination anchor simplifies fitting patients with hip flexion contracture making it easier for you to optimize alignment. Otto Bock’s new 4R119 features an angled posterior arm. That angle means less bending, which can also weaken a component and lead to failure. The durable stainless steel construction accommodates a 330 lb weight limit.

Exclusively from Otto Bock, you can trust the quality built into everything we do.

For more information, contact your local sales representative at 800/328-4058.

MOBILITY WITH STABILITY–– NEXT-GENERATION IN K2 FOOT DESIGN

Eliminate the need for realignment or painstaking adjustments and help improve your patient’s stability, with the 1M10 Adjust. Designed specifically for the K2 walker, the Adjust foot provides a stable center of gravity, allowing you to make adjustments, even change the heel strike stiffness with the Adjustable Heel Function, without realignment. To find out more about Adjust call 800/3284058 or visit www.1M10Adjust.com.

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O&P BOARD STUDY

FINALLY!! O&P Board Study Resources RESOURCES We can help you PASS your BOARDS

The ONLY Comprehensive Study Guides

We Specifically for Orthotics and Prosthetics can help you pass your boards.

(Many of our products are available in DVD Format also!)

The only comprehensive study JUST ADDED: guides specifically for orthotics and The MASTECTOMY FITTER’s Review and Study Guide prosthetics. Many of our products are We also have Board Study Value Packages available in DVD format also! Just in Orthotics and Prosthetics added: the Mastectomy Fitter’s Review Our BEST SELLING products to save you money! and Study Guide. We also have board www.oandpstudyguide.com study value packages in orthotics and prosthetics. Our bestselling products save you money!

For more information, visit www. oandpstudyguide.com.

• Maintenance-free Oilite® Sleeve Bearings • Standard pyramid adapter included • Integrated distal pyramid • ISO tested & rated:220 lbs (100 kg) PEL Supply stocks over 45,000. products, components, tools and accessories, with many available for same day shipment. For information on the Entegra SV or any products from the Fillauer Companies, contact PEL by phone at 800/321-1264, by fax at 800/222-6176, or e-mail customerservice@pelsupply.com, or visit www. pelsupply.com.

HOSMER ENTEGRA SV FROM PEL SUPPLY The new smaller version (SV) of the Entegra Knee from Hosmer has hydraulic swing phase control and is constructed using a durable, lightweight aluminum alloy with a polished finish that allows it to be used with or without a cosmetic cover.

It features four modular proximal attachment component configurations: pyramid, four-hole pattern, threaded, and spectrum alignment slide attachments. This unique proximal attachment design permits knee rotation for alignment and its compact size is perfect for smaller patients where clearance and weight are concerns.

• Only 7-inches (18 cm) tall • 135° range of motion • Integrated kneeling pad • Rugged thru-bolt design

WATER-RESISTANT PLIE 2.0 MPC KNEE AT SPS Discover all the wonders of the NEW Plie’ 2.0 MPC Knee. SPS has the redesigned microprocessor knee in stock and available Its synergistic microprocessor and hydraulic technologies deliver a highly responsive prosthetic knee, while facilitating a natural and intuitive mobility. Microprocessor control of both swing and stance phases delivers advanced stumble recover capability.

The finely tuned control system delivers near instantaneous adaptation to gait dynamics. Freedom Innovations’ game-changing Plie’ Set-Up Wizard eases performance optimization and increases fitting efficiency. The new Wizard streamlines programming and set-up of the knee, utilizing automated parameter settings to maximize performance.

For additional product information call SPS Customer Service at 800/7677776 x 3.

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Jobs Pacific

INCREASE EXPOSURE AND SAVE!

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

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

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

Member Non-member 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 $634

$678 $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 e-mailed 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.

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 board in the industry at jobs.AOPAnet.org!

Member Rate $80

Non-member Rate $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 AUGUST 2010

CO, CPO California Leading orthotics and prosthetics company is looking for energetic and motivated individuals to provide comprehensive assessment, treatment, and follow-up for patients.

Duties include assisting in day-to-day office activities such as but not limited to: • See in-office patients and perform comprehensive assessments to obtain an understanding of their orthotic/ prosthetic needs.

