April 2014 Almanac

Page 14

IN THE NEWS

Update on O&P Alliance Challenge to PODs The questionable self-referral practices of physicianowned distributorships (PODs)—physicians who own distribution facilities for O&P devices—and the potential conflicts of interest has been a long-running issue for the O&P industry. In a May 23, 2013, letter to Daniel Levinson, inspector general of Health and Human Services (HHS), the O&P Alliance wrote, “With the exception of certain prefabricated off-the-shelf orthoses or supply items, allowing the provision of other types of O&P care by referring physicians opens the door to overutilization, potentially suspect medical judgment, unfair competition and increased costs to the Medicare program and its beneficiaries.” The letter also called attention to an alert published March 26, 2013, by the Office of the Inspector General (OIG) on potential fraud on self-referred implantable medical devices. The Alliance letter noted that the “same principles would apply when evaluating arrangements involving other types of physician-owned entities.” The HHS OIG responded to the Alliance in a letter dated Sept.10, 2013, indicating that recommendations the Alliance made for solving the problem “do not fall within the jurisdiction of the OIG and are more appropriately directed to CMS.” In response to the Alliance suggestion “that OIG increase its enforcement activities with respect to physician ownership of O&P laboratories and include the analysis and observation of physician-owned O&P laboratories in its

TRANSITIONS

The Amputee Coalition, in conjunction with members of its Scientific and Medical Advisory Committee, has created a body mass index (BMI) calculator to help individuals with limb loss assess their weight status by calculating their BMI. Visit the Limb Loss Resource Center page on the Amputee Coalition’s website, www.amputeecoalition.org.

O&P Almanac APRIL 2014

fiscal year 2014 work plan,” the letter said, “We will consider your observations and recommendations as we plan future activities. In addition, we welcome any specific information that you can provide regarding abuse practice.” The O&P Alliance followed up with a Nov. 18, 2013, letter to CMS Administrator Marilyn Tavenner indicating the OIG recommended that the Alliance bring the profession’s areas of concerns to the attention of the administrator. The Alliance letter referenced the In-Office Ancillary Services Exception (IOAS), which allows certain tests and other services described as Designated Health Services to accommodate certain “legitimate physician business arrangements.” The Alliance pointed out “that the IOAS exception and other loopholes in Medicare regulations related to O&P services are being exploited and do not conform to the IOAS original exception’s intent.” The letter went on to recommend that these loopholes should be eliminated. The response to the Alliance letter from CMS of Jan. 8, 2014, was helpful to the extent that it acknowledged the potential for a problem and allowed, “The information you have provided is helpful as we continue consider physician self-referral policy options.” This statement is an indication that the O&P Alliance’s persistence on this issue may bear fruit at some point. The full text of the letters and documentation can be viewed at www.aopanet.org/op-alliance-updates/.

BUSINESSES in the news

Ability Prosthetics and Orthotics has unveiled a new anniversary logo for its 10th anniversary.

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www.bocusa.org

The Board of Certification/ www.bocusa.org Accreditation (BOC) has been honored with a Stevie Award for Sales & Customer Service in the “Best Use of Technology in Customer Service” category. BOC was recognized for its exceptional integration of technology and customer service. BOC also has announced it is a 2014 Silver Level Sponsor of OPAF, the Orthotic & Prosthetic Activities Foundation. LIMBS International has announced it will be sending 150 legs to a partner clinic, The Center for Disability in Development, in Bangladesh.

New England Orthotic & Prosthetic Systems has opened a new patient-care center in Poughkeepsie, New York. The facility will be staffed by Kimberly Hertz, BOCO, cFOM, CMF, COA, and David Zwissler, BOCO, BOCP. Rx Textiles Inc. and SPT Technology Inc. have announced a new company name: Paceline Inc. Rx Textiles acquired SPT Technology three years ago, and the new name is a reflection of the unified company.


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April 2014 Almanac by AOPA - Issuu