OP
The American Orthotic & Prosthetic Association
AUGUST 2012
&
WWW.AOPANET.ORG
THE MAGAZINE FOR THE ORTHOTICS & PROSTHETICS INDUSTRY
MaSTERING
OUR Future
Dedicated O&P professionals conduct industry research that validates and energizes the industry
EXCLUSIVE: 2012 AOPA National Assembly Preview and Product Showcase Tips for Preparing for a Prepayment Review
Time to make your move
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O&P Almanac AUGUST 2012, VOLUME 61, No. 8
COLUMNS
Cover Story
20 Mastering Our Future
By Deborah Conn The state of O&P research is improving in both quantity and quality, with O&P professionals taking on an important role. Recent studies at North American educational institutions offer a few examples of how hard data and scientific evidence are paving the way for O&P professionals to demonstrate the significance of their work.
Feature
30
CONTENTS
The
Placee!
Shipping Up To Boston By Sam Waymire The 2012 AOPA National Assembly will offer an unforgettable learning and networking experience for the O&P community. Prepare for your trip by reading this primer—learn who will be speaking, what topics will be covered at educational sessions, and which Boston landmarks you’ll have the opportunity to experience.
To B
SPeCIAL FEATURE
50 2012 Product Guide
Get an advance look at the companies and products showcased at this year’s Annual Meeting.
Product Guide
16
Reimbursement Page Follow 10 easy steps to prepare for a prepayment review
36
Facility Spotlight Kormylo Orthopedic Inc.
departments
4 AOPA Contact Page How to reach staff
6 At a Glance
08
Statistics and O&P data
In the News Research, updates, and company announcements
42 AOPA Headlines
News about AOPA initiatives, meetings, member benefits, and more
48 AOPA Membership 00 Applications 56 Jobs Opportunities for O&P professionals 61 Calendar
Upcoming meetings and events
63 Ad Index 64 AOPA Answers
Expert answers to your FAQs
O&P Almanac (ISSN: 1061-4621) is published monthly by the American Orthotic & Prosthetic Association, 330 John Carlyle St., Ste. 200, Alexandria, VA 22314; 571/431-0876; fax 571/4310899; email: almanac@AOPAnet.org. Yearly subscription rates: $59 domestic; $99 foreign. All foreign subscriptions must be prepaid in U.S. currency, and payment should come from a U.S. affiliate bank. A $35 processing fee must be added for non-affiliate bank checks. O&P Almanac does not issue refunds. Periodical postage paid at Alexandria, VA, and additional mailing offices. Postmaster: Send address changes to: O&P Almanac, 330 John Carlyle St., Ste. 200, Alexandria, VA 22314. For advertising information, contact Dean Mather, M.J. Mrvica Associates Inc. at 856/768-9360, email: dmather@mrvica.com. AUGUST 2012 O&P Almanac
3
AOPA IN THE Contact NEWS INFORMATION
AMERICAN ORTHOTIC & PROSTHETIC ASSOCIATION (AOPA) 330 John Carlyle St., Ste. 200, Alexandria, VA 22314 AOPA Main Number: 571/431-0876 AOPA Fax: 571/431-0899 www.AOPAnet.org EXECUTIVE OFFICES
MEMBERSHIP and Meetings
Thomas F. Fise, JD, executive director, 571/431-0802, tfise@AOPAnet.org
Tina Moran, CMP, senior director of membership operations and meetings, 571/431-0808, tmoran@AOPAnet.org
Don DeBolt, chief operating officer, 571/431-0814, ddebolt@AOPAnet.org O&p Almanac Thomas F. Fise, JD, publisher, 571/431-0802, tfise@AOPAnet.org Josephine Rossi, editor, 703/914-9200 x26, jrossi@strattonpublishing.com
Stephen Custer, coordinator, membership operations and meetings, 571/431-0876, scuster@AOPAnet.org
BOARD oF DIRECTORS
Government affairs
President Thomas V. DiBello, CO, FAAOP, Dynamic O&P, a subsidiary of Hanger Inc., Houston, TX President-Elect Tom Kirk, PhD, Hanger Inc., Austin, TX Vice President Anita Liberman-Lampear, MA, University of Michigan Orthotics and Prosthetics Center, Ann Arbor, MI Treasurer James Weber, MBA, Prosthetic & Orthotic Care Inc., St. Louis, MO
Devon Bernard, manager of reimbursement services, 571/431-0854, dbernard@AOPAnet.org
Immediate Past President James A. Kaiser, CP, Scheck & Siress, Chicago, IL
Joe McTernan, director of coding and reimbursement services, education and programming, 571/431-0811, jmcternan@AOPAnet.org
e k a M own r u o Y
y r o t His at the
2012 AOPA National Assembly and Combined New England Chapter Meeting
O&P Almanac AUGUST 2012
Officers
Catherine Graf, JD, director of regulatory affairs, 571/431-0807, cgraf@AOPAnet.org
Reimbursement/Coding: 571/431-0833, www.LCodeSearch.com a
4
Advertising Sales M.J. Mrvica Associates Inc.
Printing Dartmouth Printing Company
AOPA Bookstore: 571/431-0865
www.AOPAassembly.org
Editorial Management Stratton Publishing & Marketing Inc.
Steven Rybicki, communications manager, 571/431-0835, srybicki@AOPAnet.org
Dean Mather, advertising sales representative, 856/768-9360, dmather@mrvica.com
Christine Umbrell, editorial/production associate, 703/914-9200 x33, cumbrell@strattonpublishing.com
Publisher Thomas F. Fise, JD
Design & Production Marinoff Design LLC
Lauren Anderson, coordinator, membership operations and meetings, 571/431-0873, landerson@AOPAnet.org
Stephen Custer, staff writer, 571/431-0876, scuster@AOPAnet.org
&
Kelly O’Neill, manager of membership and meetings, 571/431-0852, koneill@AOPAnet.org
Catherine Marinoff, art director, 786/293-1577, catherine@marinoffdesign.com
Steven Rybicki, production manager, 571/431-0835, srybicki@AOPAnet.org
OP Almanac
September 6-9 Historic downtown Boston
Executive Director/Secretary Thomas F. Fise, JD, AOPA, Alexandria, VA
directors Kel M. Bergmann, CPO, SCOPe Orthotics and Prosthetics Inc., San Diego, CA Michael Hamontree, OrPro Inc, Irvine, CA Russell J. Hornfisher, MBA, MSOD, Becker Orthopedic Appliance Co., Troy, MI Alfred E. Kritter, Jr., CPO, FAAOP, Hanger Inc., Savannah, GA Eileen Levis, Orthologix LLC, Philadelphia, PA Ron Manganiello, New England Orthotic & Prosthetic Systems LLC, Branford, CT Mahesh Mansukhani, MBA Ă–ssur Americas, Aliso Viejo, CA Michael Oros, CPO, Scheck & Siress, Chicago, IL Frank Vero, CPO, Mid-Florida Prosthetics & Orthotics, Ocala, FL Copyright 2012 American Orthotic and Prosthetic Association. All rights reserved. This publication may not be copied in part or in whole without written permission from the publisher. The opinions expressed by authors do not necessarily reflect the official views of AOPA, nor does the association necessarily endorse products shown in the Almanac. The Almanac is not responsible for returning any unsolicited materials. All letters, press releases, announcements, and articles submitted to the Almanac may be edited for space and content. The magazine is meant to provide accurate, authoritative information about the subject matter covered. It is provided and disseminated with the understanding that the publisher is not engaged in rendering legal or other professional services. If legal advice and/or expert assistance is required, a competent professional should be consulted.
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AT IN THE A GLANCE NEWS
AOPA Turns 95 With only five years until AOPA’s centennial anniversary, we can look back at the evolution of the industry to see how O&P history and U.S. history intertwine.
1917
l Limb Artificiars and e r ctu ManufaAssociation, Brace is founded ) . (ALMBAsor to AOPA s e c e pred
1860
1870
1880
1890
1900
1910
2012
1946
tes celebra AOPA of history rs 95 yea PA National O A t ston. a ly in Bo Assemb
es 1966 becom ALMBArthopedic ALMA O the O nd Limb s the e becom rican nce a cturers a li p p A Ame nd Manufa tion otic a c th Associa r ). O A ti (OALM Prostheon ti ia c Asso OPA). (A 1920
1930
1940
1950
1960
1970
1980
1990
2000
Operation Iraqi Freedom, 2003-2011
Vietnam Conflict, 1964-1973 Korean War, 1950-1953 Civil War, 1861-1865
World War I, 1917-1918
2010
Operating Enduring Freedom, 2001-Present
World War II, 1941-1946
Persian Gulf War, 1990-1991
Sources: AOPA; Congressional Research Service
28%
Primary amputation mortality rate during the Civil War.
1:6
Ratio of amputations versus deaths during Operation Enduring Freedom (as of July 2009).
1992 Year AOPA’s first legislative conference was held (and AOPA’s 75th anniversary).
7,489 Number of amputations during World War II.
1946
Year the first issue of Orthopedic and Prosthetic Appliance Journal was published by OALMA.
$3.45
billion
Current estimated worth of patient services provided by O&P businesses annually.
Sources: www.aopanet.org; www.huntermcguire.goellnitz.org/amputation.html; “How O&P Began,” O&P Almanac, May 2007, www.aopanet.org; Congressional Research Service 6
O&P Almanac AUGUST 2012
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IN THE NEWS
CMS Updates Prosthetic Hand L Codes The CMS has added prosthetic hand-related L codes to the Healthcare Common Procedure Coding System (HCPCS). L6715, terminal device, multiple articulating digit, includes motor(s), initial issue or replacement; and L6880, electric hand, switch or myolelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s), were added to the HCPCS file and implemented July 2. The fee schedule amounts for these codes are effective for claims
with dates of service on or after Jan. 1, 2012. According to CMS, these items were paid on a local fee schedule basis prior to implementation of the fee schedule amounts established in accordance with this update. Already processed claims for codes L6715 and L6880 with dates of service on or after Jan. 1, 2012, may be adjusted to reflect the newly established fees if brought to the attention of the provider’s Durable Medical Equipment Medicare Administrative Contractor.
Sugar May Fuel Neuroprosthetics
Above: Power extraction from cerebrospinal fluid by an implantable glucose fuel cell. Photo: Central Nervous System Visual Perspectives Project, Karolinska Institute and Stanford University.
8
O&P Almanac AUGUST 2012
An implantable fuel cell that runs on the same sugar that powers human cells—glucose—is being studied for its potential to power neuroprosthetic devices. Built at the Massachusetts Institute of Technology (MIT), Cambridge, the fuel cell strips electrons from glucose molecules to create a small electric current, according to the June edition of the Plos One journal. The researchers, led by Rahul Sarpeshkar, PhD, an associate professor of electrical engineering with the MIT Department of Electrical Engineering and Computer Science, fabricated the fuel cell on a silicon chip, allowing it to be integrated with other circuits that would be needed for a brain implant. The idea of a glucose fuel cell is not new. In the 1970s, scientists showed they could power a pacemaker with a glucose fuel cell, but the idea was abandoned in favor of lithium-ion
batteries, which could provide significantly more power per unit area than glucose fuel cells. These glucose fuel cells also used enzymes that proved to be impractical for long-term implantation in the body since they eventually ceased to function efficiently. The twist to the new MIT fuel cell is that it is fabricated from silicon, using the same technology used to make semiconductor electronic chips, and has no biological components. It consists of a platinum catalyst that strips electrons from glucose, mimicking the activity of cellular enzymes that break down glucose to generate adenosine triphosphate, the cell’s energy currency. (Platinum has a proven record of long-term biocompatibility within the body.) So far, the fuel cell can generate hundreds of microwatts—enough to power an ultra-low-power and clinically useful neural implant.
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University of Utah Researchers Move Forward With Prosthetic Implant Researchers and surgeons from the University of Utah and the George E. Wahlen Department of Veterans Affairs (VA) Medical Center in Salt Lake City are developing a device that can be implanted directly into a person’s residual bone, passing through the skin, so they can securely attach a prosthetic limb without the need for a socket. Nothing like it has been done at a U.S. hospital, according to the researchers, and the procedure has only been attempted an estimated 250 times worldwide in Europe and Australia, with mixed results. The goal of the project is to provide relief to the many veterans who have lost a limb—most of whom are relatively young and have many active years ahead of them—and to avoid many of the issues associated with
TRANSITIONS
people in the news
Carl Caspers, CPO, has been inducted into the Minnesota Inventors Hall of Fame in recognition of his many contributions to the prosthetics industry. He holds more than 15 patents for liners, suspension sleeves, and postoperative and volumemanagement products and technology for the prosthetic industry. The Amputee Coalition has elected Michael Estrada, executive vice president, new business initiatives, of THOR-LO Inc. to serve a three-year term on the organization’s board of directors. Ability Prosthetics & Orthotics, headquartered in Gettysburg, Pennsylvania, has hired Bryan G. Fairbanks, CP, to join its Lexington, Kentucky, patient-care center as a managing practitioner.