• Formulate and implement treatment plans by performing a diagnosis-specific functional clinical examination that includes manual muscle testing, gait analysis, cognitive ability, range of motion, etc.

• Perform the necessary procedures to deliver the appropriate orthotic/prosthetic services, including fabrication.

• Abide by the Canons of Ethical Conduct instilled by ABC. • Physical requirements such as casting patients, assisting with lifting patients, walking/providing stability for patients, etc.

• Excellent communication a must.

SCOPe offers competitive salaries as well as an excellent benefits package for full-time employees. Salary is commensurate with experience. All communications will be held in the strictest confidence. Interested parties can send resumes via e-mail to:

Fax: 858/292-5496 E-mail: jobs@scop.net www.scop.net

Orthotics-Prosthetics Practitioner Seattle, Washington Come experience Harborview, an exciting place where extraordinary work is completed in our daily routine!

Region’s only level-one adult/pediatric trauma and burn care center, Harborview Medical Center manages a prosthetic and orthotic service program that offers an exciting opportunity in the prosthetic and orthotic management of a complex, and diverse patient population. Perfect match for individuals seeking exciting professional challenge.

Visit www.uw.edu/jobs/hmc for req 63712.

Maria Kim, Recruiter Phone: 206/598-3784 E-mail: mariakim@uw.edu EO/AAE

CO/CPO

Northeast

CPO Boston Immediate career opportunity in Boston as O&P practitioner. Individual would be expected to have knowledge of both lower- and upper-extremity prostheses, as well as orthotics. Professional demeanor and appearance, attentiveness to detail, pride in work, all a must. Benefits include health insurance, 401(k), paid vacation and holidays, disability. Forward qualifications to:

Vermont Yankee Medical is looking for a CO or CPO who wants to participate in Vermont’s way of life. Vermont is a small state with a small population and all the benefits of more populous areas such as theater, orchestra, and the rest of the arts, but without traffic jams and high crime rates. Also, if you are someone who wants access to skiing, hiking, hunting, snowmobiling, sailing, diving, and all of the other activities that make us a year-round destination, then Yankee Medical is the place you want to be.

Contact:

John Ficociello, CPO Yankee Medical Phone: 800/649-4591 E-mail: jnf@yankeemedical.com

United Prosthetics 295 Columbia Rd. Boston, MA 02121 E-mail: chris@unitedprosthetics.com www.unitedprosthetics.com

AVAILABLE POSITIONS

Why do I work for Hanger?

“

Hanger offers amazing resources for growing my skills. I have access to a vast network of more than 1,000 fellow practitioners across the country that I can call on—and I can learn far more from their real-life experience than I ever could from a textbook.

Phoenix, AZ Rancho Mirage, CA Denver, CO Jacksonville Area, FL Tampa, FL Chicago, IL Springfield, IL Evansville, IN Michigan City, IN Methuen, MA

Jackson, MS Las Cruces, NM Toledo, OH Philadelphia Area, PA Richland, WA Milwaukee, WI Manitowoc, WI Morgantown, WV Wheeler, WV

Orthotist/Prosthetist

Plus, I can take advantage of continuing education opportunities and extensive technological resources by being part of the largest prosthetic and orthotic company in the nation. I plan to have a long career with Hanger.

”

Charlye Tran, CPO, Practice Manager

Contact, in confidence: Sharon King, Director, Recruitment Tel: 678-455-8865 sking@hanger.com Hanger Orthopedic Group, Inc. 10910 Domain Drive, Suite 300 Austin, TX 78758

Frisco, CO Hollywood, FL Tallahassee, FL Thomasville, GA

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

Jackson, MS Cincinnati, OH El Paso, TX

Prosthetist

Denver, CO New Orleans, LA Hattiesburg, MS Meridian, MS

Cleveland, OH Westlake, OH Enid, OK Morgantown, WV

Prosthetist/Orthotist

Merced, CA Denver, CO Grand Junction, CO Miami, FL Marietta, GA Louisville, KY

For more information 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

Orthotist

Mesa, AZ Tacoma, WA

West Monroe, LA Baltimore, MD Farmingdale, NJ Olympia, WA Port Angeles, WA Lakewood, WA

Certified Pedorthist

Vancouver, WA Wheeling, WV

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Jobs Southeast

Northeast

CPO, CO, Board-Eligible Orthotist or Prosthetist, BOCO or BOCPO, C.Ped Maine • Are you looking for something more?

