The OHFAMA Journal | Vol. 66 | Issue 1 | Winter 2024

Page 1


VOL 66 • NO. 1 • WINTER 2024

Incoming OHFAMA President Thom Arnold, DPM, presents the Thomas J. Meyer Award to outgoing President Adam Thomas, DPM, at the 2023 OHFAMA Annual Business Meeting in Columbus.


A Word from the President

Thom Arnold, DPM

I would like to start by wishing everyone a Happy New Year. May 2024 bring you good health and happiness. I would like to congratulate Dr. Adam Thomas for an outstanding term as President. I would also like to congratulate the staff at OHFAMA as well as the Board of Trustees for a very good year. This being my first column I would like to briefly recap my objectives serving as your President this year. My goals for the next year are very straightforward. First, uphold the mission of the association, which is to act as a single voice for all of you. Your membership is not taken for granted. We are here to serve you. Second, retain and increase membership, as we have strength in numbers. This has been made a priority by our leadership. To do this, we must show value and the return on investment of membership in the Ohio Foot and Ankle Medical Association.

Lastly, I hope to increase member advocacy and gain more support for our political action committee. We need your contributions to support advocacy. The legislative victories last year, with a 5% increase in Medicaid reimbursement and $6.8 million in SSI funding to reduce tuition for KSUCPM should be evidence enough of the importance of funding advocacy. Please take time to use the APMA eAdvocacy tools to send letters to your specific representatives. This process will take you less than one minute! There is no doubt medicine is an ever-changing landscape. We are here to help you navigate this terrain. I would encourage you to refer to both the OHFAMA and APMA websites for guidance as there are many resources available to members. I encourage anyone, at any time, to please reach out with concerns, ideas, or feedback. I look forward to serving everyone this year and will do my best to continue the legacy of great leadership in the state of Ohio.

OHFAMA Calendar

Table of Contents

February 22, 2024 Budget and Finance Meeting OHFAMA Headquarters

Page 2........................................................... Letter from the President

February 22, 2024 Board of Trustees Meeting OHFAMA Headquarters March 8-10, 2024 No-Nonsense Seminar Virtual April 10, 2024 Stewart Surloff Memorial Seminar Fairlawn, Ohio April 11, 2024 Budget and Finance Meeting OHFAMA Headquarters April 20, 2024 108th Annual Scientific Seminar Virtual May 16-17, 2024 108th Annual Scientific Seminar Columbus Hilton at Easton August 8-9, 2024 GXMO - Didactic Course Virtual August 10, 2024 GXMO - Clinical Course Virtual 2 | THE OHFAMA JOURNAL | WINTER 2024

Page 2......................................................OHFAMA Calendar of Events Page 3-4.....................................................Membership News & Notes Page 5-7........................................................Annual Business Meeting Page 9...................................................................... Member Spotlight Page 11.........................................................................Advocacy News Page 12-13...............................................Coding & Compliance Corner Page 14-15...........................................................Continuing Education Page 15........................... Annual Scientific Seminar Program Schedule Page 16...................................................................... Member Benefits Page 18..................................................Thank You to Our Contributors Page 19........................................................................... Classified Ads



Abshier Appointed to AMA CPT Editorial Panel

Sarah Abshier, DPM, APMA’s CPT alternate advisor, was appointed to serve a four-year term representing the Health Care Professional Advisory Committee (HCPAC) on the CPT Editorial Panel. She is believed to be only the second podiatric physician and second female to serve in this capacity.

Dr. Abshier serves on the APMA Coding Committee and is an article reviewer for JAPMA. She has been a speaker and panelist on numerous webinars and has multiple publications on proper coding and billing.

The CPT Editorial Panel is tasked with ensuring that CPT codes remain up to date and reflect the latest medical care provided to patients. The CPT Editorial Panel meets three times per year to create, delete, and modify the CPT code set through a series of processes involving many medical specialties. At these meetings, APMA attendees may caucus with related specialty groups, provide input on relevant codes, and participate in votes on proposed code changes. Dr. Abshier’s term is effective at the conclusion of the February 2024 CPT Editorial Panel meeting and runs through the February 2028 CPT Editorial Panel meeting. She is eligible for an additional four-year term at that time contingent upon approval of the AMA Board of Trustees. Dr. Abshier is in private practice in Columbus and is a board-certified wound care specialist. She is a past president of OHFAMA, serves as a director of the OHFAMA Foundation, and is co-chair of the 108th Annual Ohio Foot and Ankle Scientific Seminar.

Sarah Abshier, DPM, attends an AMA CPT Editorial Panel meeting with fellow APMA representatives Ira Kraus, DPM, and Jeffrey Lehrman, DPM. THE OHFAMA JOURNAL | WINTER 2024 | 3

