My fellow colleagues,
The following is what I submitted to SBA Ombudsmen office in Washington,
DC. at _http://web.sba.gov/nocms/client/dsp_welcome.cfm_
(http://web.sba.gov/nocms/client/dsp_welcome.cfm)
Wil Haines, CPO is correct, if nothing is done, we only have ourselves to
blame. I suggest everyone tell their own experiences.
_________
Medicare within the last year and half has established and implemented a
system to uncover fraud (great idea). Unfortunately, in doing so, they have
targeted honest, ethical, decent , tax paying Americans and flag waving
Americans. I am referring to the Orthotic and Prosthetic (artificial limbs for
amputees) professions in the U.S.
I attended a documentation program from Medicare University approximately 3
weeks ago. The program in the AM provided information, the repeat program
in the afternoon provided completely different information, contradicting
the morning session. If Medicare can not agree amongst themselves, how can
they implement fairness nationally.
Where is due process? Medicare established that the Prescribing Physician
must evaluate the amputee functional level. My job for 33 years has been to
establish functional level and report back to the physician with my
recommendation; then the Prescribing Physician must approve (functional level
determines the cost of foot, knee). Medicare established the Prescribing
Physician must determine and have this information in their files (the
information can not be provided by us the professionals). The problem is the
physicians knew nothing about this requirement, additional my profession knew
nothing about these rules.
So now Medicare implements prepayment audits and post payment audits. When
the audits ask for this information, no one has the documents. They hold up
payment until the audits are completed (months and I mean months). When
the system can not obtain these documents, Medicare keeps the money on work
done or they want the payments back. In the interim, I go out of business,
like a lot of my fellow colleagues in small practices.The
government/Medicare/whomever is devastating my profession. Where is due process?
Jake R. Wood C.P., FAAOP
O&P Associates, Inc.
10506 W. Bluemound Rd.
Milwaukee, WI 53226
414-257-2727
414-257-9898 (Fax)
414-315-9749 (Cell)