• Do you want to be more than a number?

• Do you want a great life and a great job?

• We are a terrific practice looking for some nice people.

Is this you?

We are a well-established, patient-oriented, ABC-accredited facility seeking to strengthen our staff. Competitive salary offered, with bonuses commensurate with productivity, and renumeration for required educational credits. Offices located in picturesque Maine, just a short distance from our coast and mountain regions. Learn more about joining our team of dedicated specialists by contacting:

O&P Ad 25356 O&P Almanac 330 John Carlyle St., Ste. 200 Alexandria, VA 22314 Fax: 571/431-0899

CO Albany, New York Well-established, innovative patient-oriented facility celebrating our 90th year in private practice seeking an experienced orthotist. Supported by a skilled, talented technical and office staff, we offer the right person a competitive salary, health benefits, CEUs, matching IRA contributions, and more. Located in the Albany/Capital Region of upstate New York. Send your resume and call to discuss your opportunity to join us. All inquiries kept strictly confidential.

Timothy Lacy, CP La Torre Orthopedic Laboratory 960 Troy-Schenectady Road Latham, NY 12110 518/786-8655 E-mail: latorrelab@aol.com

CPO Birmingham, Alabama We have an immediate opening for a certified orthotist/prosthetist to join our well-established practice in Birmingham, Alabama. The ideal candidate must have or be eligible for Alabama State licensure. The ideal candidate should also possess at least three years of broad experience in orthotics/prosthetics. Fabrication skills are desired. We offer a competitive salary based on experience, and benefits including health insurance, vacation, personal time, and 401(k). Forward your resume, in confidence, to:

Eric S. Eisenberg, MS, CPO BioTech Limb & Brace, LLC 2421 4th Avenue South Birmingham, AL 35233 Phone: 205/324-7897 Fax: 205/324-7899 E-mail: eseisenberg@msn.com

Director of Clinical & Technical Services Alpharetta, Georgia Immediate opening for CP or CPO with minimum six years clinical experience to serve as technical liaison with customers and suppliers. Ideal candidate will have been a technician for period of three to five years before furthering education as CP or CPO. Position provides education to SPS customers, customer service, sales team, purchasing and operations. Position serves as primary contact point for clinical questions regarding product use/applications for all products SPS distributes. Responsibilities include development/presentation of educational programs on product technologies, materials, application, contraindications, product evaluations, and sales/marketing support. Position works intimately with sales force to support customer needs for in-service, hands-on product demonstrations and patient fittings.

Ideal candidate will be very well-organized multi-tasker who is enthusiastic and a highly motivated individual with a positive attitude. Must be strong team player. Hands-on fabrication experience in O&P field is highly desired.

Position requires 65 to 70 percent travel and is located at SPS headquarters in Alpharetta, Georgia. Please send resume and references to:

Vickie Quinn Southern Prosthetic Supply P.O. Box 406 Alpharetta, GA 30009 Phone: 678/455-8880 x 183 Fax: 800/288-5607

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O&P ALMANAC AUGUST 2010

Southeast

Certified Prosthetists and Orthotists Florida Due to recent growth and expansion, we are adding to our Florida team! If you have excellent clinical, organizational and communication skills and possess or are eligible for Florida licensure, we would love to speak with you.

Bi-lingual is a plus! These positions are accompanied by top compensation and benefits, relocation assistance, paid certification dues, state of the art education and much more!

If you have what it takes, the sky is the limit! Send resume, in confidence, to:

Sharon King Director, Recruitment Hanger Prosthetics & Orthotics, Inc. Phone: 512/777-3814 Fax: 512/777-3772 E-mail: Sking@hanger.com www.hanger.com/careers

Certified Prosthetist/Orthotist Tallahassee, Flordia Come to Sunny Tallahassee, Florida! One of the greatest college towns in the U.S., and one of the fastest growing metropolitan areas in Florida, Tallahassee offers long summers and short mild winters. If you have excellent clinical, organizational and communication skills and possess or are eligible for Florida licensure, we would love to speak with you. This position is accompanied by top compensation and benefits, relocation assistance, paid certification dues, state of the art education and much more! If you have what it takes, the sky is the limit! Send resume, in confidence, to:

Sharon King Director, Recruitment Hanger Prosthetics & Orthotics, Inc. Phone: 512/777-3814 Fax: 512/777-3772 E-mail: Sking@hanger.com www.hanger.com/careers

Certified Orthotist and/or Prosthetist Jackson, Mississippi Jackson: “the Crossroads of the South.” A college town so there’s always something to do! Parks, museums, cultural events, historic sites, sports and major downtown project improvements. This patient care facility is a top-producing facility and a two-time winner of Hanger’s Excellence Award! 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:

Sharon King Director, Recruitment Hanger Prosthetics & Orthotics, Inc. Phone: 512/777-3814 Fax: 512/777-3772 E-mail: Sking@hanger.com www.hanger.com/careers

Certified Prosthetist/Orthotist Atlanta More than just home of the Big Chicken, Marietta is close enough to enjoy the city of Atlanta but far enough away to give you the best of both cities! The area has it all: professional sports; Centennial Olympic Park; Atlanta Symphony Orchestra, Opera, Ballet; the Fox Theatre; the Tabernacle; the High Museum of Art; the world’s largest indoor aquarium; the World of Coca-Cola and much, much more!

We have an opening for a well-rounded Prosthetist/ Orthotist who possesses great organizational and communication skills, along with excellent patient care experience.

We offer a very attractive salary and benefit package, which includes relocation assistance and a sign-on bonus potential. Ready to make a change? Join the Hanger Team!

If interested, please contact, in confidence:

Sharon King Director, Recruitment Hanger Prosthetics & Orthotics, Inc. Phone: 512/777-3814 Fax: 512/777-3772 E-mail: Sking@hanger.com www.hanger.com/careers

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Jobs Inter Mountain

Pediatric Orthotic Specialist Denver Have a front seat to the Colorado Rockies! 300+ days of sunshine each year! Visit the 165-acre Washington Park, which is hopping with activities for every taste, and the Children’s Museum of Denver. Enjoy being near some of the best of the Old West, the historic Station Number One firehouse, Molly Brown’s Little Johnny Silver Mine. In addition, don’t forget the scenic drives, train travel, dinosaur bones, and amazing wildlife viewing!

We offer an exceptional opportunity for an Orthotist who has extensive pediatric experience and possesses great organizational and communication skills. We offer a very attractive salary and benefit package which includes relocation assistance and significant sign-on bonus potential!

Ready to make a change? Join the Hanger Team! If interested, please contact, in confidence:

Sharon King Director, Recruitment Hanger Prosthetics & Orthotics, Inc. Phone: 512/777-3814 Fax: 512/777-3772 E-mail: Sking@hanger.com www.hanger.com/careers

Certified Prosthetist/Orthotist, Practice Manager/Owner Idaho O&P practice searching for a CPO with exceptional clinical skills. Must display talent in leadership, teamwork, and customer service. Five years of CPO experience and certification required. Field-leading practice with product development and design history. Profit sharing and/or ownership opportunity available. Competitive benefits, relocation package. Submit resumes to:

E-mail: angie@rehabsystems.ws

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O&P ALMANAC AUGUST 2010

Certified Orthotist/Certified Prosthetist New Orleans Bourbon Street! French Creole Architecture! The French Quarter! New Orleans has it all! It is the state’s largest city and the “most unique” city in America. It includes crosscultural and multilingual heritage, cuisine, music (birth place of jazz), and Mardi Gras. 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, plus much more! If interested, please contact, in confidence:

Sharon King Director, Recruitment Hanger Prosthetics & Orthotics, Inc. Phone: 512/777-3814 Fax: 512/777-3772 E-mail: Sking@hanger.com www.hanger.com/careers

Certified Prosthetist/Orthotist West Monroe, Louisiana We are searching for an individual who desires the security of working for the oldest patient care company in the world!