Congressman Brad Wenstrup, DPM, Announces Retirement Longtime Cincinnati-area congressman Brad Wenstrup, DPM, announced November 9 that he will be retiring from Congress at the conclusion of his term, citing a desire to spend more time with his wife and two children. “I work in a place where a lot of people want to be somebody, but a surgeon mentor of mine once said, ‘You don’t have to be somebody somewhere else as long as you’re somebody at home,’” said Dr. Wenstrup. “Sadly, all too often the frantic pace of Washington has kept me away from our home. I’m ready to change that.” Dr. Wenstrup, a longtime OHFAMA member and the only podiatric physician and surgeon serving in Congress, was elected in 2012 to represent the people of Ohio’s Second Congressional District in the United States House of Representatives. A Cincinnati native, Dr. Wenstrup attended St. Xavier High School and graduated from the University of Cincinnati in 1980 with a bachelor’s degree in psychology. In 1985, he earned his Doctor of Podiatric Medicine degree from Scholl College of Podiatric Medicine at Rosalind Franklin University in Chicago. After completing his surgical residency at Thorek Hospital in Chicago, Dr. Wenstrup returned to Cincinnati to open his own private practice, treating patients in southwest Ohio for over 27 years. In 1999, he joined and became a partner with Wellington Orthopaedic and Sports Medicine in Cincinnati. Dr. Wenstrup also served on the Cincinnati Board of Health and was the Podiatric Surgical Residency Director at Christ Hospital in Cincinnati. Dr. Wenstrup served in the U.S. Army Reserve from 1988 to 2022, retiring with rank of colonel. From 2005 to 2006, he deployed to Iraq, where he served as the Chief of Surgery with the 344th Combat Support Hospital. He was awarded the Bronze Star and the Combat Action Badge for his service. In 2018, he was awarded the Soldier’s Medal. In the 118th Congress, Dr. Wenstrup serves on the House Committee on Ways and Means and the House Permanent Select Committee on Intelligence. He also serves as Chairman of the Select Subcommittee on the Coronavirus Pandemic. Previously, Dr. Wenstrup spent six years on the Armed Services Committee and the Committee on Veterans’ Affairs. As a member of the Ways and Means and Intelligence Committees, Dr. Wenstrup is working to address the national health and systemic poverty issues, while strengthening our national security. He has long been a

voice of support for southern Ohio’s veteran community. He also serves as a co-chair of the GOP Doctors Caucus. “One of the many reasons that I ran for Congress was because I saw officials who have never seen a patient making decisions that impact the health care of millions of Americans. Real world experience is critical; we need to listen to patients and those who wear the white coats, not just those who write the white papers. Doctors and health care providers must have a seat at the table in all policymaking decisions,” said Dr. Wenstrup.

Ohio Rep. Brad Wenstrup, DPM, at a House Intelligence Committee hearing.

Dr. Wenstrup to Speak at Annual Seminar Congressman Brad Wenstrup, DPM, will be a featured presenter at the 108th Annual Ohio Foot & Ankle Scientific Seminar on Friday, May 17 at Columbus Hilton at Easton. Make plans today to hear Dr. Wenstrup’s presentation on the importance of community and attend a networking reception to celebrate his years of service to our country and our profession.

Kellogg Leads University of Akron Student Recruiting Event Karen Kellogg, DPM, MBA, volunteered for a student recruitment event on November 7 at the University of Akron. During the event, sponsored by Kent State University College of Podiatric Medicine, Dr. Kellogg shared valuable insights into her dynamic career in podiatric medicine and led an engaging suturing workshop.

Dr. Kristen Fulton Announces Birth of Daughter

Dr. Kristin (Shaw) Fulton and her husband welcomed their daughter, Violet Marie Fulton, into the world on November 25. Violet weighed in at 6 lbs. 4 oz. and was 18.5 inches long. Dr. Fulton is grateful to have a healthy and happy baby girl! Dr. Fulton was born and raised in rural Kansas. She attended Midwestern University, completed her residency training in Toledo, and serves as the Young Physician Representative on the OHFAMA Board of Trustees.


ANNUAL BUSINESS MEETING OHFAMA Members Elect 2023-24 Leadership Team

Ohio Foot and Ankle Medical Association members elected a new leadership team at the association’s Annual Business Meeting on November 4. Thom Arnold, Jr., DPM, FACFAS, President Dr. Arnold, a lifelong Ohio resident, was elected to serve as President. Dr. Arnold is a graduate of the Ohio College of Podiatric Medicine, a partner in Stark County Foot and Ankle Clinic, LLC, and Section Head of Podiatry at Canton Mercy Medical Center. Dr. Arnold served his profession as a Past Secretary and Past President of the Mideast Academy and served numerous times as Reference Committee Chairman for the OHFAMA House of Delegates. Martin Lesnak, DPM, 1st Vice President Dr. Lesnak was elected to serve as 1st Vice President. Dr. Lesnak is a graduate of the Ohio College of Podiatric Medicine, completed his residency at Medical Center of Independence, and is Board Certified by the American Board of Foot and Ankle Surgery. He owns and operates Huron Podiatry, serves as Associate Clinical Professor for Ohio University, and has served as North Central Academy Trustee on the OHFAMA Board of Trustees since 2018. Joy Rowland, DPM, 2nd Vice President Dr. Rowland, a podiatric physician at Cleveland Clinic, was elected to serve as 2nd Vice President. Dr. Rowland is a graduate of the Ohio College of Podiatric Medicine and completed her residency at the Louis Stokes VA Medical Center. She has served as president of the Northeast Academy since 2022. Tom McCabe, DPM, Secretary-Treasurer Dr. McCabe was re-elected as Secretary-Treasurer and chair of the Budget and Finance Committee. Dr. McCabe is a past president of OHFAMA, has served on the OHFAMA Board of Trustees since 2015, and is a past president of the Northwest Academy. He is a graduate of the Ohio College of Podiatric Medicine and owns Trilby Foot Center in Toledo. A special thank you to Adam Thomas, DPM, who completed his term as president of OHFAMA at the Annual Business Meeting. Dr. Thomas will continue to serve on the Executive Committee as immediate past president.

Dr. Thom Arnold, who was sworn in as the new OHFAMA president, presented Dr. Thomas with the Thomas J. Meyer Award to recognize his dedicated service and outstanding leadership of the association.

