ABC Expands Advocacy Efforts Through Participation in the O&P Alliance
August 2015 Issue
This article continues our series of articles about the Orthotic and Prosthetic Alliance (O&P Alliance) to highlight united advocacy efforts in the profession. This issue features reflections about the role of the American Board for Certification in Orthotics, Prosthetics and Pedorthics (ABC) in the Alliance.
ABC advocates for high standards in the provision of safe and effective orthotic, prosthetic, and pedorthic care. One of the ways ABC accomplishes this goal is through participation in the O&P Alliance. Over the past eight years, ABC and the Alliance have spent considerable resources educating federal and state legislators, the Centers for Medicare & Medicaid Services (CMS), and other payers about the orthotics, prosthetics, and pedorthics professions. Along with other Alliance members, ABC volunteers and staff have participated in meetings with congressional representatives and CMS officials to explain the education and training that O&P professionals receive and how the services they provide are vital to the health and rehabilitation of their patients.
In the first years of the Alliance's existence, one of its main activities was assisting CMS with developing the DMEPOS [Durable Medical Equipment, Prosthetics, Orthotics, and Supplies] Quality Standards. This work had a direct impact on ABC's programs since the quality standards impact O&P providers and their practices. The reality is that regulatory advocacy efforts do not always result in optimal outcomes; however, ABC believes its participation in this early work of the Alliance made a positive impact on how CMS views O&P professionals.
Alliance representatives have worked with the leading researchers in the profession to support their efforts and make sure they are aware of all potential funding opportunities, and Alliance members have worked diligently in the challenging area of requesting new reimbursement coding for innovative technology.
Being a member of the Alliance provides ABC a means to support its mission by interacting with policymakers about professional standards. For example, when ABC learns of pending legislation that may have an adverse impact on ABCcertified individuals or their practices, timely communication with our stakeholders allows them to get involved and let their voices be heard.
This was illustrated recently when CMS proposed a rule to clarify the definition of minimal self-adjustment, as it relates to off-the-shelf orthoses. The rule went beyond clarifying that definition and potentially would have had a negative impact on all certified orthotic fitters. ABC was able to alert its constituents about this pending regulation so they could submit comments during the public comment period of the rulemaking process.
Over the years, the Alliance has engaged with CMS officials, provided written and verbal testimony at congressional hearings, and met with legislators and their staff about critical issues related to O&P. Through ABC's involvement with the Alliance, each ABC credential holder has access to decision makers who are responsible for policies that will impact their daily practices.
Some of the recent issues the Alliance has addressed include the onerous documentation requirements that are affecting patient care, including the physician documentation requirements associated with the provision of prosthetic limbs and diabetic shoes and inserts, and encouraging CMS to establish real provider qualifications for the provision of complex O&P care.
Congress passed the Benefits Improvement and Protection Act (BIPA) in 2000. That law established the qualifications needed to be reimbursed by Medicare for custom O&P care. ABC and the Alliance have been urging CMS to issue regulations to implement BIPA for almost a decade. We are hopeful that the years of interaction with CMS staff will garner a positive result in how the rules will be established.
ABC will continue to work with the Alliance to educate and advocate for equitable treatment of O&P professionals and reasonable administrative requirements in order to provide services for Medicare beneficiaries.
Editor's note: All member organizations of the O&P Alliance will be given the opportunity to submit their perspective about their involvement in the organization. Views expressed by the individual associations do not necessarily reflect those of the editor or publisher.