If you have excellent clinical, organizational and communication skills, we would love to speak with you. Management experience a plus! This position is accompanied by top compensation and benefits, relocation assistance, paid certification dues, state of the art education and much, much more! Contact, in confidence:

Sharon King Director, Recruitment Hanger Prosthetics & Orthotics, Inc. Phone: 512/777-3814 Fax: 512/777-3772 E-mail: Sking@hanger.com www.hanger.com/careers

Certified Orthotist

Inter Mountain

CPOs, COs San Antonio Do you want to work for an established, growing company in an environment that values autonomy, clinical excellence, and work/life balance? Do you want to live in an area where hill country, brush country, historic homes, and exciting metropolitan living are all within minutes of each other?

If so, MK Prosthetic and Orthotic Services in San Antonio, Texas, is the place for you.

We are seeking experienced, self-motivated practitioners to join our dynamic private practice. Our ideal candidates will have at least three years of experience; pediatric experience is a major plus. Practitioners must be eligible for Texas licensure and be ABC certified. Come and build a rewarding, successful career with us. With multiple locations in San Antonio, we’re sure to have a facility that will suit your lifestyle. We offer a competitive salary, full benefits, and an excellent bonus structure. All inquiries will be kept in confidence.

Fax: 210/614-9333 E-mail: hr@mkprosthetics.com

Fargo, North Dakota Great Plains Health Company located in Fargo, North Dakota is seeking a full-time certified orthotist. The individual we are looking for should be a self-motivated practitioner with fabrication experience. Must be proficient in all aspects of orthotic care and be comfortable with physician contact. Five years of experience a plus. Apply online at:

www.st.alexius.org or www.st.alexius.jobs Call 701/530-7160 or Jerry Geiger at Great Plains Health Company Phone: 888/777-1489 E-mail: ggeiger@primecare.org

North Central

CPO Chicago Excellent opportunity in Chicagoland area for an experienced ABC certified CPO. Self-motivation, project load maintenance, and business minded a key to success in our quality, patient caring environment. Clinician needs to have patient care and fabrication experience and ability to travel within the surrounding area. Ability to market self and facility a plus. Salary and benefit package negotiable. Please forward resume to:

E-mail: oandpopportunity@gmail.com

DON’T MISS THE THIRD ANNUAL AOPA WINE TASTING AND AUCTION.

3rd ANNUAL

AOPA Wine Tasting & Auction

ace The Pl !

To Be

Thursday, September 30 6:30 – 8:00 PM Spend a fun evening learning about and tasting different wines. Enjoy both a silent and live auction. Registration is required and since federal laws apply to events that support political candidates, additional information will follow after you sign up. Visit www.AOPAnet.org for more information.

AUGUST 2010 O&P ALMANAC

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Calendar

2010 AUGUST 3-4: Allard USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

Birmingham, AL. Sheraton Birmingham Hotel. Three courses: New Perspectives in the Comprehensive Management in Gait Disorders; Tri-planar Biomechanics in Pediatric Function; Custom Fabrication TLSO/LSO and KAFO and New Approaches for Partial Foot Prostheses. Approved for 18.25 CEU’s. Contact 888/6786548; e-mail: info@allardusa.com.

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PROMOTE EVENTS IN THE O&P ALMANAC

CALENDAR RATES Telephone and fax numbers, e-mail addresses and Web sites are counted as single words. Refer to www.AOPAnet.org for content deadlines.

Words

Member Non-member Rate Rate

25 or less 26-50 51+

$40 $50 $2.25 per word

$50 $60 $3.00 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 e-mail 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. For information on continuing education credits, contact the sponsor.

Questions?

E-mail srybicki@AOPAnet.org.

AOPA-sponsored activities appear in red.

62

O&P ALMANAC AUGUST 2010

AUGUST 4-5: Canadian Association of Prosthetists and Orthotists Meeting. Quebec City. Hilton Quebec. Contact Kathy Kostycz at 204/949-4970 or capo@mts.net.

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AUGUST 5-6: 2 Day RCR Transtibial Socket Workshop. Boise, ID. Extensive workshop on the casting, modifying, and fitting of the RCR Transtibial Socket with multiple suspension options. 10.25 credits. Schedule is designed to maximize instruction and hands-on activity while minimizing travel time.

Contact Coyote Design at 800/819-5980 or visit www. coyotedesign.com ■■

AUGUST 6-7: Texas Chapter of the American Academy of Orthotist and Prosthetist (TCAAOP). Annual meeting and Scientific Symposium.