Annual Business Meeting Highlights

• Dr. John Boyle, a Chillicothe-based podiatrist who serves on the State Medical Board of Ohio (SMBO), provided an overview of the board and reviewed services offered by the Ohio Professionals Health Program. Dr. Boyle also reported on the new retired licensee status option, eligibility requirements, and application process. • Dr. Bryan Caldwell, Senior Associate Dean at Kent State University College of Podiatric Medicine, provided a report on behalf of the college. The incoming class in 2023 has 58 students, including students from 19 states and three countries. The 2023 graduating class had 98 graduates and 100% of eligible graduates were placed into residency programs. Dr. Caldwell reported the college received State Share of Instruction (SSI) funding for the first time through the 2024-25 state budget, which will lower tuition nearly $14,000 annually for in-state students. • OHFAMA lobbyist Dan Leite highlighted the 5% increase in Medicaid reimbursement passed in the 2024-25 state budget, which was the first increase approved in eight years. Mr. Leite thanked members for their contributions to the Ohio Podiatric Political Action Committee and noted how important it is for us to support policymakers who support podiatry. • Ohio Foot and Ankle Medical Foundation Executive Director Luci Ridolfo, CAE, reported the Annual Ohio Foot & Ankle Scientific Seminar transitioned to a one-day virtual seminar (8 CE hours) and two-day in-person seminar (17 CE hours) in 2023. The format was well-received and will continue is 2024. • OHFAMA Executive Director Mike Mathy, CAE, highlighted successful advocacy and public outreach campaigns, including the Associations Advance Ohio radio ad campaign, which featured over 13,000 radio commercials across the state promoting podiatric medicine. Mr. Mathy also discussed the new OHFAMA website, highlighted the new Ohio Foot & Ankle Today digital newsletter, and noted upcoming improvements to The OHFAMA Journal. THE OHFAMA JOURNAL | WINTER 2024 | 5

The 2024 OHFAMA Board of Trustees gather for a photo following the 2023 Annual Business Meeting.

White Elected At-Large Trustee

OHFAMA Members Elect APMA Delegates

Dr. White is employed by Five Rivers Health Center and has surgical privileges at Miami Valley Hospital. He was previously employed by Colonial Foot and Ankle Center and held surgical privileges at Fairfield Medical Center.

Dr. Kellogg first served as an APMA Delegate in 2016 and was reelected to serve a three-year term in 2017, 2020, and 2023. Dr. Abshier was elected for her first three-year term at the 2023 OHFAMA Annual Business Meeting.

Dr. White completed his undergraduate studies at the University of Dayton in 2012, graduated from Kent State University College of Podiatric Medicine in 2016, and completed his residency at The Ohio State University Wexner Medical Center in 2019. He is board certified by American Board of Podiatric Medicine and board qualified in Foot Surgery and Reconstructive Rearfoot/Ankle Surgery by the American Board of Foot and Ankle Surgery.

Dr. Marc Greenberg was re-elected as chief delegate after serving in that role for the past two years.

Jonathan White, DPM, was elected to a three-year term as at-large trustee at the 2023 OHFAMA Annual Business Meeting on November 4.

Dr. White is an Ohio native currently residing in Dayton, Ohio. He enjoys spending his free time with his wife and two toddlers. OHFAMA members approved Proposition B-22 at the 2022 Annual Business Meeting, which modified the bylaws to provide each Academy with one trustee on the OHFAMA Board of Trustees and create two at-large trustee positions to be voted on by the membership at the Annual Business Meeting. The change provides Academies with equal representation on the Board of Trustees and enables the Association to recruit talented leaders from underrepresented constituencies to serve the organization as at-large trustees. OHFAMA members will elect a second at-large trustee at the 2024 ABM to serve a three-year term on the Board of Trustees.


Dr. Karen Kellogg, DPM, MBA, and Dr. Sarah Abshier, DPM, were elected by OHFAMA members to represent Ohio at the APMA House of Delegates.

The House of Delegates (HOD) is the legislative and governing body of APMA and is composed of certified delegates and alternates from each component society and the American Podiatric Medical Student Association. The 2024 APMA HOD will take place March 15-17 in Washington, DC.

Atway Elected Central Academy Trustee The Central Academy elected Said Atway, DPM, to serve on the OHFAMA Board of Trustees at its December 12 meeting.

Dr. Atway is the Clinical Associate Professor at Ohio State University Wexner Medical Center, and the director of the Limb Preservation Program at Ohio State University Wexner Medical Center. He is a graduate of the Ohio College of Podiatric Medicine, completed his residency at The Ohio State University Wexner Medical Center, and is board certified by the American Board of Foot and Ankle Surgery. Dr. Atway will complete the term of Anastasia Koss, which expires at the end of 2024. Dr. Koss will remain an APMA Delegate representing Ohio.

Scenes from the 2023 Annual Business Meeting

The 2023 Annual Business Meeting took place November 4 in Columbus.


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Why did you choose a career in podiatry? What led you to this career path? I immediately chose a Biology/Pre-Med Major at John Carroll University. I shadowed many medical specialties. In short, I was fortunate to shadow Dr. Chip Tighe while in undergrad at John Carroll. He is a prime example of the work/life balance afforded by a career in podiatry. This convinced me podiatry was for me. How did you get involved in OHFAMA and the Mideast Academy? My surgical residency in Northwest Indiana always emphasized service at the local and state level. Because of this, I always felt it was my obligation to give back to the profession by service in local and state associations. What led you to join Stark County Foot & Ankle Clinic? I was looking to return to Northeast Ohio to practice after completing my training in Indiana. I was fortunate to have the opportunity to join Stark County Foot & Ankle as an associate. At that time, 2005, it was just me and Dr. Steve Gross. Since then, the practice has steadily grown to a total of four physicians. What do you love most about podiatry? My favorite aspects of podiatry are flexibility of lifestyle and variety of ages and pathologies treated.