10
O&P Almanac AUGUST 2012
typical socket-type attachment An implantable prosthetic device is being developed systems, such as skin problems by researchers at the University of Utah and George E. or issues with short remaining Wahlen Department of Veterans Affairs Medical Center. limb length. The solution clinical research team will implant involves osseointegrated direct skeletal their device into 10 patients. A unique attachment of prosthetic limbs. element will be the ability to develop The research team recently and refine their device between partnered with DJO Surgical, a operations, which should accelerate global developer, manufacturer, and the overall refinement process by distributor of medical devices, which compressing the development cycle. has licensed the implant technology The research is being led by and is assisting with the remaining Roy Bloebaum, professor of orthoresearch and development. The project paedics at the University of Utah has been accepted into a new Food and the director of the VA Bone and and Drug Administration (FDA) Joint Research Lab; Kent Bachus, program that allows them to design an engineer and a professor of a human early feasibility study. DJO orthopaedics and director of the Surgical applied for the FDA study Orthopaedic Research Lab at the and is responsible for managing university; and Peter Beck, an orthoits implementation. paedic surgeon and adjunct professor During the early feasibility study, of orthopaedics. which will last up to three years, the
Ability Prosthetics & Orthotics, headquartered in Gettysburg, Pennsylvania, has hired Nikki Hooks, CO, a board-eligible prosthetist, to join its Greenville, South Carolina, patientcare center. Jonathan Naber, a graduate of the University of Illinois at UrbanaChampaign, has received a Whitaker International Fellow Grant, which he will use to conduct a long-term trial of the low-cost, transradial prosthesis he developed through his nonprofit organization, IPT, formerly known as Illini Prosthetic Technologies. The Amputee Coalition has announced Theresa Ott of Modesto, California, is the recipient of the Christina Skoski, M.D., Scholarship. Ott, a bilateral below-knee amputee,
was recognized for her academic excellence as well as her strong commitment to a goal of helping others. Micki Pawlowski, vice president and owner of Calumet Orthopedic & Prosthetics, Hobart, Indiana, was named as the Up-and-Coming Woman of the Year in Health Care during the Influential Women of Northwest Indiana Awards Banquet in Merrillville. Claudia Zacharias, MBA, CAE, president and CEO of the Board of Certification/Accreditation, International, recently received the 2012 Brava! Award, which is given to top female CEOs in the Baltimore area by Baltimore SmartCEO magazine.
Photo: Technology Venture Development
IN THE NEWS
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IN THE NEWS
CDC Releases Diabetes Report Card 2012
Diabetes Report Card 2012
etes
Diab adults who report tages of U.S. diabetes, ts the percen that they have Table 1 presen diabetes are ever been told that they have people with undiagnosed for based on data in Table 1 are by state. Data System The estimates Surveillance not included. hold ioral Risk Factor ased, house from CDC’s Behav is an ongoing, state-b 18 years or BRFSS aged ation (BRFSS). The in of the U.S. popul nt to 11.3% telephone surveyrange from 5.8% in Vermo tes older. Estima Mississippi. and the U.S. from the BRFSS tes CDC used data county estima -based For Figure 3, model l estimates to develop County-leve Census Bureau sed diabetes. ers to diagno provid care with of adults s and health from diabetes unity leader benefit most allow comm areas that would . identify local control efforts prevention and
Diagnosed
CS230427
National Center for Chronic Disease Prevention and Health Promotion Division of Diabetes Translation
Diagnosed Adults with ntage of U.S. Table 1. Perce State, 2010 (%) Diabetes, by Percentage State
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware bia District of Colum Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland s Massachusett Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada hire New Hamps New Jersey New Mexico New York a North Carolin North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island a South Carolin South Dakota Tennessee Texas Utah Vermont Virginia Washington a West Virgini Wisconsin Wyoming sed diabetes
of diagno the distribution generally Figure 3 shows States, with percentages to define data across the United east. CDC used these where the South diabetes belt, higher in the area, called the es is especially high. This a geographic diagnosed diabet states.9 15 prevalence of in 644 counties area includes
11.1 6.3 8.1 9.2 8.9 6.0 6.4 7.7 8.0 8.7 9.8 7.8 7.7 8.2 9.1 6.9 8.0 10.1 10.3 7.4 8.9 7.2 9.2 6.2 11.3 8.0 6.2 7.1 8.1 7.0 8.3 8.1 8.4 9.3 6.9 9.4 10.1 7.2 8.7 6.8 9.9 6.4 10.2 9.8 7.1 5.8 8.1 7.4 10.7 7.1 6.6
for more details. ral Risk Factor Technical Notes adjusted. See System, Behavio Data were age l Diabetes Surveillance Source: Nationa System data. Surveillance
3
TRANSITIONS
The Division of Diabetes Translation of the Centers for Disease Control and Prevention (CDC) has released Diabetes Report Card 2012. The publication uses 2010 data to present a profile of diabetes and its complications at the national and state level. The document features information about prediabetes awareness, diabetes outcomes, and risk factors. The report card is a requirement of the Catalyst to Better Diabetes Care Act, which is part of the Patient Protection and Affordable Care Act; this legislation includes several provisions that address gaps in diabetes prevention, screening, care, and treatment. Download Diabetes Report Card 2012 by visiting cdc.gov/diabetes/pubs/ reportcard.htm.
BUSINESSES in the news
The American Board for Certification in Orthotics, Prosthetics, and Pedorthics Inc. (ABC) tested nearly 200 candidates to become ABC-certified prosthetists, certified orthotists, or certified prosthetists/ orthotists at its June Clinical Patient Management (CPM) exams. The exams were given over a six-day period at the St. Petersburg College—College of Health Sciences. The Board of Certification/ Accreditation, International orthotist, prosthetist, orthotic fitter, and mastectomy fitter certification programs were recently reaccredited through 2016 by the National Commission for Certifying Agencies. Freedom Innovations, Irvine, California, announced that its Plié 2.0 MPC Knee has won the Health & Medical Technologies category for the TechAmerica Foundation’s American Technology Awards.
Hanger Orthopedic Group, Austin, has changed its name to Hanger Inc., effective immediately. The company’s New York Stock Exchange (NYSE) stock symbol, HGR, remains unchanged. This initiative also has led to the rebranding of Hanger’s core patient-care business from Hanger Prosthetics & Orthotics to Hanger Clinic. The new brand identity includes new names, logos, designs, and communications.
Orthocare Innovations, Oklahoma City, has been awarded two new Phase II grants from the National Institutes of Health, under the Small Business Innovative Research program. The grants, with a combined total of more than $2.3 million, are funded by the National Center for Medical Rehabilitation Research within the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
Illinois nonprofit organization IPT, formerly known as Illini Prosthetic Technologies, received $7,000 in donations to aid its mission of developing affordable transradial prostheses for amputees in Guatemala. The donations from the Springfield Westside and Waterloo chapters of Rotary International will go toward fitting and distributing the prostheses, and will pay for more than 20 of the arms.
Össur has added a portable compression device to expand its bracing and support line in the therapeutic market for the prevention of deep vein thrombosis.
Kenney Orthopedics, headquartered in Lexington, Kentucky, has announced the opening of a fifth patient-care facility, located in Louisville.
12
O&P Almanac AUGUST 2012
Marking its first international delivery, The Bra Recyclers, Gilbert, Arizona, recently donated prostheses and postmastectomy bras to Reach for Recovery South Africa, a nonprofit, volunteer-driven breast cancer support group, for fitting and distribution to breast cancer survivors in South Africa.
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Reimbursement Page By Kathy Dodson, AOPA government affairs department
Preparing for a
Prepayment Review A prepayment review may be unavoidable, but you don’t have to be caught off guard
U
ntil recently, it had been somewhat likely that you’d get hit with a prepayment review. Now it’s almost a guarantee. To prepare for such an event, here are 10 steps you should consider carrying out before coming under review:
1
Set up a weekly or biweekly staff meeting to review open cases.
During these staff meetings, it’s important to ensure that open cases are not languishing for some preventable reason; it’s equally important to make sure all appropriate documentation needed to file a claim is present or will be before billing. These meetings also offer an opportunity to emphasize to your staff the importance of proper documentation. But keep your messaging positive: This shouldn’t be an occasion to call anyone to task for missing information. Reprimanding staff in a group setting will only make employees reluctant to be open about the status of their cases. If something is missing, arrange for it to be obtained and then talk to the person responsible in private.
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O&P Almanac AUGUST 2012
2
Develop a relationship with your major payors’ staff.
Although you and your staff don’t have the time to establish relationships with all payors, you’ll find the effort worth it for major insurance companies. Reach out to your payors’ staff and offer to provide an in-service if geography allows. Inquire about serving on advisory groups or as a consultant. Suggest topics to the payors’ educational staff they may want to cover in regional presentations. Ask payor staff to be speakers at state or regional meetings. If you can get through the phone maze to reach the medical review team, discuss your appeals directly with a team member in a knowledgeable and professional manner. You want to establish yourself as a good resource for review nurses to call in the future.
3
Organize your files.
Being organized will not only help with any audit, it also will streamline your office operation. If you co-mingle all paperwork in a patient’s file, you’ll waste time searching again and again for the one item you need. At a minimum, arrange the file so that medical records are placed on one side of the file and billing and administrative records are on the other. Take that idea one step further by following the paperwork of a few patients from the front office through the whole chain of procedures that finally leads to a payment. Make sure that a few of the claims include appeals. The purpose of this review is not to look at the quality of the documents, but rather to simply assess the procedures used to produce a finished product. Is your process streamlined or duplicative?
n
LCDs and policy articles, but also conducting at least a quarterly review of them on your DME MAC’s website to ensure you haven’t missed any updates. In addition, your office must be signed up to your DME MAC’s email to receive updates as they occur. While some jurisdictions are better than others at notifying the provider community about changes, you also can sign up directly with CMS to receive timely notices. Remember each medical policy is in two parts—the LCD and the policy article—that spell out the rules specific to each type of device. For example, the lower-limb prosthetic LCD and policy article give you the Medicare rules that are specific to lower-limb prosthetics. Those rules must be followed in addition to the general Medicare rules that apply to all claims and can be found in the Medical Supplier Manual and on the DME MAC’s website.
Do too many people handle a case (which could result in wasted time and effort)? Do too few (creating a possible conflict of interest or questionable financial processes)? Are there holes in your process that allow documents to be overlooked? Do you have checklists to help staff remember to obtain critical information?
4
Become familiar with LCDs/policy articles.
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Unless you or someone on your billing staff is very familiar with Medicare’s local coverage decisions (LCDs) and policy articles, you are bound to run afoul of Medicare’s complex billing rules. While there is no guarantee that will not happen even if you have a knowledgeable person on staff, the odds are certainly much better if you do. Keeping current on this information involves not only reading the current
Reimbursement Page
5
Develop an appeal strategy.
6
Prepare your staff.
Your strategy should include decisions on what to appeal and what not to appeal. Is there a dollar limit on what is worth your time to go after? Are there some cases, if unchallenged, would set a bad precedent? Are there some types of care that, if denied, should always be brought to your attention for an appeal decision? If you are not successful at the first level of appeal, should you continue on all claims or only on some types or amounts?
Because a confused staff is a vulnerable staff, the last thing you want is for your staff to be taken by surprise. Let them know that reviews are common and it is not automatically a sign that you or they are doing anything wrong.
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AUGUST 2012 O&P Almanac
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Reimbursement Page
You should convey, however, that reviews are also serious and should not be treated lightly. Prepare a plan detailing how you will handle inquiries, including time frames that govern your responses. (You don’t want to lose your appeal rights simply because you didn’t respond to a request on time). Also, set up a chain of command—who is notified first, who should be brought in later, and so on. You don’t want the outcome of a review and, in the worst case, the fate of your company to rest on the front office staff you just hired last week and haven’t had time to train yet. Give them clear direction on who or what to turn to for guidance.
7
Review and, if necessary, update your policy manual.
In order for your staff to know how to handle review situations, memorialize your directions in your policy manual and make it available to all employees. Take the time to review the contents at least once a year to make sure the manual is up to date, then discuss those updates with your staff at a staff meeting. One creative way to review the manual is to assign each staff member one section to review and then ask him or her to report on that section “in 25 words or less” and give a small prize for the best summary. This exercise encourages staff to read their sections carefully and listen attentively to see whose summary is best. Perhaps you can think of a better way to review the policy manual; just remember, this is an important document, so do something to make this boring task worth your staff’s time.
8
Conduct a self audit.
It’s always better to find problems yourself than to have a payor find them for you. Set aside some time each month or each quarter for you or some of your top-level staff to randomly pull files and review them in detail. This review is different from the task discussed
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O&P Almanac AUGUST 2012
in the third step because you are not scrutinizing procedures but rather reviewing which documents are in the files—and what they say. Here is where you determine, for a Medicare claim, if you have followed all the LCD and policy article rules. Here is where you read the medical notes not only from your staff but also from the physician. Are your practitioners doing complete notes that would support an appeal, or are they shortchanging the record and leaving you vulnerable on a review? Has the referring physician included everything in his documentation that the payor demands, or is he simply saying “it’s medically necessary” without any further notes to support the need for the device? Such a note won’t fly with Medicare these days, so the presence of such a note is hardly worth the time it took you to obtain it. Once your audit is complete, use this as an opportunity to correct deficiencies in your records or in your staff’s understanding of the billing rules for the payor. If you find billing errors (such as overpayments), notify payors. While this is still optional for most private payors, it is no longer optional for Medicare. But at least you can assess the size of the problem and have a corrective plan prepared before you bring Medicare into the picture. This is much better than having Medicare identify an error on prepayment review and then descend on your office looking for any error it can find.
9
Prepare for payment slowdown.
There are times when prepayment reviews lead to slower payments or even a temporary payment stoppage. Think about how you will deal with such events. Do you have enough cash reserves to see you through those times? Do you have a line of credit you could tap? Do you have any other financial resources you can turn to? Develop a backup plan now, before you need it.
10
Keep your accountant/CPA in the loop.
If you do run into payment difficulties, make sure to notify your accountant or CPA because she will have to deal with the fallout. Your accountant may also have some thoughts on how to handle future situations, should the need arise. While there is no silver bullet to make all reviews go away, being prepared will make responding to them easier. Take a little time now to save you and your staff some time and much stress in the future. a Kathy Dodson, formerly senior director of government affairs, is a consultant for AOPA. For questions about this column, contact Joe McTernan at jmcternan@ AOPAnet.org.
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O&P Almanac AUGUST 2012
COVER STORY By Deborah Conn
Mastering Our Future
As more O&P professionals conduct industry research, the fusion of art and science presents endless possibilities for the field
t
he state of research in orthotics and prosthetics has been described as “emerging,” as reliance on anecdotal evidence slowly gives way to hard data and scientific studies. “Historically, prosthetics has moved from an art to a science,” says David Moe, CP, of Barber Prosthetics Clinic in Vancouver. “But in that movement, the key component we missed was the research to validate what we are doing day to day.” The quantity and quality of research is advancing, however, due to the heightened attention to O&P fueled by long-running wars in Iraq and Afghanistan, according to sources. Another major impetus stems from payors demanding proof that what they are paying for actually works. Accompanying that scrutiny is a growth in O&P advanced degree programs, building capacity within the profession to conduct research and analyze the results. O&P Almanac recently took a look at a few of those studies.