Austin, TX. Sheraton Austin Hotel. Contact Jonathon Cassens, CPO at 979/255-5165 or ctoplp@aol.com.

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AUGUST 9: Ultraflex: Pediatric UltraSafeGait™ Continuing Education Course, via WebEx, Noon–1:00 pm ET. Covers assessment of pediatric pathological gait and influencing shank kinematics with the new Adjustable Dynamic ResponseTM (ADRTM) technology. Register at www.ultraflexsystems.com or call 800/220-6670.

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AUGUST 10: Ultraflex: Adult UltraSafeStep™ Continuing Education Course, via WebEx, Noon–1:00 pm ET. Focuses on normalizing adult pathological gait with the utilization of Adjustable Dynamic ResponseTM (ADRTM) knee and ankle technology.

Register at www.ultraflexsystems. com or call 800/220-6670.

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AUGUST 13-14: Ohio Willow Wood: 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, troubleshooting.

Fabricate sockets following recommended techniques for airtight socket designs.

Credits: 12.25 ABC/12.0 BOC. Registration deadline: July 22, 2010. Contact: 877/665-5443.

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AUGUST 20-21: Arkansas Orthotic, Prosthetic, & Pedorthic Association State Meeting.

Little Rock, AR. Peabody Hotel. Contact Tonya Horton at 501/663-2908 or thorton@ hortonsoandp.com.

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AUGUST 23: Ultraflex: Pediatric Spasticity Continuing Education Course, via WebEx, Noon– 1:00 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. Register at www. ultraflexsystems.com or call 800/220-6670.

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AUGUST 11: AOPA Audio Conference: “Medicare’s Knocking: How Good Is Your Compliance Plan?” To register contact Ann Davis at 571/431-0876 or adavis@aopanet.org.

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AUGUST 12: Ohio Willow Wood: 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/7.0 BOC. Registration deadline: July 22, 2010.

Contact: 877/665-5443.

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AUGUST 24: Ultraflex: Complex Orthopedic Rehabilitation Continuing Education Course, via WebEx, Noon–1:00 pm ET. Focuses on Ultraflex combination dynamic and static stretching orthosis for addressing complex orthopedic rehabilitation goals and restoring range and function. Register at www. ultraflexsystems.com or call 800/220-6670.

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AUGUST 24-25: Allard USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

Indianapolis. Three courses: New Perspectives in the Comprehensive Management in Gait Disorders; Tri-planar Biomechanics in Pediatric Function; Custom Fabrication TLSO/LSO and KAFO and New Approaches for Partial Foot Prostheses. Approved for 18.25 CEU’s. Contact 888/6786548; e-mail: info@allardusa.com.

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AUGUST 26-29: The Amputee Coalition of America 2010 National Conference. Hyatt Regency, Irvine, CA. For more information, contact Continuing Education Coordinator at 888/267-5669, ext. 8102, or conference@ amputee-coalition.org or visit www.amputee-coalition.org.

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SEPTEMBER 8: AOPA Audio Conference: “Missed Billing Opportunities: Are You Billing Everything You Can?” To register contact Ann Davis at 571/431-0876 or adavis@ aopanet.org.

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SEPTEMBER 14-15: Allard USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

Garden Grove, CA. Sheraton Garden Grove-Anaheim South. Three courses: New Perspectives in the Comprehensive Management in Gait Disorders; Tri-planar Biomechanics in Pediatric Function; Custom Fabrication TLSO/LSO and KAFO and New Approaches for Partial Foot Prostheses. Approved for 18.25 CEU’s. Contact 888/6786548; e-mail: info@allardusa.com.

SEPTEMBER 21: Ohio Willow Wood: Discover LimbLogic® VS via WebEx, 1:30 pm ET. Critical components and operation discussed. Covers interpreting feedback from fob and basic fabrication processes for system. Credits: 2.5 ABC/ 2.0 BOC. To register online, visit www.owwco.com/webinar.php.

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SEPTEMBER 23: Ohio Willow Wood: LimbLogic® VS for Technicians via WebEx, 1:30 pm ET. Learn essentials of elevated vacuum socket fabrication using available socket adaptors with LimbLogic VS. Learn how to deal with airtight issues, unit operation, and diagnostics that will keep the system optimal for patient use.