What are some of the challenges and opportunities facing podiatry and the association? Opportunities include continued education to the public and colleagues regarding our education and abilities. The biggest challenge, in my opinion, is reimbursement. Being in private practice without large group or hospital affiliation is challenging. Overhead expenses continue to climb and medicine is one of few sectors that cannot directly recoup such costs.

What do you like to do in your free time? In my free time I enjoy anything that gets me outside – lawn care, landscaping, gardening, walking. When it comes to home improvement, I epitomize the concept of “jack of all trades, master of none.” Unfortunately, my passion is Ohio State and Cleveland Browns football – the only two things that will get me in front of a television. What are three little-known facts about you? 1. Over the last 10 years our family has consistently had anywhere from 6 to 10 chickens for egg laying. 2. I was on the football team at John Carroll University for two years and played linebacker. 3. My great-uncle, Dr. Eugene Weigel, was a band director at OSU and the creator of “Script Ohio”.

Professional Profile

Undergraduate Education: John Carroll University Bachelor of Science, Biology / Pre-Medicine Concentration in Neuroscience 1998 Medical School: Ohio College of Podiatric Medicine Doctorate of Podiatric Medicine 2002 Residency: Cleveland Clinic Foundation Primary Podiatric Medical Residency 2003 St. Mary’s Medical Center (IN) Podiatric Surgical Residency 2005 Association Involvement: Mideast Academy Past President, Past Secretary OHFAMA Reference Committee Chairman OHFAMA First Vice President, Second Vice President Board Certifications: American Board of Foot and Ankle Surgery


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State Medical Board Advances Podiatry Rules

The State Medical Board of Ohio (SMBO) unanimously voted to advance two important administrative rules relating to the podiatry scope of practice as part of a multi-step rule review process. SMBO proposed no changes to rules that define foot and outline requirements for podiatrists to perform surgery on the ankle joint. The rules were filed in November with the Common Sense Initiative (CSI), a state body that seeks to ensure regulations are transparent, responsible, fair, and consistent. CSI cleared the rules on January 3, and they will next be filed with the Joint Committee on Agency Rule Review (JCARR), a legislative committee composed of members of the Ohio House of Representatives and the Ohio Senate. JCARR jurisdiction lasts for 65 days, during which time SMBO and JCARR must hold a public hearing on the rules. After the JCARR jurisdiction ends, SMBO can officially adopt the proposed rule and assign an effective date. Podiatry Scope of Practice Ohio Revised Code (ORC) and Ohio Administrative Code (OAC) have long recognized podiatric physicians and surgeons are uniquely qualified among medical professionals to diagnose and treat the foot, ankle, and related structures in the lower leg due to the depth and breadth of their education and training. Chapter 4731, ORC, defines (in part) the practice of podiatric medicine and surgery as consisting of the “medical, mechanical, and surgical treatment of ailments of the foot, the muscles and tendons of the leg governing the functions of the foot; and superficial lesions of the hand other than those associated with trauma.”

The Board, using rulemaking authority granted to it by the Ohio General Assembly, created Rule 4731-20-01, OAC, which defines “foot” as follows: “Foot,” as used in section 4731.51 of ORC, means the terminal appendage of the lower extremity, and includes the ankle joint which consists of the tibial plafond, its posterolateral border (posterior malleolus), the medial malleolus, distal fibula (lateral malleolus) and the talus. The Board further promulgated Rule 4731-20-02, OAC, to formally empower podiatrists to perform surgery on the ankle joint provided they hold privileges from a college of podiatric medicine, hospital, or ambulatory surgical center and can demonstrate adequate education, training, and experience needed to conform to minimal standards of care of similar practitioners. Both Rule 4731-20-01, OAC, and Rule 4731-20-02, OAC, have been in place since 1997. OHFAMA will continue to monitor the rulemaking process and participate in the upcoming public hearings to express our support for continuing the rules.

OHFAMA Awarded APMA Innovation Grant

APMA announced OHFAMA will receive a $1,000 Innovation Grant to support our efforts to foster relationships with state allopathic and osteopathic societies. The funds will be used to facilitate networking events with volunteer and staff leaders of osteopathic and allopathic associations in Ohio. APMA annually awards grants to state components to update their scope law to better align with APMA’s Scope of Practice template, change state law to define DPMs as physicians, or educate payers, policymakers, and MD/DOs about the podiatric medical profession. THE OHFAMA JOURNAL | WINTER 2024 | 11



23rd CAC-PIAC Meeting Held in November Ohio PIAC Representative Sarah Abshier, DPM, attended the 23rd Annual Carrier Advisory Committee (CAC) and Private Insurance Advisory Committee (PIAC) Representatives Meeting in Alexandria, VA, on November 10. The event brought together 50+ volunteer leaders to address state-level reimbursement issues. Emphasizing the vital role of CAC and PIAC representatives, discussions covered updates on the 2024 Medicare Physician Fee Schedule, MIPS, private insurance trends, and Durable Medical Equipment (DME). Concerns about MIPS and private insurance modifiers -25 and -59 were prominent. Below are updates from Dr. Abshier and Ohio CAC Representative Dr. Andy Bhatia:

Aetna Resolves At-Risk Foot Care and -59 Modifier Issues

Aetna has dropped its external review program regarding use of -59 Modifier when submitted with CPT 11719-11721, G0127, and 11055-11057. This development follows more than two years of APMA’s advocacy through multiple communications and meetings with Aetna leadership. Aetna had been inappropriately applying an edit to certain foot care claims. APMA’s Health Policy Committee formed a 59 Modifier workgroup more than two years ago to address this issue. Thanks to the work of that group, other APMA members, staff, and consultants all contributed to this latest victory. APMA encourages members to continue to follow NCCI guidelines and only submit callus paring codes when the calluses pared are not on the same distal phalanx of a toe that had a nail debrided.