AUGUST 2012 O&P Almanac
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BCIT Evaluates Prosthetic Feet David Moe is the clinical prosthetist in a current study evaluating prosthetic feet conducted by the British Columbia Institute of Technology (BCIT) and funded by AOPA and five manufacturers: Becker Orthopedic Appliance Company, Endolite, Freedom Innovations LLC, Ossur Americas Inc., and Ottobock. The Center for Orthotic & Prosthetic Learning (COPL) board of directors reviewed and scored the dozen responses to AOPA’s request for proposals and recommended BCIT for the project. While many factors may influence the choice of a prosthesis, this study focuses on what is best for the amputee, says Silvia Raschke, PhD, principal investigator of the project and of the Centre for Rehabilitation Engineering and Technology that Enables (CREATE). Researchers are working with 12 unilateral transtibial amputees, each of whom will try out up to six different prosthetic feet along a wide range of mechanical designs. The team evaluates each foot using a method of quantifying gait variations called Symmetry in External Work (SEW) and Compas, a miniature force sensor developed by Orthocare Innovations. Researchers also use subjective measures, including amputee feedback and a short questionnaire. Based on their performance in the lab, two of the feet will be selected by Moe for further testing by each subject. At the start of the study, subjects will wear their own prosthetic feet for a week using the StepWatch Activity Monitor, also made by Orthocare Innovations. “StepWatch measures every step the user takes over the course of seven days to give us an accurate profile of someone’s activity levels,” explains Raschke. “If someone sits at a desk most of the day but then has bursts of activity for short periods, the monitor will capture that information. We want to incorporate these types of issues more effectively in our clinical decision making.”
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“Back and forth walking in the lab is not indicative of what the amputee does out in the world. It’s important to find a measure that captures a snapshot of what the amputee does in daily life.” —Silvia Raschke, PhD
During the second week, subjects will try the first test foot, again using StepWatch to assess their activity at home and in the community, and repeat with the second test foot the following week. “Community walking is critical,” emphasizes Raschke. “Back and forth walking in the lab is not indicative of what the amputee does out in the world. It’s important to find a measure that captures a snapshot of what the amputee does in daily life.” The BCIT study is a double-blind study: Neither the prosthetist nor the amputees know which foot they are wearing. “We use a standard black sock to cover the feet, so only two of us—who are not in the lab setting— know which foot is which,” says Raschke. “This removes bias in how we communicate with the amputee.” Although results are not yet available because Raschke and her team are still collecting data, she has drawn some early conclusions.
“What’s becoming clear is that the prosthetist is a very important part of the process of choosing a device,” she explains. “In Canada, prosthetists are paid on a per-device basis and are not fully considered to be impartial clinicians. But critical thinking is valuable and the prosthetist’s involvement is critical.” Raschke already is looking ahead to further studies. Based on feedback from subjects, she would like to take longer than a week to test devices. “Someone was sick for a week, so [he] didn’t walk much. Someone else had visitors, so she walked a lot every day. I want to adapt the technology, so they can take it with them over a longer period of time,” she says. Other proposals involve creating community-like environments in the lab, such as graveled walkways, sand, and obstacle courses. Raschke expects the final project report to be completed by the end of 2012.
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A growing wave of O&P professionals are pursuing degrees in research traditionally held by medical doctors.
USF Studies Transfemoral Vacuum-Assisted Suspension A recent study of a transfemoral vacuum-assisted suspension system brought together Jason Kahle, CPO, LPO, FAAOP, and University of South Florida (USF) Assistant Professor Jason Highsmith, CP, DPT, FAAOP—and earned them AOPA’s prestigious Thranhardt Award for 2012. Kahle, who is finishing a master’s degree in clinical and translational research at USF, and Highsmith, who has a master’s degree as a clinical trialist and is a USF doctoral candidate in that field, are part of a growing wave of O&P professionals pursuing degrees in research traditionally held by medical doctors. Vacuum-assisted suspension is fairly common for transtibial amputees because the socket must be sealed to the interface to achieve a vacuum, and a below-knee amputation offers the entire thigh to accommodate a silicone seal. “You don’t have that real estate to seal off the top of the socket with
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O&P Almanac AUGUST 2012
a transfemoral amputation,” says Kahle. But a company called Symmetry, based in Dothan, Alabama, has patented a product that combines the liner and seal as one unit within the socket, thereby creating a larger surface area for the vacuum seal. It is the only commercially available vacuum-assisted suspension system for transfemoral amputees. Symmetry wanted to know whether a socket using its liner would work as well without the proximal aspect, or brim. The company contracted with USF to conduct clinical efficacy trials comparing brimmed and brimless sockets using the Symmetry liner. “The brim is uncomfortable for amputees and difficult to fit for the prosthetist, so if the system worked as well without it, removing the brim would be a plus,” says Kahle. The researchers used X-rays and fluoroscopic images along with walking and balance tests to evaluate the two sockets.
The results? “Removing the brim under elevated vacuum seemed not to make a difference in the subjects’ balance, stability, or quality of walking,” says Highsmith. “And the amputees’ subjective assessment clearly favored the brimless socket.” Kahle and Highsmith are collaborating in other studies, including a comparative efficiency trial of a new C-leg knee developed by Ottobock. “The C-leg knee released in 1997 has become the standard of care,” says Highsmith. “But new generations have come out, and we are now comparing Ottobock’s new Genium knee with the original version.” The trial should be completed within a few months. Another study, funded by a Department of Defense grant, will compare three different prosthetic feet with an eye toward enabling military amputees to return to active duty if they are willing. Subjects will wear the feet on a field obstacle course as well as in the lab. “We’ve partnered with a local sheriff to use a SWAT training facility,” says Highsmith. The $750,000 project will launch later this year.
Georgia Tech Examines Lower-Limb Motion At Georgia Tech in Atlanta, students can participate in both clinical and research graduate programs in orthotics and prosthetics. The university’s Master of Science in Prosthetics and Orthotics (MSPO) program is designed for students who have earned a bachelor’s degree and completed the prerequisite coursework to pursue a clinical career in O&P. But the school is unique in that it also offers a PhD program designed to train scientists to become principal investigators in O&P research. In 2007, Georgia Tech’s School of Applied Physiology was awarded the nation’s first grant from the National Institutes of Health to fund the training of scientists with a focus in orthotics and prosthetics; the grant comes up for its five-year renewal cycle soon.
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“The PhD program in applied physiology with focus in prosthetics and orthotics has yielded publishable research,” says Chris Hovorka, MS, CPO, LPO, FAAOP, co-director of the MSPO program and a PhD candidate studying applied physiology with emphasis in biomechanics. “The first graduate of this program, Dr. Lee Split belt instrumented treadmill Childers, investigated the of lower-limb motion as they walk motor control behavior of unilateral while wearing an ankle-foot-orthosis/ transtibial amputees. Dr. Childers footwear combination. was interested in examining clinically “When health-care professionals relevant questions such as whether a fit wearable technology such as a person with unilateral limb loss at the lower-limb orthosis that is designed transtibial level responds the same or to constrain lower-limb movement, differently to a particular movement we know that repeated and regular challenge on the amputated limb exposure to constraint of movement compared to the intact limb. This over a long term produces ‘learned was a fundamental, basic question, disuse’ of a number of systems: but one that had been previously nervous, muscular, etc.,” he explains. answered with clinical anecdote rather “Clinically, we can observe learned than rigorous research. To address disuse in patients displaying muscle the gap in knowledge, Dr. Childers atrophy and slowed neurological pursued this line of research for his reflexes. But we don’t know what PhD dissertation and has published happens to the neurological and a number of articles in peer reviewed muscular systems when joint motion research journals.” is constrained while walking for a For his PhD dissertation, Hovorka is few minutes, or a few hours.” examining the motor control behavior Hovorka wants to understand how of persons in response to constraint
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systems such as the central nervous system and skeletal muscular system respond to the challenge of constraint of joint motion. The thought is that clinicians might be able to exploit the use of an orthosis as a constraining tool to re-direct motor behaviors in persons with neurological disorders, such as stroke, that produce unilateral deficits. Hovorka hopes the knowledge gained from his research may enable clinicians to “wake up” patients’ neuromuscular systems as a strategy to retrain certain locomotor behaviors. Hovorka is currently investigating a nonclinical sample of persons, as is usual in novel research involving human subjects. His research approach is to fit intact able-bodied subjects with an anklefoot-orthosis/footwear combination and examine their lower-limb movement behaviors using 3-D motion analysis and surface electromyography as they walk on a split belt instrumented treadmill. That specialized gait analysis laboratory enables Hovorka to record subjects’ limb and joint displacements, forces, and moments, as well as electrical signals elicited by muscles during each portion of the gait cycle. “We’ve found that in healthy subjects who wear an AFO/footwear combination with rocker-profile, the behavior of certain lower-limb muscles actually increases, rather than decreases, in response to the constraint of motion,” says Hovorka. “What we don’t know is whether this response is similar or different in persons with pathology of the neurological system.
prosthetics research. “We have studied balance and gait in young and older adults for many years,” she says, “but there are many gaps in our knowledge in the amputee population. We’re hopeful this AOPA-funded study will open the door for more proposals with the National Institutes of Health and the military.”
Just the Beginning
Once we validate the protocol among our able-bodied sample of subjects, we aim to eventually extend the research to a sample of stroke survivors in order to evaluate if we can achieve a similar, and hopefully beneficial, carryover effect.”
Pitt Aims to Help Older Populations Rakié Cham, PhD, and April Chambers, PhD, of the Human Movement and Balance Laboratory at the University of Pittsburgh are conducting an AOPA/manufacturer jointly funded study of prosthetic knees. Like BCIT, Pitt’s response to AOPA’s RFP also was recommended for the research award by COPL’s board of directors. Working with a population of adults 65 years and older with unilateral transfemoral amputations, Cham and Chambers are comparing mobility performance measures and risk of falls between microprocessor controlled knee joints (MCKs) and non-microprocessor controlled knees (NMCKs). “Other studies have shown that MCK joints improve certain aspects of gait in young adults, such as side-to-side symmetry, loading patterns, energy consumption, and risk of falling,” says Chambers. “But no studies have determined whether those benefits would apply to an older
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population, typically at a higher risk of falls than young adults.” “We would like to provide some quantitative data as to why it’s important to pay for microprocessor knees,” says Cham. At first, Cham and Chambers observe subjects who are wearing their own prosthetic knees ambulate in various environments (flat surfaces, ramps, stairs) and while being exposed to conditions that dynamically challenge their balance (uneven flooring surfaces, trips/slips). Motioncapture cameras, force plates, and other equipment record full-body movements and biomechanics. The team also assesses mobility performance outside the laboratory using activity monitors, falls diaries, and surveys. Researchers then fit subjects who were using an MCK with an NMCK and vice-versa. Subjects are given eight weeks to become accustomed to their new knees before undergoing the same assessments. The team is using MCKs from the four different manufacturers that are co-funding the study with AOPA although their assignment is random and when researchers process the data, they won’t know which brand was used. Cham hopes this study will lead to larger grants in orthotics and
O&P research may still be in its infancy, but, says Silvia Raschke of the BCIT, “I see a bright future.” She believes educational advances in the field are opening doors for O&P professionals to take their place on interdisciplinary teams. “P&O research is done in teams—prosthetists working with engineers working with biomechanists—and the greatest benefits come from teams,” she says. “Education is absolutely key in this, making sure young people are going into these fields with good critical thinking and an understanding of the interdisciplinary process.” Even more important, says Raschke, is that O&P professionals are claiming their place in the process. “Before, those with advanced degrees were physiotherapists or medical doctors who drove the research theme and the project itself. We had other professions doing our research,” she says. “This is really [instrumental] to the future of P&O research. If we don’t drive our own future, other people will do it for us. We need to be in control of our own destiny.” a Deborah Conn is a contributing writer to O&P Almanac. Reach her at debconn@ cox.net. Editor’s Note: In 2009, AOPA launched another avenue to fund pilot research projects. Initial funding was at the $7,500 level, but that amount increased to $15,000 in 2012. AOPA hopes that results from these studies will gather enough data to attract much higher levels of funding from foundations and government agencies to support more expanded and sophisticated O&P research projects.
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Shipping Up
To Boston
Don’t miss the chance to learn, network, and experience the 2012 AOPA National Assembly with your O&P peers
W
ith a mix of dynamic learning opportunities, revolutionary technical showcases, and thrilling leisure activities, the 2012 AOPA National Assembly will once again provide an unforgettable experience for professionals in the orthotics, prosthetics, and pedorthic profession. Held in downtown Boston at the Hynes Convention Center and adjoining Sheraton from September 6-9, the Assembly will give industry decision makers the tools they need to advance their practices from both a business and a technological standpoint, and will
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allow them to gain new insight into the state of the O&P field. The AOPA National Assembly has been known to bring together a varied array of speakers and educational sessions structured around the goal of helping attendees adapt their skills to the ever-evolving O&P landscape. With a revamped business certification program, an all-new technical fabrication competition, and countless other instructive offerings, this year’s annual Assembly will undoubtedly remain true to its reputation. And for the first
By S a m Waymi r e
Schedule of Events THURSDAY September 6 8 AM - 3 PM
Thranhardt Golf Classic
8 AM - 5 PM 5:30 PM
Concurrent Manufacturers’ Workshops (Tiers I & II)
6:30 - 8:00 PM
Exhibit Hall Opening Ceremony Welcome To Boston Reception
FRIDAY September 7 7 AM
Registration Open
7:30 - 8:45 AM
General Session: Breakfast, Welcome, and Opening Remarks/ Max H. Bazerman Keynote Address
8:45 AM - 6:30 PM
Exhibit Hall Open/Product Preview Theater Presentations
10:00 AM - Noon
Concurrent Education Sessions
Noon - 2:30 PM
Break in Exhibit Hall
2:30 - 5:30 PM
Concurrent Education Sessions
5:30 - 6:30 PM
Exhibitor Sponsored Happy Hour
6:30 – 8:00 PM
Wine Tasting and Auction
SATURDAY September 8 7 AM
Registration Open
7:00 - 8:30 AM
General Session: Breakfast, Membership Meeting, Hamontree Business Presentations
time ever, AOPA will partner with the New England chapter in order to bring attendees and locals together for a combined National Assembly and local chapter Keynote Speaker Max H. Bazerman, PhD meeting. Professionals and students who seek to remain on the cutting edge of the orthotics and prosthetics industry owe it to themselves to attend this crucial event.