Credits: 2.5 ABC/2.0 BOC. www.owwco.com/webinar.php ■■

SEPTEMBER 29OCTOBER 2 AOPA National Assembly.

Orlando, FL. Rosen Shingle Creek Resort. Exhibitors and sponsorship opportunities, contact Kelly O’Neill, 571/431-0852, or koneill@ AOPAnet.org.

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OCTOBER 13: AOPA Audio Conference: “You’re Going To Pay Me WHAT? Hints on Managed Care Contracting.”

To register contact Ann Davis at 571/431-0876 or adavis@ aopanet.org.

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OCTOBER 14: Ohio Willow Wood: 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/7.0 BOC. Registration deadline: September 23, 010.

Contact: 877/665-5443.

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OCTOBER 14-15: AOPA Mastering Medicare: Advance Coding and Billing Seminar. Las Vegas. Mandalay Bay Resort. To register contact Ann Davis at 571/431-0876 or adavis@aopanet.org.

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OCTOBER 5-6 Allard USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

St. Louis. Sheraton St. Louis City Center Hotel and Suites. Three courses: New Perspectives in the Comprehensive Management in Gait Disorders; Tri-planar Biomechanics in Pediatric Function; Custom Fabrication TLSO/LSO and KAFO and New Approaches for Partial Foot Prostheses. Approved for 18.25 CEU’s. Contact 888/6786548; e-mail: info@allardusa.com.

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OCTOBER 22: Ohio Orthotics and Prosthetics Association Annual Fall Meeting, Embassy Suites. Dublin, OH. Contact Dianne Farabi 614/659-0197 or dfarabi@ columbus.rr.com.

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OCTOBER 23: Ohio Chapter, American Academy of Orthotists and Prosthetists (AAOP) Annual Fall Scientific Meeting, Embassy Suites. Dublin, OH. Contact Richard W. Butchko 614/659-0197 or butchko1@ columbus.rr.com. Visit www. ohiochapteraaop.com.

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OCTOBER 26-27 Allard USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

Emeryville, CA. Four Points

By Sheraton. Three courses: New Perspectives in the Comprehensive Management in Gait Disorders; Tri-planar Biomechanics in Pediatric Function; Custom Fabrication TLSO/LSO and KAFO and New Approaches for Partial Foot Prostheses. Approved for 18.25 CEU’s. Contact 888/6786548; e-mail: info@allardusa.com.

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OCTOBER 15-16: Ohio Willow Wood: 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, troubleshooting.

Fabricate sockets following recommended techniques for airtight socket designs.

Credits: 12.25 ABC/12.0 BOC. Registration deadline: September 23, 2010. Contact: 877/665-5443.

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OCTOBER 19-20 Allard USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

Orlando, FL. Three courses: New Perspectives in the Comprehensive Management in Gait Disorders; Tri-planar Biomechanics in Pediatric Function; Custom Fabrication TLSO/LSO and KAFO and New Approaches for Partial Foot Prostheses. Approved for 18.25 CEU’s. Contact 888/6786548; e-mail: info@allardusa.com.

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NOVEMBER 10: AOPA Audio Conference: “The Ins and Outs of Billing in a Part A Setting: Hospital, SNF and Hospice.”

To register contact Ann Davis at 571/431-0876 or adavis@ aopanet.org.

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AUGUST 2010 O&P ALMANAC

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Calendar

NOVEMBER 16-17 Allard USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

Chicago. Three courses: New Perspectives in the Comprehensive Management in Gait Disorders; Tri-planar Biomechanics in Pediatric Function; Custom Fabrication TLSO/LSO and KAFO and New Approaches for Partial Foot Prostheses. Approved for 18.25 CEU’s. Contact 888/678-6548; e-mail: info@ allardusa.com.

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DECEMBER 2-3 Allard USA: T.O.T.E. (Tomorrow’s Orthotic Technology Education).

Parsippany, NJ. Three courses: New Perspectives in the Comprehensive Management in Gait Disorders; Tri-planar Biomechanics in Pediatric Function; Custom Fabrication TLSO/LSO and KAFO and New Approaches for Partial ■■

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2011

Foot Prostheses. Approved for 18.25 CEU’s. Contact 888/678-6548; e-mail: info@ allardusa.com.