Sarah Abshier

Andy Bhatia

OHFAMA Issues Letter to Humana Regarding Podiatry Coverage Humana will no long cover routine podiatry visits through Gold Plus Medicare Advantage plans, per the company’s 2024 Annual Notice of Changes OHFAMA sent a memo objecting to the move and urging Humana to cover Medicare covered podiatry services in accordance with the LCD on Routine Foot Care and Debridement of Nails.


The CAC and PIAC structure consists of representatives appointed by state podiatric medical associations to assist members in resolving Medicare and private insurance-related concerns. Knowing and using your appointed CAC and PIAC representatives, who are practicing podiatric physicians with expertise in dealing with insurance issues, may help in claims appeal, contracting, understanding medical policy, and more.

CMS Revises Surgical Nails Treatment Policy

CMS has clarified its policy on the surgical treatment of nails and established use parameters for CPT® 11730 and 11732. The policy states a medically reasonable and necessary repeat CPT 11730/11732 of the same nail within 32 weeks of a previous avulsion will be considered upon redetermination. The policy cites “ingrown nail of the opposite border or a new significant pathology on the same border recently treated” as examples of why a repeat procedure of the same nail may be medically necessary. Repeat procedures will probably be rejected initially. They should be resubmitted for redetermination. It is important to thoroughly document why the procedure was repeated in your notes.

CGS Reconsiders Local Coverage Determination on Skin Substitutes

A CGS Local Coverage Determination (LCD) that would have placed new limits on the use of skin substitutes for the treatment of diabetic foot ulcers and venous leg ulcers was not implemented. The withdrawn LCD stated, “greater than four applications of a skin substitute graft or cellular and/or tissue-based products (CTP) within the episode of skin replacement surgery (defined as 12 weeks from the first application of a skin substitute graft or CTP)” are “not medically reasonable and necessary.” We expect a new LCD change proposal at some point in the future. We will keep you updated on this issue.

MIPS 2024 is concerning. It will require 75 MIPS points to avoid a penalty. There are studies that have been published that demonstrate MIPS is not beneficial and is detrimental to patients and providers alike. There is significant push back when it comes to MIPS, but unfortunately for now it remains a reality.

Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Documentation Updates • ETF/revalidation applications should be sent to the DME enrollment carrier not the DME MAC. Consider using professional help with completing the application, it’s not just the two page form it used to be!

• RAC audits are on the rise for L1971 Ankle foot orthosis, plastic or other material with ankle joint, prefabricated, includes fitting and adjustment. Need to document what have you done to fit and adjust the brace to the specific patient. You must specify what was performed to customize the device. For example, “I bent it/molded it around prominent bony prominences.” • Across the country we have seen a reduction in DME suppliers who offer DM shoes. This is becoming an access to care issue.

Medicare Advantage Updates

• Medicare advantage market snapshot demonstrates that 51% of the eligible Medicare population are enrolled in advantage plans. • Medicare advantage plans have consistently had high claims denial rates secondary to system errors and manual reviews. 2024 Medicare Advantage and Part D Final Rule • Prior authorization where a Medicare Advantage Organization (MAO) requires prior authorization for a service to be covered. • Pre-determination can be requested: enrollees and providers acting on their behalf have a right to request an organization determination prior to furnishing a service. These are voluntary requests. Rule Change 1. Can only require prior authorization to confirm presence of diagnosis or medical criteria 2. For benefits covered under part A or part B, to ensure an item or service is medically necessary based on Medicare criteria or if no Medicare criteria exists than on the MAOs internal criteria 3. For supplementation benefits to ensure its clinically appropriate. Be aware! Rule does not override contractual provisions that Providers may have with MAOs.

Dual Plan Issues Reported Appropriate Use Criteria Program Paused

CMS paused efforts to implement the Appropriate Use Criteria (AUC) program for reevaluation and rescinded existing AUC regulations. Effective January 1, 2024, providers and suppliers should no longer include AUC consultation information on Medicare FFS claims. The AUC program impacts all physicians and practitioners that order advanced diagnostic imaging and whose claims are paid under the physician fee schedule, hospital outpatient prospective payment system or ambulatory surgical center payment system.

2024 MIPS Performance Threshold Will Remain at 75 Points

MIPS, or the Merit-based Incentive Payment System, is a program administered by CMS that determines whether eligible clinicians or clinician groups receive a positive, negative, or neutral adjustment to their Medicare Part B payments.

There have been issues with dual plans (Medicare/Medicaid). Sometimes patients are getting redetermined and falling off the Medicaid portion. They can be kept on those plans for up to 90 days if the carrier thinks the patient will again fall under coverage by the Medicaid portion. Unfortunately, many patients who are getting the redeterminations of benefits are missing the notices and only finding out they have the Medicare portion of their coverage at the physician’s office in the form of a balance. Be sure to communicate with your dual plan patients.