8:30 AM
Exhibit Hall Opens
10 AM - Noon
Concurrent Education Sessions
Noon - 2:30 PM
Break in Exhibit Hall/Poster Presentations
2:30 - 5:30 PM
Concurrent Education Sessions
7 PM
Optional Event: Red Sox vs. Blue Jays at Fenway Park
SUNDAY September 9 8 AM 8:00 - 9:30 AM
Registration Open General Session: Science and Practice of AFO Tuning/
BEST
OF SHOw
Thranhardt Lectures 9:30 AM - Noon
Break in Exhibit Hall
10 AM - 5 PM
Optional Event: Elaine Owen Instructional Seminar
10 AM - 1 PM
Concurrent Education Sessions
1 - 5 PM
Concurrent Manufacturers’ Workshops (Tier III)
1 - 4 PM
Business Certificate Programming: Market Your Way to Success
AUGUST 2012 O&P Almanac
31
Picture-Perfect Research Returning yet again to the National Assembly floor are the annual scientific poster presentations. These sessions offer attendees an unmatched glimpse into the research being conducted in the O&P field. “Scientific posters are one of the best ways to communicate the results of research,” says Geza Kogler, CO, LO, PhD, MSPO, professor at the Georgia Institute of Technology and member of the Assembly Planning Committee. Practitioners are not always acquainted with the studies conducted in the field, says Kogler, and, for that reason, the posters play a special role in disseminating current scientific information to the clinicians who can put it to use. Through a historic partnership with the American Society of Biomechanics (ASB), AOPA strives to bring the finest posters possible to the 2012 Assembly. The ASB will review submissions, and, through a strict assessment process, will ensure that each poster is worthy of presentation. Because of that process, attendees can be sure that the posters on display represent the highest level of research being conducted and will cover topics that are most useful to Assembly attendees. The ASB and AOPA partnership will also help bring to light the work of those who might not consider the AOPA Assembly a typical forum in which to present their findings, says Kogler. While the Assembly is highly focused on the clinical side of O&P, the poster presentations will provide a window into the science that is going on behind the scenes. The goal is to offer a “translation of bench work science to clinicians.” Most of the research conducted in the orthotics and prosthetics arena takes place not in clinics but in academic institutions. But that doesn’t mean clinicians must remain unaware of the groundbreaking work that is driving their industry forward. AOPA hopes that through the poster presentations, Assembly attendees will gain a new understanding of the work that will define the future of the O&P world.
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A variety of speakers will convene at the Assembly to share their insights with attendees. Max H. Bazerman, PhD, Strauss Professor at Harvard Business School, will discuss the key to successful negotiations during the Assembly’s opening keynote address on the morning of Friday, September 7. Other speakers will address such topics as the relationship between dermatology and the O&P arena, the role of pharmacology, and the burgeoning impact of idiopathic scoliosis. Attendees will find there’s no shortage of fascinating and informative educational sessions at this year’s gathering. Returning once again and strengthened through a partnership with the University of Virginia’s School of Continuing and Professional Studies, the Business Certificate Program (http://bit.ly/AOPAbuscert) will undoubtedly offer participants the tools they need to grow their patient-care facilities beyond measure. This comprehensive program offers a series of seminars designed to help attendees bolster their “Business Management” expertise. Through the Business Certificate Program, participants will learn how to create a better customer service experience, grow a business through strategic marketing, develop a viable reimbursement policy, and much more. At the heart of each session is the fundamental goal of giving O&P professionals the skills they need to create ongoing returns for their business. Classes aligned with the program are offered on site at the Assembly and at several targeted seminars throughout the country.
INTRODUCING THE TACTICAL SOLEUS FOOT, BUILT FOR THE HEROES AMONG US. Its lighter, stronger and more rugged design can overcome barriers whether on the front line or the home front. Engineered and manufactured right here in the U.S.A, the Tactical Soleus is only available for a limited time. The foot was inspired by Dale Beatty, Military Veteran, bilateral amputee and co-founder of Purple Heart Homes. His organization is committed to leaving no veteran left behind and provides personalized housing solutions for disabled veterans and their families.
Starting on July 4, 2012, College Park will donate $200 of each Tactical Soleus purchase directly back to Purple Heart Homes. For more information visit phhusa.org or call 800.728.7950
www.college-park.com/tactical
is the first annual Technical Fabrication Contest. In this competition, participants will work to fabricate a finished below-knee swim prosthesis. All entrants will be provided with a digital positive mold as well as a specifications sheet, and a cast mold will be provided for those who lack access to a carver. Categories have been established for both students and field professionals, and the top three in both classes will receive a cash prize. The prostheses will be judged on, among other things, weight, buoyancy, alignment accuracy, and lamination quality.
Networking Through Recreation Technical Education
The
Placee! To B
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O&P Almanac AUGUST 2012
A large focus of each year’s AOPA National Assembly is the technical aspect of the O&P business, and this year will be no exception. Held in conjunction with the Assembly is this year’s technical summit: a two-day event, held from September 7-8, that is cosponsored by AOPA and the Orthotic & Prosthetic Technical Association (OPTA). The technical summit will offer attendees an expanded and highly detailed technical program. Program features include an in-depth look at managing quality control, joint alignment, metal contouring, thermoforming, and much more. For those interested in the work one goes through to craft a prosthetic device, be sure to make room on your schedule for this must-attend event. Those with an interest in lower-body orthotics will no doubt be interested in Elaine Owen’s instructional seminar on the “Science and Practice of AFO Tuning.” Owen, a visionary in tuning AFOs to work in conjunction with shoes, will host this day-long session on Sunday, September 9. During the seminar, Owen will share with the audience the techniques and processes she personally developed, and give members the tools they need to help optimize gait in patients with AFOs. Making its debut in Boston this year
As in years past, the AOPA National Assembly will provide a variety of exciting leisure activities not only to help attendees unwind but also to give them a chance to network with other professionals across the industry. On September 6, the annual Thranhardt Golf Classic returns for its fourth year and kicks off Thursday morning’s schedule of events. Cosponsored by AOPA’s Capital Connection and the Orthotic and Prosthetic Assistance Fund (OPAF), the golfing event’s proceeds will go on to benefit the O&P agenda in a variety of ways. Assembly and local chapter meeting attendees can be sure that this year’s golf tournament will provide a fun experience and a valuable networking opportunity. All Assembly-goers are invited to take part in the inaugural “Welcome to Boston” reception, which takes place Thursday evening. During the reception, attendees will be granted a sneak peek into the exhibit hall and will have another chance to mingle with colleagues. The following night, Assembly participants will be granted a similar networking opportunity at the exhibitor-sponsored happy hour. From 5:30-6:30 p.m. on Friday, September 7, attendees are welcome to peruse the exhibit hall and check out the technologies and services on display while enjoying a variety of different snacks and drinks.
e k a M own r u o Y
y r o t His
Hynes Convention Center
Following the happy hour and appearing for the fifth year in a row is the annual Wine Tasting and Auction. Held on Friday evening, this event will give participants a chance to taste and learn about a variety of different wines, as well as the opportunity to take part in both silent and live auctions. For the first time ever, auction attendees will receive a $100 voucher that can be used toward their first bid. Participants can expect to bid on a variety of highly sought after items.
Historic Boston Outside of the Assembly itself, the city of Boston has no shortage of vibrant and invigorating leisure activities. The Hynes Convention Center is located in Boston’s Back Bay neighborhood, an area considered by many to be among the most affluent and lively the city has to offer. The neighborhood boasts such world renowned landmarks as the Prudential Center, Copley Square, and Fenway Park, the home of the Boston Red Sox. The Massachusetts Institute of Technology (MIT), located a mere mile away from the Assembly grounds, will graciously open its doors to Assemblygoers, giving registered attendees a walking tour of its museum at no additional charge. As a historically
significant technological institution and a noted contributor to the O&P agenda, MIT offers the tour to provide attendees a fascinating glimpse into the school’s scientific past. For those looking to gain insight into Boston’s unique role in American history, world famous Duck tours will be offered to Assembly attendees at discounted prices. After tour-goers board their WWII era amphibious landing vehicle known as a “Duck,” they will visit a variety of the city’s most impressive sites before dropping off into the Charles River for an unmatched view of the Boston and Cambridge skylines. You haven’t seen Boston until you have seen it from aboard a Duck! And what visit to Boston would be complete without catching a Red Sox game held at major league baseball’s most famous stadium, Fenway Park? Opened in 1912, Fenway is celebrating its 100th anniversary as a Boston
cultural landmark, and you can be a part of this historic season by watching as the Red Sox take on the Toronto Blue Jays on Saturday night, September 8; it’s bound to be a game to remember. Focusing equally on the technical, clinical, and business sides of the O&P world, there is just nothing like the AOPA National Assembly. Nowhere else can members of the industry find a more complete representation of the current trends in the field. For those looking to learn more about their profession, become further rooted in the AOPA community, and experience the sites of one of America’s most richly historic cities, they needn’t look further than the AOPA combined National Assembly and New England Chapter meeting. As it has for more than 90 years, AOPA will once again prove to be the defining voice in the orthotic and prosthetic profession. a
Sam Waymire is a contributing writer to O&P Almanac. Reach him at swaymire@strattonpublishing.com.
AUGUST 2012 O&P Almanac
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n
Facility Spotlight By Deborah Conn
Sized toFit
Kormylo Orthopedic offers patients a personal touch
FacilitY:
Kormylo Orthopedic Inc.
Location:
Boise and Nampa, Idaho
Owner:
Mark Kormylo, CPO
HISTORY: 38 years
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O&P Almanac AUGUST 2012
A
s Mark Kormylo, CPO, recounts it, his grandfather entered the O&P field by literally getting a (wooden) foot in the door. John Kormylo was a nine-year-old Russian immigrant in Minneapolis when he lost his leg scavenging coal at the rail yards. A limb and brace shop owner took pity on him and built the boy a wooden leg. John expressed his gratitude by sweeping up around the store, learning the business as he got older. In 1974, John and his son Phillip opened Kormylo Orthopedic Appliance in Rapid City, South Dakota, where Phillip’s younger brother, John, Jr., joined them. Eventually, John, Jr., ended up
with his own facility in Billings, Montana, while his brother Phillip moved to Idaho, where he opened shops in Idaho Falls, Pocatello, and, finally, Boise, where he settled in 1990. Phillip’s son, Mark, joined his father in the family business in 1977, assuming sole ownership of Kormylo Orthopedic Inc. in Boise in 2006. Although Phillip retired seven years ago, he still enjoys working a few days a month in the fabrication lab. For Mark, 37, the choice of a career was never in question. “My dad saved one of my papers from kindergarten,” he says. “I wrote, ‘I want to be a brace and limb man just like my dad and grandpa.’”
Don’t want to be limited to 4 months a year when your certification exam is offered?
we CARE.
“We offer year-
round testing so you can take your test on a date that works for you.” Michelle Yoon, Certification/External Relations Coordinator
877.776.2200
www.bocusa.org
The Personal Touch Today, Kormylo Orthopedic has offices in Boise and Nampa, about 30 minutes away. In addition to Mark Kormylo, the practice employs two certified orthotistprosthetists and a resident, as well as two administrative staff members, one of whom is also a certified mastectomy fitter. The facility fabricates everything in house, with labs at both locations and two technicians on staff. Prosthetics represents about two thirds of Kormylo’s business, and practitioners see patients of all ages, although geriatrics predominate. The company stays competitive with four other facilities in town by having a full-time marketing specialist on staff. “She really serves as patient-care coordinator as well as a marketer,” says Kormylo. “We do a ton of casting in the hospital, and she makes sure to visit patients to answer questions and follow their progress. We also have a number of extended-care hospitals here where patients can get overlooked. We are careful to follow through, and that attention has definitely had a positive impact on our business.” In spite of a thriving business, Kormylo has no plans to expand. “Too many facilities have gotten too big and lost touch with their patients,” he explains. “I want to stay this size and keep being the best.” Treating new amputees is, for Kormylo, the most satisfying aspect of his job. “It is extremely rewarding to give someone something back that they lost. You really are giving them back their life. When I can help that way, it doesn’t feel like I go to work, it’s just something I love to do.” a Deborah Conn is contributing writer to O&P Almanac. Reach her at debconn@cox.net.
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O&P Almanac AUGUST 2012
T I M I N G
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AOPA HEADLINES
AOPA WORKING FOR YOU
Essential Health Benefits Help ensure your state’s elected officials select the benchmark plan that includes O&P
W
hen Health and Human Services (HHS) Secretary Kathryn Sebelius opted to delegate defining “essential health benefits” to the 50 states, providing only broad benchmark plan options, it became a new legislative ballgame for all involved. AOPA’s Executive Committee immediately sensed the perils of this scenario and realized that the four basic benchmark plans the states were being asked to select from to define their version of essential benefits posed a huge danger for O&P. As a small piece of the pie, O&P could be overlooked when states are finalizing their included services. The Executive Committee took prompt action and within a few days began discussions with McGuireWoods Consulting, asking the firm to undertake a detailed survey of what those benchmark plans actually included on a state-by-state basis and, more important, which benchmark plans included or excluded O&P coverage. All in all, AOPA’s study sought information on eight plans in each of
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O&P Almanac AUGUST 2012
the 50 states or a collective review of 400 plans. Identifying the designated benchmark plans in each state that did not include O&P coverage was necessary because AOPA could use that knowledge to advise members to take concerted action with their legislators and state officials. By discussing the issue with their elected officials, members could help ensure that plans excluding O&P would not be considered when “essential benefit” was defined in their states. States must select their benchmark plan in the third quarter of 2012, and it would apply for plan years 2014 and 2015. HHS has stated it will revisit this approach for plan years starting in 2016.
