Wednesday, October 9, 2024

Follow up on Accreditatation replies

Jim DeWees

Thanks to all that responded to my posting. I received many emails, and some good insights on this topic of accreditation.

I got 3 emails from 2 of our organizations, the most direct response was from BOC which clearly stated that I am correct in my evaluation that prosthetists and orthotists are exempt from accreditation.

In a couple of emails from others practitioners, I was directed to the ABC website to review their information that ABC has posted, which does say that certified practitioners are exempt….BUT it does go on to say that those with accreditation need to stay in good standing, and those that have started the process need to continue on the path in order to avoid the rush of applicants when the deadline comes closer. Several of the people that replied commented that on one page of ABC’s website it sounds like it is mandatory, but then on another page it sounds like it’s optional, but still highly encouraged, and only adds to the confusion here.

One reply states that if I am a certified prosthetist and only bill for prosthetics, then that is fine. This raises a huge question, which is about this accreditation. Let’s suppose that there is a facility that only has certified orthotists on staff, and occasionally do some prosthetic work (or certified prosthetists that do orthotics), and so under this new rule, they could ONLY do work and bill for it in the area of their credentials. BUT, if they become an accredited facility, it would be acceptable to bill for the branch in which they are not credentialed??? Is that how this works? And, if so, isn’t that exactly against everything this accreditation quest is trying to fix, which is ensuring that the provider is truly qualified and trained in that field??? Just some food for thought here.

And, another question that was raised by a few was about why any practitioners would be applying for accreditation if they know they are exempt from this rule? Why does ABC continue to encourage practitioners, who already pay their dues and membership fees, to pay them even more money for more redundant rules and guidelines? I realize that there is a difference between credentials and accreditation and they focus on some different issues.

What is this accreditation really trying to do here? Is this an attempt to ensure some “qualified provider” issues, or is this to prevent fraud and abuse? I am not sure that many people know this answer….I certainly don’t. I know that the “qualified provider” issue has been around for some time, and is this a response to that?

I also know that CMS is trying to crack down on the fraud and abuse, and so maybe this accreditation requirement is being created for that purpose. But, it seems to me that this accreditation is being required first in the targeted areas where the competitive bidding was taking place. So, it seems possible that CMS was trying to have some watchdog in place to ensure that the consumer/patients are still getting quality services, even though the prices are being slashed and not allow some facility to actually provide the service that they are getting paid for. It is like CMS is forcing (well, they are not really forcing anything, it is up to the facilities to propose their fees and offer the discount, and then accept it…but whatever the case…) it is still like CMS and the government is wanting the patients to get the Dillard’s, Nordstrom’s or whatever quality merchandise at the Wal-Mart prices….and not get Wal-Mart quality merchandise…like getting the Swiss Army Watch at the Armitron Watch price. That’s another topic, not for tonight.

But regardless of the reasons for accreditation, whether it is a qualified provider issue, or a fraud and abuse issue, the ABC Canons of Ethical conduct or their Book of Rules clearly has all these issues already covered for the certified practitioners. We are already committed and obligated with ABC to adhere to these policies that are supposed to prevent these things from happening. Will accreditation have any more of an impact on this, or more “teeth” with these issues?

Another person raised the question about why all the literature, emails about conferences, faxes, or magazines that we get all the time, why haven’t any of these organizations sent out emails or any information that clearly states who needs accreditation, and who does NOT need to spend time, money and energy on this process. After all, the amount of time and energy that is consumed in this process only takes away from patient care time and takes our attention and focus off the patients. Isn’t that what we are supposed to be doing? Providing quality care, or are we supposed to be filling out more forms, and working harder just to pay more professional fees and spending more money on bureaucratic nonsense.

And, if the certified practitioners are not needing accreditation, and decide to not go through that, then who is getting this accreditation? Are ABC, BOC and the other organizations giving accreditation to facilities that do not have any certified practitioners on staff. I have always been curious to how the local pharmacy managed to get a couple of their employees certified as fitters when there has never been any certified orthotist employed at that business, but maybe I missed something along the way on the accepted route to getting that certification. Everyone should look at the ABC website and see just who is credentialed in your neighborhood and you might be surprised to see some names that will shock you.

Anyway, back to the point here, the bottom line is that for now it seems clear that certified orthotists and prosthetists are exempt from this accreditation requirement. We are classified among other professionals, such as PTs, OTs, physicians, nurse practitioners, audiologists, etc.

If anyone disagrees with this, and has some information that shows that I am wrong, PLEASE post this and let me know, and I will send out a correction. But, from all the emails that I received over the past couple days, it seems pretty safe to trust the CMS website and written rules that we (certified practitioners) are exempt, and can go back to work and help our patients now.

Thanks to everyone that responded, and to the people at ABC and BOC that responded especially….ok, so now you know who the 2 organizations were that replied. So, the question is where are the others that make up the coalition of forces that are there to negotiate these rules? Just thought I would ask and see if anyone of these other organizations might have anything to add to this conversation.

Thanks again,

Jim DeWees, CP

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