CGS to Perform TPE Audits on E&M Coding

CGS will be performing Target Probe and Educate (TPE) audits on proper E&M coding. This consultative program is designed to educate providers while reducing E&M claim and payment errors. There are many resources available to members on the new E&M coding guidelines that went into effect in 2021 for office/outpatient and in 2023 for the other POS. Visit for more information. THE OHFAMA JOURNAL | WINTER 2024 | 13



Save the Date: The 108th Annual Foot and Ankle Scientific sSeminar April 20, 2024 8 Hours Virtual CE May 16 – 17, 2024 17 Hours In-Person CE

Make plans today to attend Ohio’s pre-eminent podiatric educational seminar -- the 108th Annual Foot and Ankle Scientific Seminar. This year’s event offers the convenience of eight virtual CE hours on Saturday, April 20. An additional 17 in-person CE hours will be offered May 16-17 at the Columbus Hilton at Easton. Registrants may attend just the virtual day, just the in-person days, or the full seminar at a discounted rate. The seminar will cover a broad variety of education including diabetic management, updates on current technology, social media information, multiple malpractice items to consider, coding updates including information on artificial intelligence, pain management updates, and much more. New this year, the PICA malpractice session will be offered during the virtual day for physicians’ convenience. There will also be a two-day assistant track offered in-person May 16-17, 2024. The course will include important information and refreshers for medical assistants, coding tracks, OSHA, and HIPAA compliance. This is simply one event you won’t want to miss. Come to the Hilton for food, fun, and camaraderie. Bring your office shopping list to receive 14 | THE OHFAMA JOURNAL | WINTER 2024

fabulous exhibit hall discounts from over 80 exhibitors! Door prizes abound along with an exceptional experience that only OHFAMA and OFAMF can provide. We hope to see you there!

Third Annual Wound Care Seminar a Success The Ohio Foot and Ankle Medical Foundation held its third annual Wound Care Seminar on November 4. Thank you to seminar chair Richard Schilling, DPM, for putting together an outstanding slate of speakers. Special thank you to the generous sponsors who supported the event.

Annual Scientific Seminar Program Announced SATURDAY - April 20, 2024 - VIRTUAL ONLY 7:00 AM - 9:30 AM The Forefoot & Revision Forefoot Cases - Faculty: Dr. Patrick Burns, Dr. Lawrence DiDomenico, Dr. Jacqueline Donovan, Dr. Scott Malay, Dr. Robert Mendicino, Dr. Al Ng 9:30 AM - 9:45 AM Break 9:45 AM - 11:30 AM Diabetic Salvage, My “Sweetest” and Worst Case - Faculty: Dr. Patrick Burns, Dr. Lawrence DiDomenico, Dr. Jacqueline Donovan, Dr. Mike Dujela, Dr. Scott Malay, Dr. Al Ng 11:30 AM - 1:30 PM PICA Risk Management Lecture - Principles of Complications Management - Faculty: Dr. Luke Cicchinelli, June Laird, Esq, Dr. Kate Swanstrom 1:30 PM - 1:45 PM Break 1:45 PM - 4:00 PM Hindfoot and Ankle Cases - Faculty: Dr. Lawrence DiDomenico, Dr. Mike Dujela, Dr. Scott Malay, Dr. Robert Mendicino, Dr. Al Ng

THURSDAY - May 16, 2024 - IN PERSON ONLY 6:30 AM - 7:00 AM Registration 7:00 AM - 9:30 AM Diabetic Patient Management - Faculty: Dr. Patrick Burns; Dr. David DeLuccia; Dr. Krishna Mannava; Dr. Suhail Masadeh; Dr. Rolland Ramdass; Dr. Matthew Reiner; Dr. Randall Thomas Presentations: Flexor Tenotomies and ‘In-Office’ Diabetic Procedures; Sneaky Ischemia in the Diabetic, Think Pre-Op; MIS Procedures in the Neuropathic/Diabetic; MRSA/Infection Management in the Diabetic; Charcot and Frames - Pearls for Keeping it Easy; Charcot and Beams - All at Once? Staged? Why Beam?; Charcot and Orthotic/Prosthetic Options; Charcot and Diabetic Care Malpractice Risks 9:30 AM - 10:00 AM Break 10:00 AM - 11:30 AM MIS Possibilities and Forefoot Surgery - Faculty: Dr. Joshua Banks; Dr. Samantha Bark; Dr. Roberto Brandao; Dr. Elizabeth Wakefield Presentations: MIS Bunion/MIS Akin; Hallux Rigidus Management: Office, Surgical, What Works for Me; MTP Fusion Options; Strategies for Forefoot Post-Op Edema; MIS Achilles/Haglunds; 11:30 AM - 1:00 PM Lunch and Learn (Pickup Tickets in the Exhibit Hall) Non-CECH – Ohio Category I 1:00 PM - 3:00 PM Scientific Paper and Poster Competitions: Presentations from Podiatric Physician Residents - Dr. Robert Brarens 3:00 PM - 3:30 PM Break 3:30 PM - 5:30 PM Looking Forward: Cutting Edge Technologies, Recent Trends, and How to Protect Yourself in a Changing World - Faculty: Dr. Peter Highlander; Dr. Christopher Hyer; Dr. Rolland Ramdass; Dr. Matthew Reiner; Dan Zinsmaster, Esq

Presentations: What is 3D Printing and What Role in F&A? ; My Cases with 3D Printing; Medical Practice/New Techniques/Standard of Care: Tips and Caution; Medical Practice and Social Media, Tips and Caution; Update on Contracts and Non-Competes in Medical; Top 10 Reasons for Malpractice Claims 5:30 PM - 6:30 PM Sponsor Reception