How We Got Here The plans recommended by HHS for guidance were • the largest plan by enrollment in any of the three largest small group insurance products in the state’s small group market • any of the largest three state
employee health benefit plans by enrollment • any of the largest three national Federal Employee Health Benefits (FEHB) Plan options by enrollment • the largest insured commercial non-Medicaid Health Maintenance Organization (HMO) operating in the state. In its Guidance Bulletin of Dec. 16, 2011, HHS stated that, “under our intended approach, States are permitted to select a single benchmark to serve as the standard for qualified health plans inside the Exchange operating in their State and plans offered in the individual and small group markets in their State.” On several fronts, AOPA had requested that HHS include O&P, including during a critical meeting on Aug. 14, 2011, with top CMS officials. During that meeting, AOPA pointed out the deficiencies of a flawed Department of Labor (DOL) study that seriously misrepresented the prevalence of O&P coverage in current health plans. AOPA presented data gleaned from an independent survey
HEAT ADJUSTABLE
COST SAVINGS. PATIENT CONVENIENCE. Orthomerica gauntlets are now able to be worn throughout the patients’ volume changes via unlimited heat adjustments to the plastic material sandwiched between the leather or synthetic material. A unique plastic allows for a dynamic orthosis, saving both time and money for all concerned. Our unique and innovative designs have been tested and refined in high volume orthotic centers. The resulting high-quality custom AFOs, synthetic and leather gauntlets offer optimal fit and are less expensive in today’s ultra cost-conscious environment — without compromising comfort or function. Orthomerica’s experienced custom fabrication team of certified orthotists, technicians and customer service representatives deliver prompt and exceptional service at highly competitive prices.
www.orthomerica.com/spectrum 877-737-8444
The O&P Business Management Certificate Program addresses skills that are fundamental to the success of an O&P business.
O&P Business Management: This unique leadership learning experience will provide business owners, managers and practitioners an opportunity to experience fresh insights, new tools and proven techniques as a pathway for developing better business practices, while creating ongoing returns for your company. ■ REFRESH YOUR KNOWLEDGE ■ DEVELOP BETTER BUSINESS PRACTICES ■ ADVANCE YOUR CAREER ■ CREATE ONGOING RETURNS FOR YOUR COMPANY
Earn Your Certificate in
O&P BUSINESS MANAGEMENT
Through a joint partnership between AOPA and the University of Virginia School of Continuing and Professional Studies
How to get started: 1.
Complete the online sign up form: https://aopa.wufoo.com/forms/earn-acertificate-in-op-business-management/
2.
Select and complete four required core modules and four elective modules within three years.
A NEW AOPAversity OPPORTUNITY! Another addition to the valuable education, products and services offered by AOPA that you need to succeed.
3.
Complete a Module specific quiz for each program.
4.
Participants that successfully complete the program will be awarded a certificate of completion, in addition to being recognized at the AOPA National Assembly and the O&P Almanac.
AOPA HEADLINES by the Society of Human Resource Management (SHRM) that reported a 75 percent frequency of O&P coverage. SHRM’s study confirmed an earlier AOPA study of seven major healthcare markets, which showed about the same prevalence of O&P coverage. Surprisingly, one of the CMS officials present at the August 14 meeting acknowledged CMS’ awareness of the DOL study deficiencies. Letters to Secretary Sebelius urging inclusion of O&P from members of Congress, including Rep. Rob Andrews (D-New Jersey) and others, were the product of efforts by AOPA staff, lobbyists, and members. Those letters aimed to educate legislators about the cost benefits of timely O&P intervention versus Medicare and Medicaid being hit with greater expense for co-morbid conditions if there wasn’t timely O&P intervention. Information about the cost savings disclosed in the Colorado study and preliminary information on the AOPA cost-effectiveness study based on Medicare data now underway was also made available. Ultimately, in its Dec. 16, 2011 Bulletin, HHS left the final definition of essential health benefits up to individual states. Thus, that’s the reason AOPA has significantly invested in the McGuireWoods state-bystate project. It’s worrisome that details on the four benchmark plans represent proprietary information of the insurers, and it was impossible to secure all the data on all of the plans in all of the states. But, imperfect as it may be, the AOPA study is the only tool so far to guide members on which benchmark offerings exist in their states. Members can use that study to help them educate decision makers on how to select the right plan choice that includes O&P.
covered at 80 percent, subject to a calendar year deductible in network; and out of network, DME is covered at 50 percent subject to a calendar deductible. Obviously, Alabamians should push for selection of an FEHB plan to ensure their patients are best served. In Nevada, no information is available on one of the plans, but the other three do offer O&P coverage— although copayment and cost-sharing information is not available. That’s due to the proprietary nature of the coverage details. The three FEHB programs may be the best bet for Nevada O&P patients as well. Every member and every regional or state O&P organization should consult the AOPA Compilation of Coverage in Essential Health Benefit Benchmark Plans. This reference tool will ensure they know which of the benchmark plans meet patient needs in their states. With AOPA’s handy tool, members can mobilize to make sure decision makers get it right. a
Do Your Research, Then Contact Your Legislators Members can view the 95-page AOPA Compilation of Coverage in Essential Health Benefit Benchmark Plans by going to www.AOPAnet.org. When visiting the website, select the Legislative and Regulatory pull-down menu and click on the last offering, “EHB Report for Members.” It is members-only material, so you’ll need your username and password.
O&P Board Study Resources We can help you PASS your BOARDS All products updated to 2012 test standards.
The ONLY Comprehensive Study Guides Specifically for Orthotics and Prosthetics (Many of our products are available in DVD Format also!)
State Examples As an example, in Alabama, the three FEHB programs provide coverage for prosthetics and orthotics. Three other benchmark plans clearly include prosthetics, but orthotic coverage is lumped under DME
Now Offering Customizable Orthotic and Prosthetic Patient Device Instruction Sheets in English AND Spanish
www.oandpstudyguide.com AUGUST 2012 O&P Almanac
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AOPA HEADLINES
House Repeals Medical Device Tax
AOPA Sought O&P’s Exemption From the Tax
The U.S. House of Representatives repealed the medical device excise tax in a 270–146 vote on June 7. Nearly all House members were present for the vote: Not a single Republican voted against the measure, but only about a dozen Democrats offered their support. The vote took place in the shadow of a Capitol Hill bulletin assuring that White House senior advisors would block the bill, H.R. 436, Protect Medical Innovation Act of 2012, should the measure reach the President’s desk. Prior to this vote, many Democrats had reserved judgment on this repeal bill, which is more than a year in the making, while waiting for Republicans to come up with a “pay-for” to make up for the $30 billion in revenue the 2.3 percent medical device excise tax would generate over 10 years. A week prior to the vote, GOP leaders unveiled a way to pay for the medical device tax repeal through a measure that would strengthen efforts to recoup health-care insurance subsidies paid to low- and mid-income households should their eligibility change. The measure could raise as much as $43.9 billion over 10 years. The debate now moves forward to the Democratic-led Senate.
A device tax repeal by the U.S. House of Representatives and then signed into law by the President would be a welcome solution for many in the medical device manufacturing field. But the President has made clear his opposition and promised a veto in the unlikely event that a repeal bill passes the Senate. However, AOPA has been working on this issue since January of 2011, shortly after the Patient Protection and Affordable Care Act became law. AOPA first met with officials from the U.S. Department of Treasury and the Internal Revenue Service (IRS). Treasury and IRS were charged with writing the regulations that would implement the law. Subsequent meetings, testimony at hearings, and encouraging letters and public statements from senators and representatives were all further efforts mounted by AOPA to secure the exemption for O&P devices. These efforts paid off as the proposed regulations issued by Treasury indeed offer an exemption for O&P medical devices. If the final regulations include the same O&P medical device exemption as in the proposed regulations, the law’s repeal will not affect O&P directly. AOPA made the case that O&P medical devices should be eligible for the law’s exemption that applies to eyeglasses, contact lenses, and hearing aids. AOPA contends that orthotic and prosthetic medical devices are also custommade and fitted for an individual’s specific use based on a prescription. So far, Treasury and IRS have agreed.
Get Paid for Orthopedic & Diabetic Shoes—Join the Audio Conference September 12 Explore the difference between orthopedic shoes and diabetic shoes. Join AOPA on September 12 at 1 p.m. EDT for an AOPAversity Mastering Medicare audio conference that will focus on and cover the basics of orthopedic and diabetic shoe policies. Learn strategies and techniques from an AOPA expert who will address the following topics: • the importance of modifiers on shoe claims • how to bill for diabetic shoes for amputees • requirements of the Certifying Statement and physician documentation • when to ask patients to sign an Advanced Beneficiary Notice for shoes.
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O&P Almanac AUGUST 2012
The cost of participating is $99 for AOPA members ($199 for nonmembers), and any number of employees may listen on a given line. Participants can earn 1.5 continuing education credits by returning the provided quiz within 30 days and scoring at least 80 percent. Contact Devon Bernard at dbernard@AOPAnet.org or 571/431-0854 with content questions. Register online at https://aopa.wufoo.com/forms/2012telephone-audio-conferences/. Contact Stephen Custer at scuster@AOPAnet.org or 571/431-0876 with registration questions.
AOPA HEADLINES
Learn Everything You Need to Know About the FDA—Join the Audio Conference October 10 Join AOPA October 10 at 1 p.m. EDT for an AOPAversity Mastering Medicare Audio Conference that will cover what your facility needs to know regarding the U.S. Food and Drug Administration. Learn strategies and techniques from an AOPA expert who will address the following topics: • An overview of the FDA • What the FDA is responsible for regulating • Where the FDA’s authority derives from • How medical devices are regulated • Important information on the Unique Device Identification System (UDI) proposed rule.
The cost of participating is $99 for AOPA members ($199 for nonmembers), and any number of employees may listen on a given line. Participants can earn 1.5 continuing education credits by returning the provided quiz within 30 days and scoring at least 80 percent. Contact Devon Bernard at dbernard@AOPAnet.org or 571/431-0854 with content questions. Register online at https://aopa.wufoo.com/forms/2012telephone-audio-conferences/. Contact Stephen Custer at scuster@AOPAnet.org or 571/431-0876 with registration questions.
Master Medicare in Las Vegas: Essential Coding & Billing Techniques Seminar
Discover Employment Opportunities at AOPA’s Online Career Center
Join your colleagues October 18-19 at the Mirage Hotel and Casino in Las Vegas for AOPA’s “Mastering Medicare: Essential Coding & Billing Techniques” seminar. AOPA experts will provide the most up-to-date information to help O&P practitioners and office billing staff learn how to code complex devices, including repairs and adjustments, through interactive discussions and much more. Meant for practitioners and office staff, this advanced two-day event will feature break-out sessions for these two groups to ensure concentration on material appropriate to each. Basic material that was covered in AOPA’s previous Coding & Billing seminars has been converted into nine one-hour webcasts. Register for the webcasts on AOPA’s homepage. Register online for the “Mastering Medicare: Essential Coding & Billing Techniques” seminar in Las Vegas at https://aopa.wufoo.com/forms/2012-mastering-medicare-lasvegas/ or contact Devon Bernard at dbernard@aopanet.org, 571/431-0854.
As an O&P professional, you can make a difference every day. Job opportunities abound throughout the country, and the need for O&P professionals is increasing rapidly. Currently, 100 percent of O&P program graduates find employment, and most choose to make it a lifelong profession. If you’re seeking employment, access the most recent jobs available. If you’re recruiting, reach the most qualified candidates by posting your job on AOPA’s Online Career Center. Visit http://jobs.AOPAnet.org, or email Steven Rybicki at srybicki@AOPAnet.org with questions.
AUGUST 2012 O&P Almanac
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AOPA HEADLINES
O&P PAC Recognition The O&P PAC would like to acknowledge and thank the following AOPA members for their recent contributions to and support of the O&P PAC*: J. Martin Carlson, CPO Tom DiBello, CO, FAAOP Ted Drygas, CPO David Falk, CPO Rick Fleetwood, MPA Mark Porth, CPO John Ruzich, CP Frank Vero, CP The O&P PAC advocates for legislative or political interests at the federal level that have an impact on the orthotic and prosthetic community. To achieve this goal, committee members work closely with members of the House and Senate to educate them about the issues, and help elect those individuals who support the orthotic and prosthetic community. To participate in the O&P PAC, federal law mandates that you must first sign an authorization form. To obtain an authorization form, contact Devon Bernard at dbernard@AOPAnet.org. a *Due to publishing deadlines this list was created on July 12, 2012, and includes only donations received between May 24, 2012, and July 12, 2012. Any donations received or made after July 12, 2012, will be published in the next issue of O&P Almanac.
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 state-licensed practitioner to be eligible for membership. At the end of each new supplier member listing is the supplier level associated with that company. Supplier levels are based on annual gross sales volume: Level 1: equal to or less than $1 million Level 2: $1 million to $1,999,999
B&L Prosthetics, PLLC dba Twin City O&P 1607 W. Frank Avenue, Ste. 111 Lufkin, TX 75904 936/634-0013 Fax: 936/634-0015 Category: Patient Care Facility Lauren Raney 48
O&P Almanac AUGUST 2012
Level 3: $2 million to $4,999,999 Level 4: more than $5 million.
DR - HO’S 145 Anderson Avenue Markham, ON L6E 1A4 Canada 905/471-4735 Fax: 905/471-2608 Category: International Supplier Member Fiona Tang
Insightful Products, LLC 2 Lincoln Avenue, Ste. 8 Scarborough, ME 04074 207/885-0414 Category: Supplier Member Sean Morrissey
OPED, LLC 203 Crescent Street, Ste. 205 Waltham, MA 02453 781/891-6733 Fax: 781/891-6735 Category: Supplier Member Carol Hovey
Universal Limb and Brace 7028 Owensmouth Avenue, Ste. 102 Canoga Park, CA 91303 818/340-6900 Fax: 818/340-6910 Category: Patient Care Facility Michael Nadell a
Simple As :
1.
3.
2. Visit www.kiss-suspension.com or Call 410-663-KISS (5477) Š 2011, U.S. Patent, Patent Pending Worldwide KISS is a registered trademark
2012
Product Guide On the following pages, you’ll see a sampling of the products that will be displayed at AOPA’s National Assembly, Sept. 6-9, 2012. Go to www.AOPAnet.org to register.