DECEMBER 8: AOPA Audio Conference: ”New Codes and Medical Policies for 2011.”

To register contact Ann Davis at 571/431-0876 or adavis@ aopanet.org.

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FEBRUARY 17-19: PrimeFare West Regional Scientific Symposium 2011.

Salt Lake City. Salt Palace Convention Center. Contact Jane Edwards at 888/3885243.

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APRIL 15-16: Ohio Chapter, American Academy of Orthotists and Prosthetists (AAOP) Annual Spring Technical Meeting.

Columbus, OH. Hilton Columbus. Exhibits included.

Contact Richard W. Butchko 614/659-0197 or butchko1@ columbus.rr.com. Visit www. ohiochapteraaop.com.

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JUNE 3-4: PrimeFare East Regional Scientific Symposium 2011.

Nashville, TN. Nashville Convention Center. Contact Jane Edwards at 888/388-5243.

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MARCH 28-APRIL 2: Association of Children’s Prosthetic-Orthotic Clinics 2011 Annual Meeting.

Park City, UT. The Canyons.

For more information, call 847/698-1637, e-mail acpoc@ aaos.org, or visit www.acpoc.org.

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DECEMBER 9-11: Rehabilitation Institute of Chicago: Pediatric Gait Analysis and Orthotic Management. Chicago.

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

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APRIL 15 Ohio Orthotics and Prosthetics Association Annual Spring Meeting.

Columbus, OH. Hilton Columbus. Contact Dianne Farabi 614/ 659-0197 or dfarabi@columbus.rr.com.

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SEPTEMBER 19-22 AOPA National Assembly.

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

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Ad Index For free product information from these advertisers, enter the advertiser name online at www.opalmanac.org/shop.

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Company

Page

Phone

Allard USA Inc. ALPS American Board for Certification in Orthotics, Prosthetics & Pedorthics Apis Footwear College Park Industries Inc. Custom Composite Daw Industries Dr. Comfort Dycor Euro International Fillauer Companies Inc. KISS Technologies LLC Ohio Willow Wood OPTEC Ossur® Americas Inc. Otto Bock HealthCare PEL Supply Company Spinal Technology Inc. Texas Assistive Devices LLC

29 23, 53

888/678-6548 800/574-5426

55 39 41 32, 33 1 5, C3 9, 51 13 49 31, 47 2 6,7; 42, 43 11, C4 C2 37 21 27

703/836-7114 888/937-2747 800/728-7950 866/273-2230 800/252-2828 800/556-5572 800/794-6099 800/378-2480 800/251-6398 410/663-5477 800/848-4930 888/982-8181 800/233-6263 800/328-4058 800/321-1264 800/253-7868 800/532-6840

www.abcop.org www.bigwideshoes.com www.college-park.com www.cc-mfg.com www.daw-usa.com www.drcomfortdpm.com www.dycormfg.com www.eurointl.com www.fillauercompanies.com www.kiss-suspension.com www.owwco.com www.optecusa.com www.ossur.com www.ottobockus.com www.pelsupply.com www.spinaltech.com www.n-abler.org

SPS

19

800/767-7776 Ext. 3

www.spsco.com

O&P ALMANAC AUGUST 2010

Web site or E-mail www.allardusa.com www.easyliner.com

and even more comfort for your patients.

CALL 1-800-992-3580 OR VISIT www.drcomfort.com ®

THE NEW FLEX-FooT ooT BALANCE.™ THE LIGHTEST MULTI-AXIAL K2 FooT. ®

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Introducing Flex-Foot Balance, the ideal balance of light weight and stability for household/K2 ambulators.

In addition to being the lightest foot in its class, Flex-Foot Balance offers a host of premium features, like an integrated multi-axial ankle, a full-length toe lever, and a removable sandal toe foot cover.

All of which make Flex-Foot Balance comfortable and smooth for unilateral users, yet stable and reliable for bilateral users.

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CALL (800) 233-6263 or VISIT oSSUr.CoM To LEArN MorE.

©2010 Ossur. All rights reserved. Össur, Flex-Foot and Talux are registered trademarks of Össur.