FRIDAY - May 17, 2024 - IN PERSON ONLY 7:00 AM - 7:30 AM Registration 7:30 AM - 9:00 AM Stuff Happens: How to Make the Most of Bad Outcomes and Complications - Faculty: Dr. Patrick Burns; Dr. Mark Hofbauer; Dr. Marcus Richardson; Dr. William Scherer Presentations: Salvage of Bunions Gone Wrong; Salvage of Lesser Toes Gone Wrong; When to Biopsy Skin and Nails and Why; Complications of Trauma; Salvage of Prior Hindfoot/Ankle Recon 9:00 AM - 9:30 AM Break 9:30 AM - 11:30 AM Difficult Patients, Conditions, and Decisions: How to Optimize Their Management - Faculty: Dr. Sarah Abshier; Dr. Gladstone McDowell; Dr. Mark Mendeszoon; Dr. Jeffrey Strakowski; Dr. Rebecca Sundling; Dr. Elizabeth Wakefield; Dan Zinsmaster, Esq Presentations: Eval & Non-Operative Management of Tarsal Tunnel Syndrome; Opioid Crisis and Patient Management; When to Refer to Pain Management and What Can Be Done; What to Be Aware of with Nerve Pain Meds and Stay Compliant with Pharmacy Board; Latest and Greatest in Shoe Gear for Your Patients; When an OTC Insert Might Be an Option Too; Strategies for Chronic Peroneal Pain 11:30 AM - 1:00 PM Exhibitor Marketplace Luncheon 1:00 PM - 2:30 PM Ankle Arthitis, TAR, Sports Injury and Recovery - Faculty: Dr. Joshua Banks; Dr. Roberto Brandao; Dr. Melissa Galli; Dr. Christopher Hyer Presentations: Ankle Trauma and Post Trauma DJD; When TAR or Ankle Fusion?; Evolution of TAR, Not So Experimental Anymore; Common Sports Injuries of Foot & Ankle; Rehab in Foot and Ankle and Importance of Proprioception 2:30 PM - 3:00 PM Break 3:00 PM - 4:45 PM Evolution of Practice: Nothing Stays the Same - Faculty: Dr. Patrick Burns; Dr. Lawrence DiDomenico; Dr. Mark Hofbauer; Dr. Mark Mendeszoon; Dr. Randall Thomas Presentations: Changes to My Surgical Practice Over the Years: Bunion; Changes to My Surgical Practice Over the Years: PTTD/PPV; Changes to My Surgical Practice Over the Years: PF; Changes to My Surgical Practice Over the Years: Hammertoe; What You Should Know About SPECT CT; WBCT in Your Foot and Ankle Practice 4:45 PM - 5:30 PM Podiatry - O Doctor, Where Art Thou? - Congressman Brad Wenstrup, DPM 5:30 PM - 6:30 PM Sponsor Reception THE OHFAMA JOURNAL | WINTER 2024 | 15

MEMBER BENEFITS Proud to Partner with Ohio Foot and Ankle Medical Association!

By Peggy N. Slaughter, CFP®, CRPS®, AIF®, CPFA® The following article is a synopsis of a white paper published by Empower Retirement LLC in March 2023. If you would like a complete copy of the white paper, please call or email me. Gen Zers, also known as Zoomers, were born from 1996 to 2012. They are the first digital natives, growing up with internet and smartphones. They are highly mobile and more racially diverse than previous generations. Diversity is a key trait; don’t make assumptions about cultural background or practices when communicating with them. Ranging in age from early teens to mid-twenties, Zoomers are now entering the work force and, subsequently, their first retirement plans. While 88% of Gen Zers are contributing to employer-sponsored plans, they are saving less as a percentage of pay than previous generations. They are also less engaged with their retirement planning and more likely to change jobs frequently, often cashing in small balances rather than rolling them to a new employer’s plan. Compared to earlier generations, Zoomers are more self-reliant and collaborative, likely due to gaining an early proficiency in digital tools. Yet they are more guarded about social media than millennials, preferring to share less online and expressing distrust of big tech. Building trust with Gen Zers with in-person meetings encourages the collaboration they crave, resulting in greater engagement related to their financial well-being.

APMA Business Mastercard Offers Benefits to Members APMA has launched a new member benefit – the APMA Business Mastercard® – the only business credit card exclusively tailored for your practice’s financial needs. This new benefit of APMA membership offers 5% cash back on the most relevant expenses for podiatric physicians and surgeons. The cherry on top is if you spend $30,000 on eligible purchases during your first three months, you’ll get a one-time credit for your annual APMA membership dues!

While Zoomers are highly educated, they increasingly question the cost of a college degree. For those who have taken on student loan debt, there is an opportunity for employers to help so that repaying loans doesn’t derail savings in these critical early years. Under the SECURE Act of 2022, employers who sponsor a 401(k) plan may take advantage of the Qualified Student Loan Payment provision, which allows student loan repayments to be treated as employee contributions for purposes of making a matching contribution to the plan. Roberta Katz, senior research scholar at Stanford who led a study of Gen Z, stressed that they want genuine connections. Effective communication will involve dialogue, not lecturing. Because they are so used to finding what they need on their own, Zoomers are more likely to question rules and authority. But they are not always right and often don’t know what they need. Katz says, “Both the older and the younger colleagues can learn from the other, in each case by listening with more respect, appreciation and trust.” If you are ready to up your retirement plan game, contact me at peggy. or call 614-841-1881 to learn more about the OHFAMA Members’ 401(k) Exchange Plan. It is a great way to join forces with your fellow members to reduce the expense and fiduciary liability of operating a 401(k) plan. I look forward to hearing from you! Peggy Slaughter is a retirement plan specialist at Saling Simms Associates and has been working with Associations for over 20 years. Investment advisory services offered through Saling Simms Associates, 7965 North High Street, Suite 130, Columbus, Ohio, 43235, 614-841-1881.