EZ Flex Liner Booth 1605
V-VAS™ Offloading Knee Orthosis Booth 205
ALPS new EZ Flex Liner was designed to provide greater elasticity over the patella while limiting the vertical stretch posteriorly to eliminate pistoning. The proprietary design of the EZ Flex liner combines an anterior fabric with unlimited stretch to reduce pressure on the knee with a posterior fabric with 80 percent less vertical stretch as compared to other ALPS gel liners. This unique fabric paring maximizes function without sacrificing anything. The flexibility of the anterior fabric reduces the amount of energy required to flex the knee while minimizing bunching of the liner behind the knee to significantly increase user comfort. The integrated use of antioxidants in ALPS EZGel helps protect the users’ skin from damage caused by free radicals. ALPS EZGel is the perfect choice for those with poor skin characteristics or sensitive tissues. Call ALPS customer service at 800/574-5426 for additional product information.
V-VAS™ Knee Orthosis is a one-of-a-kind offloading/realigning orthosis that helps to achieve optimal varum or valgum stress, without bulky or complex adjustments. Its unique polycentric adjustable hinge design creates an ideal bending moment that results in the precise offloading/realigning experience. It’s the first long axis off-loading, closed dynamic frame custom knee orthosis that doesn’t need to be removed to adjust offloading, and the mechanical axis is always non-binding and auto aligning. V-VAS™ Knee Orthosis features up to 30 degrees of Varum or Valgum offloading for moderate to severe unicompartmental osteoarthritis or joint alignment concerns, with or without knee joint instability. Contact Anatomical Concepts today! Call 800/837-3888, 800/657-7236, or visit www.anatomicalconceptsinc.com.
Do you need components rated over 365 lbs? Booth 118
Our flagship PRAFO® orthosis is a totally adjustable, customfitted AFO that helps manage many of the ankle/foot anomalies your patients present to you. Anatomical Concepts, Inc. is the designer and only manufacturer of the trademarked PRAFO® brand orthosis. A heel suspension ankle/foot orthosis from any other manufacturer is not a PRAFO® orthosis. Our low cost product line is the RAPO™ (Rehabilitative Ambulatory PRAFO® Orthosis) that provides the same structural support as the PRAFO® orthosis, but costs 45% less than traditional PRAFO® orthoses. Our RAPO™ Orthosis line has structurally-proven superiority over competitors’ PVC-based structures. Contact Anatomical Concepts today! Call 800/837-3888, 800/657-7236, or visit www.anatomicalconceptsinc.com.
In addition to APC’s large line of 30 mm modular components, we manufacture a line of 34 mm heavy duty modular components rated to 500 lbs. Need a foot too? Due to the patients’ weight, your choices in the past have been limited to basic feet that offer little functionality. Not any more! DuroFlex™ with its articulating ankle and vertical shock absorption offers heavy duty patients a foot with dynamic response. Need plastic? APC now carries a variety of plastics. Call today for details! For more information, call 800/772-7508 or visit www. apcomponents.com 50
O&P Almanac AUGUST 2012
PRAFO® Orthosis (PDAC Verified L4396) and RAPO™ Ankle Foot Orthosis Booth 205
2012 PRODUCT GUIDE
Introducing the Soleus foot, Tactical Edition Booth 1805 Available in limited quantities starting July 4, 2012, $200 of every Tactical Soleus sold will be donated to Purple Heart Homes. This organization provides housing solutions for serviceconnected disabled veterans and is driven by the belief that no veteran be left behind. The Tactical Soleus is engineered and manufactured right here in the U.S. and custom built for the heroes among us. College Park was able to remove unnecessary weight while retaining superior strength. A new heel spring design and a new mid spring design combined with a new belt attachment system created a foot 40 percent stronger and 10 percent lighter. For more information, visit www.college-park.com/tactical.
Ibex Booth 219 The Ibex foot system is a leap forward in multi-axial foot design. The innovative microslices in the Ibex pylon and the split heel plate provide controlled inversion/eversion for uneven terrain. The multi-axial design is energy optimized with a long carbon pylon and full length heel plate that allows the Ibex to reach foot flat sooner and store more energy. The unique components of the Ibex work together from heel strike to toe off to provide stability without sacrificing energy return. The Ibex foot’s balanced performance gives amputees the confidence they need to meet life’s challenges head on. For more information, contact Fillauer LLC at 800/2516398 or visit www.fillauer.com.
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SOFTIE and SOFTIE-TF Booth 737 Because minimizing the effects of injury at bed rest can hold a higher priority than early or immediate post-surgical ambulation, FLO-TECH® O&P Systems Inc. designed the SOFTIE™ and SOFTIE-TF™. Our sockets help healing and increase the quality of rehabilitation of post-surgical amputees. The sockets are soft, non-constricting and easy to remove for examinations. Having an inventory of SOFTIE™ and SOFTIE-TF™ sockets allows you to fit any patient at a moment’s notice. The SOFTIE™ & SOFTIE-TF™ will easily fit any size, therefore, one left and one right SOFTIE™ and one SOFTIE-TF™ is cost-effective stock for immediate care to get the patient! Call 800/FLO-TECH or visit www.1800flo-tech.com
Friddle’s is now offering the FC2 Flexion Control Ankle Joint! Booth 1627J FC2 Flexion Control Ankle Joint features: • Patented, spherical-axis FC2 Ankle • FC2 provides up to 70 degrees of anterior-posterior range of motion using plantar/dorsiflexion-stop set screws • Unique design made of high-quality, heat-treated stainless steel • Allows for adjustments to be made while patient is wearing orthosis • FC2 pre-contoured design saves fabrication time while facilitating a low-profile finish • Availability of self-squaring molding dummy to reduce fabrication time. Contact Friddle’s today at 864/369-2328, fax 864/369-1149, or visit www.friddles.com.
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BiOM Booth 117 The BiOM is the world’s first personal bionic solution capable of restoring normal walking function for lower limb amputees. Featuring fully powered plantar flexion, the system emulates the work of muscles and tendons to provide a natural gait cycle that can be fine-tuned to personal preference within normative performance standards for non-amputees. By incorporating the latest advances in personal bionics, the BiOM reduces energy requirements, joint degeneration and offers an ease of mobility that facilitates a return to work and other important daily living activities. The BiOM is currently available to individuals with transtibial (BK), transfemoral (AK), or bilateral amputations. For information, call 800/989-9998 or visit www.iwalk.com
Reformulated KISS® Adhesive: Amazing adhesion Booth 917 The reformulated KISS adhesive features increased flexibility and less time needed for bonding. The adhesive bonds porous and nonporous surfaces, and bonds flexible as well as rigid materials. It is packaged in two separate bottles for increased shelf life. For information, call 410/663-KISS (5477) or visit www.kiss-suspension.com.
OPTEC USA Booth 1505 OPTEC USA is excited to announce the launch of our new Facebook fan page! We would like to personally invite you to like our Facebook fan page to provide you with information about our new products, events, tradeshows, industry related news, health tips, special promotions, and the personal side of our great team. We hope you’ll find it an enjoyable way to stay in touch and up-to-date with happenings and news along the OPTEC USA story.
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View our page at www.facebook.com/OptecUSA1 and click “Like” to support us on Facebook. Please take a moment to suggest our new page to all your friends and we look forward to sharing the conversation with you!
NEW PROPLUS CONTROLLER IN ELECTRIC TERMINAL DEVICE (ETD) Booth 219 The new combination of Brushless DC Motor and ProPlus controller, runs 40 percent faster, with a longer-life and quieter motor. The ProPlus also allows interchange with every available myoelectric system. Features include: • High speed motor • Quiet, smooth, responsive control • The only water resistant electric TD • Great visibility—slender and tidy • Options: Wrist Rotator, Flexion Wrist, or Multi-Flex Wrist • Interchanges with i-limb Ultra, bebionic, and Ottobock Hands. For information, call 888/MYO-ARMS or visit www.UtahArm.com.
Orthomerica® introduces the NEW A-Flex™ Protective Headgear Booth 1813 Orthomerica® Products introduces a new alternative to other hard protective headgear...the A-Flex™ Protective Headgear. The A-Flex conforms to varying head shapes making it easy-to-fit upon demand. The protection is ideal for low impact forces that are distributed across the surface without cracking or penetrating. A-Flex is equipped with easy-to-adjust posterior straps and lateral straps for easy donning and doffing. Chin straps are optional. Adult & children’s sizes available in pink, blue, and white. For more information, visit Orthomerica at AOPA, contact us at 800/446-6770, or visit www.orthomerica.com.
2012 PRODUCT GUIDE
Newport® Lite™ Hip Orthosis from Orthomerica® Products Booth 1813
NEW! Introducing Spine Line from Ottobock Booth 305
Introducing a new addition to Orthomerica’s Newport® Hip Line… Newport® Lite™ Hip Orthosis. The Newport Lite complements the existing Newport 3 and Newport 4 by providing protection and support for patients at risk for problems related to hip instability. The Newport Lite is indicated for minimally invasive hip procedures, posterior hamstring repairs and offers effective ROM control following primary or hip revision surgery. Its comfortable, lightweight design is well tolerated by patients resulting in improved patient compliance. Available in one size fits most and universal for the right or left side. For more information, visit Orthomerica at AOPA, contact us at 800/446-6770, or visit www.orthomerica.com.
You asked for more—and we’ve delivered! Now your patients with spinal bracing needs can benefit from the renowned Ottobock quality and value. The complete lineup of products includes cervical, lumbar, thoracic, and sacral orthotics, (The Ottobock Fulcrum LSO is pictured here.) These latex-free, off-the-shelf spinal products provide superior support and stabilization for all your patients’ conditions, from relief of acute back pain to pre- and post-operative stabilization. Call 800/328-4058 to order.
Dive In! Waterproof Prostheses from Ottobock Booth 305 Ottobock now offers a line of waterproof components! Designed specifically for use in the water, the Aqualine® waterproof prostheses provide waterproof protection for either below-knee or above-knee users. The Aqualine components are perfect for use as a shower leg or for other water activities. The Aqualine accommodates users who weigh up to 330 lbs and includes specially modified adapters, pylons, and a tube clamp along with the waterproof knee and foot. Call your local sales representative to learn more at 800/328-4058.
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SureStep Booth 1529 SureStep is the most effective means of providing stability to children who pronate when standing and walking. This patented, dynamic system allows children to gain stability, while still allowing normal movement and function. Children with low muscle tone who have trouble with stability due to pronation can now walk, run and jump without the delays and instabilities. SureStep is not a different brace, but rather a completely unique system that manages the foot and ankle without over-managing. The thin and flexible plastic does not wedge the foot into position as traditional bracing systems do. Instead, the orthosis is tightened around the foot, the soft tissue is compressed, which results in midline positioning. This unique orthosis remains flexible, allowing the foot to continue to move and respond appropriately. The SureStep product line covers everything from the ground up—SMOs, AFOs, HEKOs, TLSOs, and children’s footwear. Contact SureStep today at 877/462-0711, fax 866/700-7837, or visit www.surestep.net.
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Galileo™ Functional Assessment System from PEL Booth 1005
DESIGN an Alpha® Liner for Maximum Comfort Booth 505
Orthocare Innovations has developed a uniquely objective functional assessment system consistent with today’s increased emphasis on selection of the most appropriate prosthetic componentry for your patients. The Galileo™ System: • Improves ability to match components with patient’s ability/potential to ambulate • Provides a systematic approach to tracking patient progress • Substantiates practitioner’s observations and other functional assessment practices • Facilitates effective communication in the patient’s treatment plan with members of the health-care team • Provides patient motivation by objectively tracking and setting functional activity goals • Expands clinical evidence of functional level increasingly sought by payers • Provides objective documentation; invaluable during audits • Creates mechanism for determining defensible device replacement intervals. Using the patented StepWatch™Activity Monitor to compile a one-week period of objective data capture, the unit provides an easy, HIPAA-compliant upload of patient data, as well as a Generation of Functional Level Report for inclusion in patient’s medical record and sharing with other healthcare professionals or incorporation into payer claims. For more information, contact PEL Supply at 800/ 321-1264, email customerservice@pelsupply.com, or visit www.pelsupply.com.
Custom Alpha DESIGN® Liners provide a more intimate liner fit and greater comfort than off-theshelf liners. The gel inside Alpha DESIGN Liners follows a residual limb’s contours so there are no voids or gaps in the liner fit. The customization all happens on the inside while the exterior is uniform in appearance. OMEGA® owners/users must upgrade to version 12 to have Hybrid gel and Select fabric options available in software. Facilities using order forms should visit www. willowwoodco.com to get the latest versions that include Hybrid gel and Select fabric ordering options. For more information, please call 800/848-4930 or visit www.willowwoodco.com.
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Lower Limb Technology Booth 121
Lower Limb Technology is a division of Spinal Technology Inc. We are a leading central fabricator of upper and lower limb orthotics and prosthetics. Our ABC-certified staff orthotists/prosthetists collaborate with highly skilled, experienced technicians to provide the highest quality custom products and prosthetic devices, fast delivery time, as well as unparalleled customer support to our customers. For information, contact 800/253-7868, fax 888/775-0588, email info@spinaltech.com, or visit www.spinaltech.com.
Product Guide
O&P Almanac AUGUST 2012
2012 PRODUCT GUIDE
Spinal Technology Booth 121
H YN ES CO NVEN TI ON C ENT ER, BO STO N
Spinal Technology Inc. is a leading central fabricator of spinal orthotics, upper and lower limb orthotics and prosthetics. Our ABC-certified staff orthotists/prosthetists collaborate with highly skilled, experienced technicians to provide the highest quality products, fastest delivery time, including weekends & holidays, as well as unparalleled customer support in the industry. Spinal Technology is the exclusive manufacturer of the Providence Scoliosis System, a nocturnal bracing system designed to prevent the progression of scoliosis, and the patented FlexFoam™ spinal orthoses. For information, contact 800/253-7868, fax 888/775-0588, email info@spinaltech.com, or visit www.spinaltech.com.
ACOR Booth 731 Acor has been servicing the Pedorthic and Orthotic communities since 1972. Our tradition of quality and innovation continues with the addition of the DRAFO® Dynamic Response Gauntlets. The DRAFO® DRG offers a flexible alternative to traditional leather ankle gauntlets. They are easily adjusted, offer flexible comfort and control, are hygienic, waterproof, durable and easily cleaned. The DRAFO® Dynamic Response Gauntlets offered by Acor are an excellent option for your moderate to severe conditions, and offer a slim profile to easily fit into shoes. See the new DRAFO® DRG gauntlets, as well as our full line of custom and prefabricated products at booth #731. Contact Acor Orthopaedic Inc. today at 800/237-2267, fax 800/830-8445, or visit www.acor.com. a
MARK YOUR CALENDAR!
Attend the country’s largest, oldest, and essential meeting for orthotic, prosthetic and pedorthic professionals. SUPERIOR EDUCATION ADVANCED PROGRAMS MYRIAD OF EXHIBITS EARN CE CREDITS QUALITY NETWORKING
For information about the show, scan the QR code on the left with a code reader on your smartphone or simply visit www.AOPAnet.org.
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JOBS
Find your region on the map to locate jobs in your area.
- Northeast - Mid-Atlantic - Southeast - North Central - Inter-Mountain - Pacific
Classified rates Classified advertising rates are calculated by counting complete words. (Telephone and fax numbers, email, and Web addresses are counted as single words.) AOPA member companies receive the member rate. Member Nonmember Words Rate Rate 50 or fewer words $140 $280 51-75 words $190 $380 76-120 words $260 $520 121 words or more $2.25 per word $5.00 per word Specials: 1/4 page, color 1/2 page, color
$482 $678 $634 $830
Advertisements and payments need to be received approximately one month prior to publication date in order to be printed in the magazine. Ads can be posted and updated at any point on the O&P Job Board online at jobs.AOPAnet.org. No orders or cancellations are taken by phone. Ads may be faxed to 571/431-0899 or emailed to srybicki@ AOPAnet.org, along with a VISA or MasterCard number, the name on the card, and the expiration date. Typed advertisements and checks in U.S. currency made out to AOPA can be mailed to P.O. Box 34711, Alexandria, VA 22334-0711. Note: AOPA reserves the right to edit Job listings for space and style considerations. Responses to O&P box numbers are forwarded free of charge. Company logos are placed free of charge. Job board rates Visit the only online job Member Nonmember board in the industry at Rate Rate jobs.AOPAnet.org! $80 $140
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.
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Inter-Mountain Clinical Marketing Representative Salt Lake City Seeking a person with excellent communication skills to provide marketing and educational services for myoelectric UL and advanced LE prostheses for prosthetists and other professionals throughout North America and international markets. Successful candidate will be responsible for: • Developing and presenting educational and marketing programs; • On-site visits to evaluate candidates and assist with upper-extremity and lower-extremity fittings and training with company’s products; and • Extensive contact with customers via a variety of media, including telephone, email, Internet and multimedia materials, including trade shows, educational seminars, printed materials, etc. • Experience in myoelectric prosthetics is preferred, but not essential; training will be provided. Benefits include: • An excellent salary/benefit package is offered, and a great working environment. • Certified Prosthetist (CP or CPO) preferred. Call us or eC1 • mail/fax resume to:
Motion Control Inc. 115 N. Wright Brothers Drive Salt Lake City, UT 84116 Phone: 801/326-3434 Fax: 801/978-0848 Email: HumanResources@UtahArm.com Website: www.UtahArm.com
Certified Prosthetist/Orthotist, Certified Orthotist, or Licensed Orthotist Corpus Christi and McAllen, Texas Immediate opening for CPO, CO, or LO with experience. Positions in Corpus Christi and McAllen, Texas, with minimal travel to satellite offices. Must be ABC-certified and licensed by the state of Texas. Competitive compensation package! Please send resume and salary requirements to Barbie Baker at:
Fax: 361/888-7424 Email: Barbie@ccprosthetics.com
JOBS
North Central ABC-Certified Prosthetist/Orthotist, ABC-Certified Orthotist Rockford, Illinois Privately owned, rapidly growing practice located in Rockford, Illinois, has an opening for a certified prosthetist/ orthotist and for a certified orthotist to evaluate, fit, and adjust orthotic and prosthetic appliances in office, hospital, nursing home, and off-site locations. This is a great opportunity for someone looking to become part of a motivated successful team. We offer a competitive compensation package including health care and employer-sponsored retirement plan. Send resume to:
Rockford Orthopedic Appliance Co. Andrew Sestak 422 E. State Street Rockford, IL 61104 Fax: 815/965-9466 Email: andy@rfdortho.com
Pacific Certified Prosthetist/Orthotist, Certified Prosthetist, Certified Orthotist Orange, Riverside, and San Bernardino Counties, California A reputable, well-established, multi-office, Southern California O&P company is looking for energetic and motivated individuals who possess strong orthotic/ prosthetic clinical skills and experience to provide comprehensive patient assessments to determine orthotic/prosthetic needs, formulate and provide treatments, perform necessary protocols to ultimately deliver the best orthotic/prosthetic services, and provide follow-up patient care. Candidates must have excellent communication, patient care, and interpersonal interaction skills, and always abide by the Canons of Ethical Conduct instilled by ABC. We offer competitive salaries and benefits to full-time employees. Salary is commensurate with experience. Send resume to:
Attention: Human Resources Inland Artificial Limb & Brace Inc. Fax: 951/734-1538 Email: ialb720@hotmail.com
AVAILABLE POSITIONS Orthotist Denver, CO Jacksonville, FL Urbana, IL
Spartanburg, SC Waukesha, WI
Prosthetist Chico, CA
Overland Park, KS
Prosthetist / Orthotist Downey, CA Stockton, CA Denver, CO New London, CT Jacksonville, FL Naples, FL Tamarac, FL Bowling Green, KY Bethesda, MD Waterville, ME
Buffalo, NY Mooresville, NC Mayfield Heights, OH Bartlesville, OK Portland, OR Wilkes Barres, PA Houston, TX San Antonio, TX Tacoma, WA
Certified Pedorthist Portland, ME
Soft Goods Fitter Grand Rapids, MI
Tulsa, OK
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International Volunteer Position: Certified Prosthetist/Orthotist Honduras Central American Medical Outreach Inc. (CAMO), humanitarian aid organization providing orthotic and prosthetic services to the local population of western Honduras, is looking to fill a volunteer interim position at its fully equipped prosthetic lab in Santa Rosa. Term length of one month to upwards of a year, expected to teach a local individual; ideal candidate must be bilingual. Supporting organization will provide housing and per diem. Learn more by contacting:
Kathy Tschiegg, Executive Director CAMO 322 Westwood Avenue Orrville, OH 44667 Phone: 330/683-5956 Email: kathrynt@camo.org
O&P HISTORY
A Look Back in Time
Northeast Certified Orthotist/Certified Fitter Long Island/New York City We are a well-established practice offering an excellent opportunity for a driven person with a positive attitude. We offer benefits including 401(k), health, and profit sharing. Send resume to:
O&P Ad 0611, C/O: The O&P Almanac 330 John Carlyle Street, Ste. 200 Alexandria, VA 22314 Fax: 571/431-0899
Certified Orthotist, Certified Orthotist and Board-Eligible Prosthetist, or Certified Prosthetist/Orthotist New York State Privately owned and growing multisite ABC-accredited P&O practice in upstate New York is seeking a certified orthotist with a minimum of two years of experience and/or a certified orthotist and board-eligible prosthetist, or certified prosthetist/orthotist. We are looking for individuals with strong orthotic backgrounds, and we may entertain an NCOPE prosthetic residency if needed. Our offices in the historic and scenic Hudson Valley and Catskill Mountains of New York are located from Saratoga to Poughkeepsie, with immediate openings in Kingston and Poughkeepsie. The ideal candidate must be self-motivated and a team player, possess good communication and technical skills, and be willing to excel for performancebased objectives. Competitive salary and benefits package offered. Submit resume to:
David Misener, CPO Clinical Prosthetics & Orthotics, LLC Fax: 518/432-0686 Email: DBM@clinicalpando.com
Certified Orthotist Vermont Yankee Medical, providing orthotic and prosthetic services for over 65 years, is looking for a certified orthotist ready to locate to Vermont. With five locations in some of the most scenic areas of the country, Yankee Medical offers a lifestyle that attracts professionals. Send your resume:
Get your fill at www.oandplibrary.org/op! A digital archive of issues ranging from 1975 to 1988 of O&P Journal, predecessor of the O&P Almanac.
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Attn: John Ficociello Yankee Medical 276 North Avenue Burlington, VT 05401 Email: jnf@yankeemedical.com
100th Anniversary
Conference & Exhibition
100 years on The
future of podiatry 11-13 October 2012 Glasgow, SECC
will celebrate 100 years of organised podiatry in the UK. Programme highlights include: • Brian Cox OBE, BBC presenter and Professor of Particle Physics, University of Manchester • Charlie Archer, Professor of Reparative Biology and Tissue Engineering, Cardiff University • David Armstrong, Professor of Surgery and Director, Southern Arizona Limb Salvage Alliance (SALSA), University of Arizona College of Medicine, USA • Jim Woodburn, Professor in Rehabilitation Studies, Glasgow Caledonian University • Nicola Sturgeon MSP, Scottish Health Secretary • Katherine Cowan, James Lind Alliance • Ben Yates, Consultant Podiatric Surgeon, Great Western Hospital, Bristol A special celebratory event will take place on the evening of Friday 12 October at the fabulous Kelvingrove Museum. Delegates will enjoy a drinks reception and dinner with unique entertainment from the award winning ‘Red Hot Chilli Pipers’ bagpipe and drum band, and a traditional Scottish Ceilidh. Don’t miss your chance to contribute to the conference programme by submitting an abstract for poster presentation. The conference provides a unique opportunity to demonstrate your work in front of 1200 of your fellow members, and raise the profile of yourself and your employing organisation. Submission deadline: 31 August 2012.
For further information please visit www.scpconference.com or call 020 8832 7311
HYNES CO NVENTI O N CENT ER , B O S T O N
Mark your calendar to attend the country’s largest, oldest, and essential meeting for orthotic, prosthetic, and pedorthic professionals.
S AV E T H E D AT E For information about the show, scan the QR code above with a code reader on your smartphone or simply visit www.AOPAnet.org.
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SEPTEMBER
6-9, 2012
Join us at the AOPA 2012 National Assembly and NE Chapter combined meeting at the Hynes Convention Center in Boston. The Place to Be for learning, networking, and exhibits.
• • • • • •
Superior Clinical Education featuring the best speakers from around the world
• • •
Largest Display of O&P exhibits in the United States
Advanced Business Programs to ensure your success during uncertain economic times Practical Learning and live demonstrations Networking with an elite and influential group of O&P professionals Preparation for the massive changes that health care reform is sure to bring Learn the latest rules, regulations, and Medicare billing changes needed to serve your patients Earn more than 34 CE Credits Ideal Location in the heart of one of America’s most historic cities. Four miles from Logan Airport and blocks from the financial district, Charles River, trendy Newbury Street, and Fenway Park.
Earn more than 34 CE credits! Visit www.AOPAnet.org for updates on events and education.
S P E A K E R S • E D U C AT I O N • E X H I B I T S • S P O N S O R S • N E T W O R K I N G
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■■ YEAR-ROUND TESTING Multiple Choice Examinations. BOC has yearround testing for Multiple Choice Examinations; candidates can apply and test when ready. Orthotist and prosthetist candidates can take the Clinical Simulation Examination in February, May, August, and November. Applications are accepted any time, although seating is limited. For more information, visit www.bocusa.org or email cert@bocusa.org.
On-site Training Motion Control Inc. On-site Training Course is focused on the expedited fitting of your first patient. Course Length: 3 days, CEUs: 19.5 hours (estimated). Recommended for prosthetists with a patient ready to be fit immediately. For more information, call 888/696-2767 or visit www. UtahArm.com. ■■
■■
2012 ■■ AUGUST 3-4 Texas Chapter of the American Academy of Orthotists and Prosthetists: Annual Meeting. Sheraton Austin Hotel at the Capitol, Austin. Contact Robb Walker at 325/793-3480, email
secretary-treasurer@txaaop. org, or visit www.txaaop.org. ■■ AUGUST 6-7 AOPA: Essential Coding & Billing Seminar. Seattle. Hyatt at Olive 8 Hotel. To register, contact Stephen Custer at 571/431-0876 or scuster@ AOPAnet.org.
PROMOTE Events in the O&P Almanac
CALENDAR RATES Telephone and fax numbers, email addresses, and websites are counted as single words. Refer to www.AOPAnet.org for content deadlines. Words
Member Rate
■■ AUGUST 8 Ultraflex: Pediatric Spasticity Continuing Education Course, via WebEx, 5-6 pm ET. Covers clinical assessment of the pediatric neuromuscular patient with spasticity and using R1 and R2 for determining orthotic design for maintaining and improving muscle length. Presenter: Keith Smith, CO, LO, FAAOP. Register at www. ultraflexsystems.com or call 800/220-6670. ■■ AUGUST 11 Ultraflex: Pediatric UltraSafeGait™ Continuing Education Course, via WebEx, 9-10 am ET. Covers assessment of pediatric pathological gait and influencing shank kinematics with the new Adjustable Dynamic Response™ (ADR™) technology. Presenter: Keith Smith, CO, LO, FAAOP. Register at www. ultraflexsystems.com or call 800/220-6670. ■■ August 15 AOPAversity Audio Conference–The Ins and Outs of Advance Beneficiary Notices (ABNs). For more information, contact Stephen Custer at 571/431-0876 or scuster@AOPAnet.org.
Nonmember Rate
25 or less................... $40..................................$50 26-50......................... $50..................................$60 51+................... $2.25 per word................$3.00 per word Color Ad Special: 1/4 page Ad.............. $482............................... $678 1/2 page Ad.............. $634............................... $830 BONUS! Listings will be placed free of charge on the Attend O&P Events section of www.AOPAnet.org. Send announcement and payment to: O&P Almanac, Calendar, P.O. Box 34711, Alexandria, VA 22334-0711, fax 571/431-0899, or email srybicki@AOPAnet.org along with VISA or MasterCard number, the name on the card, and expiration date. Make checks payable in U.S. currency to AOPA. Note: AOPA reserves the right to edit Calendar listings for space and style considerations. For information on continuing education credits, contact the sponsor. Questions? Email scuster@AOPAnet.org.