• We can cover 100% of your APMA membership dues • Up to 5% cash back on podiatry industry focused expenses • No annual fees • Unlimited employee cards with no additional fees • No effect on personal credit when you apply

“The APMA Business Mastercard® is a game-changer for podiatric physicians, offering unparalleled benefits that directly address the unique needs of our profession,” said APMA Executive Director and CEO James R. Christina, DPM. “This innovative card provides practices with substantial cash-back rewards and a unique management platform to make managing your finances simple.”

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VOL 66 • NO. 1 • WINTER 2024

DRS. CENTRAL BILLING, LLC w w w . d r s b i l l i n g i n c . c o m

Incoming OHFAMA President Thom Arnold, DPM, presents the Thomas J. Meyer Award to outgoing President Adam Thomas, DPM, at the 2023 OHFAMA Annual Business Meeting in Columbus.

The OHFAMA Journal is published 4 times per year. The advertising deadline is midmonth preceding publication. Portions may be used with permission of the publisher. President: Thom Arnold, DPM Published By : Mike Mathy, CAE, Executive Director; Advertising : Luci Ridolfo, CAE, Assistant Executive Director Contact Information: 1960 Bethel Rd., Ste. 140 | Columbus, Ohio 43220 Phone: 614.457.6269 | Fax: 614.457.3375 Editorial Disclaimer:

The OHFAMA Journal is provided to Association members and Industry Affiliates of the profession as a part of our communications to inform/ update our members on podiatric issues and events. The contents of OHFAMA Journal are intended for general information purposes only and should not be read as specific legal, financial, or business advice regarding specific issues or factual events. We urge you to consult your legal, financial, and professional advisors with any specific questions you may have. The information published herein has been prepared for educational and informational purposes only. This information is not intended as legal, podiatry or practice management advice or an opinion on same. Circumstances change from day-to-day and one situation may differ from the next; the authors and publisher cannot assume responsibility for any actions taken based on the information contained herein. This information is not a substitute for expert advice specific to your situation. More specifically, legal or regulatory advice must be tailored to the specific circumstances of each case, and laws are constantly changing. Nothing provided herein should be used as a substitute for the advice of competent counsel. Federal law requires that the authors and publisher let you know that nothing published herein is intended or written to be used, and cannot be used for the purpose of avoiding any penalties under the law. The publication of the information herein is not intended to create, and receipt does not constitute a professional or contractual relationship between the author and the publisher and you. While the publisher tries to provide accurate and helpful information, they do not make any claims, promises or guarantees about the accuracy, completeness, helpfulness or adequacy of the information contained herein. No warranties are made for the information published to be accurate and no other warranties express or implied are made. The information here is presented “as is.”

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THANK YOU TO OUR 2023 OPPAC CONTRIBUTORS: Please consider financial support of our state legislative efforts by contributing to the Ohio Podiatric Political Action Committee (OPPAC). OHFAMA’s legislative success relies on member contributions to our political action committee — the Ohio Podiatric Political Action Committee (OPPAC). Please consider making a personal donation to OPPAC today. Your generous OPPAC contribution will help preserve, protect, and advance podiatry in Ohio!

Central Academy

Sarah Abshier, DPM Roberto Brandao, DPM Andrew Brown, DPM Anthony Cozzolino, DPM Abigail Elliott, DPM Timothy Holmes, DPM Anastasia Koss, DPM Lynette Mehl, DPM Amanda Quisno, DPM Adam Thomas, DPM Jennifer Trinidad, DPM Eastern Academy Mitchell Dalvin, DPM

Mideast Academy Thomas Arnold, DPM Karen Kellogg, DPM Richard Kunig, DPM Leslie Niehaus, DPM Kenneth Nixon, DPM Lee Sayner, DPM Rodney Scott, DPM


Midwest Academy Darrell Ballinger, DPM Marc Greenberg, DPM Elizabeth Nicely, DPM Gerald Perelman, DPM John Stevenson, DPM Erica Suprenant, DPM Charles Trimble, DPM

North Central Academy Christopher Bohach, DPM Martin Lesnak, DPM Elizabeth Wakefield, DPM Brian Zimmerman, DPM

Northeast Academy Robert Bair, DPM Colleen DeBarr, DPM Michael LeCastre, DPM Joy Rowland, DPM Debra Thornton, DPM Howard Waxman, DPM Kelly Whaley, DPM

It’s easy. Go to and click on Donate to OPPAC on the top of the homepage.

Northwest Academy Charles Marlowe, DPM Thomas McCabe, DPM Pamela Sheridan, DPM

Southern Academy

Brian Ash, DPM Ruth Ann Cooper, DPM Matthew Hamilton, DPM Tatyana Hamilton, DPM Amy Masowick, DPM

Additional Contributors Michael Brody, DPM Dan Leite Mike Mathy, CAE Luci Ridolfo, CAE

*Include your name today!

CLASSIFIED ADS Cincinnati Ohio - Associate Wanted Seeking associate for growing practice with 3 office locations in Cincinnati, OH. Applicant must be personable, hard-working, independent, and a graduating resident or associate with private practice experience. Please send CV and questions to

Practice for Sale - Dayton, Ohio Well-established, busy, general practice for sale. Podiatrist with a great physician referral base is retiring. The Dayton area is a wonderful place to live with a reasonable cost of living and is close to many amenities. Email

Practice Equipment For Sale PAD Net vascular testing machine - $4,000. If interested, please contact

Associate Doctor Needed

Podiatric group seeking full-time and part-time podiatrists to provide mobile lower extremity care to long-term care residents in Dayton, Portsmouth, Cincinnati and Toledo Ohio. Competitive wages, and benefits for employees. This an excellent opportunity for those who are seeking long-term employment. Please Email your CV to



Ohio Foot and Ankle Medical Association 1960 Bethel Road, Suite 140


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