■■ AUGUST 21-23 WillowWood: OMEGA® Tracer® Training. Mt. Sterling, OH. This hands-on class covers both orthotic and prosthetic software tools, scanner applications and tasks, “by measurement” shape creation, advanced tool usage, and creating custom liners. Attendees work with patient models. Must be current OMEGA Tracer facility to attend. Credits: 18.5 ABC/18.5 BOC. www. willowwoodco.com.
AUGUST 28 Ultraflex: Adult UltraSafeStep® Continuing Education Course, via WebEx, 12-1 pm ET. ■■
Focuses on normalizing adult pathological gait with the utilization of Adjustable Dynamic Response™ (ADR™) knee and ankle technology. Presenter: Marc Kaufman, CPO. Register at www.ultraflexsystems.com or call 800/220-6670. AUGUST 30 Ultraflex: Complex Orthopedic Rehabilitation Continuing Education Course, via WebEx, 12-1 pm ET. Focuses on Ultraflex combination dynamic and static stretching orthosis for addressing complex orthopedic rehabilitation goals and restoring range and function. Presenter: Jim Rogers, CPO, FAAOP. Register at www.ultraflexsystems.com or call 800/220-6670. ■■
■■ SEPTEMBER 1 ABC: Application Deadline for Certification Exams and Clinical Patient Management (CPM) Exams. Applications must be received by Sept. 1, 2012, for individuals seeking to take the November 2012 ABC certification exams for orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, therapeutic shoe fitters, and orthotic and prosthetic technicians or winter CPM ABC exams for orthotists and prosthetists. Contact 703/8367114, email info@abcop.org, or visit www.abcop.org/ certification. ■■ SEPTEMBER 5 Ultraflex: Pediatric Spasticity Continuing Education Course, via WebEx, 8-9 am ET. Covers clinical assessment of the pediatric neuromuscular patient with spasticity and using R1 and R2 for determining orthotic design for maintaining and improving muscle length. Presenter: Keith Smith, CO, LO, FAAOP. Register at
www.ultraflexsystems.com
or call 800/220-6670.
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CALENDAR
■■ September 6-9 AOPA National Assembly & NE Chapter Combined Meeting. Boston. Hynes Convention Center. The 2012 AOPA National Assembly will be held jointly with the NE Chapter Meeting. Plan to join us for this significant event. Exhibitors and sponsorship opportunities available––contact Kelly O’Neill at 571/431-0852 or koneill@AOPAnet.org. To register, please visit www. AOPAassembly.org or contact Stephen Custer at 571/4310876 or scuster@AOPAnet.org.
■■ September 12 AOPAversity Audio Conference–How to Get Paid for Orthopedic and Diabetic Shoes. For more information, contact Stephen
Custer at 571/431-0876 or
scuster@aopanet.org. ■■ September 14 National Pedorthic Services: Therapeutic Show Fitter’s Course. Milwaukee, WI. Contact Nora Holborow at 414/438-6662, visit www. npsfoot.com, or email nholborow@npsfoot.com. ■■ SEPTEMBER 17 WillowWood: Take the Guesswork Out of Elevated Vacuum Suspension, via WebEx, 1:30 pm ET. Course covers background information and theory on the concept of elevated vacuum. Appropriate clinical applications and components discussed. Credits: 2.5 ABC/2.5 BOC. To register online, visit www. willowwoodco.com. ■■ SEPTEMBER 18 WillowWood: Discover LimbLogic® VS via WebEx, 1:30 pm ET. Critical
Motion Control
SuperCourse Fall 2012 October 15 - 19, 2012
at Fillauer Headquarters, Chattanooga, TN • In-depth training of Utah Arm / U3+ / Hybrid / ProControl2. • Hands-on experience with UI-software. Bring your laptop. • CEUs: 34 (estimated) awarded by ABC.
Overview of: NEW LI-Ion Battery for Utah Arm / U3+ / Hybrid NEW Electric Wrist Rotator NEW TRIAD Preamps Plus an overview of the NEW & EXCITING Motion Foot from Motion Control
The Fall 2012 SuperCourse is a 5-Day Course = $1,350.00 For more information or to register for the SuperCourse email: info@UtahArm.com
Motion Control, Inc. 115 N. Wright Brothers Dr. • Salt Lake City UT 84116 Phone: 801/326-3434 • FAX: 801/978-0848 Toll Free: 888.MYO.ARMS • www.UtahArm.com 62
O&P Almanac AUGUST 2012
components and operation discussed. Covers interpreting feedback from fob and basic fabrication processes for system. Credits: 2.5 ABC/2.5 BOC. To register online, visit www.willowwoodco.com. SEPTEMBER 20 Arizona AFO: The Custom AFO Workshop. Long Beach, CA. This course covers AFO selection, coding, handson casting, and footwear/ modification tips. Fee includes lectures, handouts, and lunch. Approved for 6.5 ABC CE credits. For details, call 877/780-8382 and mention the “workshop” or email education@arizonaafo.com. ■■
■■ SEPTEMBER 27 WillowWood: LimbLogic® VS Applications Practitioners 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: 7.0 ABC/7.0 BOC. Registration deadline is Sept. 6, 2012. Contact 877/665-5443 or visit www.willowwoodco.com. ■■ SEPTEMBER 28 WillowWood: LimbLogic® VS Applications Technicians Course. Mt. Sterling, OH. Learn all aspects of fabricating LimbLogic VS for various applications: socket materials, controller configurations and care, fob operation, troubleshooting. Fabricate sockets following recommended techniques for airtight socket designs. Credits: 9.75 ABC/9.75 BOC. Registration deadline is Sept. 6, 2012. Contact 877/665-5443 or visit www.willowwoodco.com. ■■ October 4 Arizona AFO: The Custom AFO Workshop. Houston. This course covers AFO selection, coding, handson casting, and footwear/ modification tips. Fee includes
lectures, handouts, and lunch. Approved for 6.5 ABC CE credits. For details, call 877/780-8382 and mention the “workshop” or email education@arizonaafo.com. ■■ OCTOBER 5-6 Tennessee Society of Orthotics and Prosthetics (TSOP) Annual Meeting. Murfreesboro, TN. Embassy Suites. Orthotic, prosthetic, pedorthic, post-mastectomy, and technical programs. Several product certification courses will be available. The schedule is being finalized, and opportunities for speakers and vendor booths are still available. For more information and online registration, visit http:// tennesseesocietyop.org/. For vendor tables, contact Gary Stokes at gary8916@aol.com. ■■ October 10 AOPAversity Audio Conference–What Every O&P Facility Needs to Know About the FDA. For more information, contact Stephen Custer at 571/431-0876 or scuster@AOPAnet.org. ■■ OCTOBER 18-19 Mastering Medicare: Essential Coding and Billing Seminar. Las Vegas. Mirage Hotel & Casino. To register, contact Stephen Custer at 571/431-0876 or scuster@ AOPAnet.org. ■■ OCTOBER 19-20 University of Michigan Orthotics and Prosthetics Center: Centennial Celebration and Education Seminar. Making a difference for 100 years, providing service, education, and research in O&P. For details and information about registration, visit www.med. umich.edu/pmr/op/index.htm.
CALENDAR
■■ NOVEMBER 7-9 New Jersey Academy of Orthotists & Prosthetists 2012 Annual Meeting. Bally’s Hotel and Casino. Atlantic City. For details, contact Lisa Lindenberg at 973/609-2263 or visit www.njaaop.com.
NOVEMBER 12-17 ABC: Certification Exams. ABC certification exams will be administered for orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, therapeutic shoe fitters, and orthotic and prosthetic technicians. The application deadline for these exams is Sept. 1, 2012. Contact 703/8367114, email info@abcop. org, or visit www.abcop.org/ certification. ■■
■■ NOVEMBER 14 AOPAversity Audio Conference–Medicare Enrollment Procedures. For more information, contact Stephen Custer at 571/4310876 or scuster@AOPAnet.org.
■■ DECEMBER 1 ABC: Certification Exam Application Deadline. Applications must be received by December 1 for individuals seeking to take the winter 2013 ABC certification exams for orthotists, prosthetists, pedorthists, orthotic fitters, mastectomy fitters, therapeutic shoe fitters, and orthotic and prosthetic technicians. Contact 703/836-7114, email info@ abcop.org, or visit www.abcop. org/certification. ■■ DECEMBER 6-8 Rehabilitation Institute of Chicago: Pediatric Gait Analysis: Segmental Kinematic Approach to Orthotic Management. Chicago. Featuring Elaine Owen. 21.25 ABC credits. Contact Melissa Kolski at 312/238-7731 or visit www.ric. org/education.
DECEMBER 7-8 ABC: Prosthetic Clinical Patient Management (CPM) Exam. The application deadline for this exam is Sept. 1, 2012. Contact 703/836-7114, ■■
email info@abcop.org, or visit www.abcop.org/certification. ■■ December 12 AOPAversity Audio Conference–Are You Ready for the New Year? 2013 New Codes and Policies. For more information, contact Stephen Custer at 571/431-0876 or scuster@AOPAnet.org.
2013 ■■ JANUARY 4-5 ABC: Prosthetic Clinical Patient Management (CPM) Exam. The application deadline for this exam is Sept. 1, 2012. Contact 703/836-7114, email info@abcop.org, or visit www.abcop.org/certification. ■■ February 20-23 39th Academy Annual Meeting & Scientific Symposium. Orlando. Caribe Royale Orlando. Contact Diane Ragusa at 202/380-3663, x208, or dragusa@oandp.org.
■■ MARCH 15-16 PrimeFare West Regional Scientific Symposium 2013. Denver Marriott City Center, Denver. Contact: Jane Edwards at 888/388-5243 or visit www.primecareop.com. ■■ MARCH 21-23 2013 Annual Meeting of the International AfricanAmerican Prosthetic Orthotic Coalition. Georgia Tech Hotel and Conference Center. Atlanta. Contact Tony Thaxton Jr. at 404/875-0066 or email thaxton.jr@comcast.net. Visit www.iaapoc.org for more information.
September 18-21 O&P World Congress. Orlando. Gaylord Palms Resort. Attend the first U.S.-hosted World Congress for the orthotic, prosthetic, and pedorthic rehabilitation profession. To register, contact Stephen Custer at 571/4310876 or scuster@aopanet.org. a ■■
AD INDEX Company Allard USA Inc. ALPS American Board for Certification in Orthotics, Prosthetics & Pedorthics Arizona AFO Aspen Medical Products BOC International College Park Industries Inc. DAW Industries Dr. Comfort Fillauer Companies Inc. Friddle’s Orthopedic Appliances KISS Technologies LLC KNIT-RITE OPTEC Orthomerica Products Orthotic and Prosthetic Study and Review Guide Ossur® Americas Inc. Otto Bock HealthCare PEL Supply Company
Page 9 11
Phone 888/678-6548 800/574-5426
Website www.allardusa.com www.easyliner.com
29 27 23 37 33 1 5, C3 2 39 19, 49 25 14,15, 40, 41 43
703/836-7114 877/780-8382 800/295-2776 877/776-2200 800/728-7950 800/252-2828 800/556-5572 800/251-6398 800/369-2328 410/663-5477 800/821-3094 888/982-8181 800/446-6770
www.abcop.org www.arizonaafo.com www.aspenmp.com www.bocinternational.org www.college-park.com www.daw-usa.com www.drcomfortdpm.com www.fillauercompanies.com www.friddles.com www.kiss-suspension.com www.knitrite.com www.optecusa.com www.orthomerica.com
45 C4, 7 C2 13
800/233-6263 800/328-4058 800/321-1264
www.oandpstudyguide.com www.ossur.com www.ottobockus.com www.pelsupply.com AUGUST 2012 O&P Almanac
63
AOPA Answers
Shoe Walk-Through Answers to your questions regarding therapeutic shoes and inserts AOPA receives hundreds of queries from readers and members who have questions about some aspect of the O&P industry. Each month, we’ll share several of these questions and answers from AOPA’s expert staff with readers. If you would like to submit a question to AOPA for possible inclusion in the department, email Editor Josephine Rossi at jrossi@strattonpublishing.com.
Q.
Q.
A.
A.
Can the supplier of therapeutic shoes complete the certifying statement as long as it is signed and dated by the certifying physician? No. The Medicare Local Coverage Determination for Therapeutic Shoes indicates the certifying statement must be “completed, signed, and dated by the certifying physician.”
Q.
Is the certifying statement considered enough documentation to support the medical need for diabetic shoes?
A.
Unfortunately, no. The Medicare Therapeutic Shoe Policy Article notes that the certification statement alone does not meet the documentation requirements for coverage. The policy article clearly outlines what must be present in the certifying physician’s medical records to support your claim. The certifying physician must personally document the occurrence of an in-person evaluation of the patient within six months of delivery of the shoes. The documentation of this visit must include the confirmation of at least one of the secondary conditions required in the policy for Medicare coverage of therapeutic shoes; this secondary condition can be documented by the certifying physician, or the certifying physician may “obtain, initial/sign, date, and indicate agreement with the records of another M.D., D.O., physician assistant, nurse practitioner, or clinical nurse specialist.”
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O&P Almanac AUGUST 2012
Can all three sets of inserts for a calendar year be dispensed at the same time as the shoes?
Yes, as long as the patient has been instructed to rotate the use of the inserts so they wear evenly. No item is covered by Medicare unless it is deemed to be medically necessary. If the patient is instructed to use one set of inserts until it is worn out and then use a second pair, the medical need for the second pair is not established until the first pair is used. If the patient is instructed to rotate the inserts, then they are deemed to be medically necessary when the shoes are dispensed.
Q. A.
If I did not provide the shoes, may I provide inserts?
Yes—in limited circumstances. In order for Medicare to cover inserts provided independently of therapeutic shoes, the provider of the inserts must obtain a written statement from the provider of the shoes that the patient has appropriate footwear into which the inserts may be placed. a
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