Tony Barr wrote:
“New York legislators, like those in many other states, have been facing
budget balancing challenges over the past few years, and the needed funds
have not been available to regulate.
The O&P providers in New York must now belly up to the bar and pay the cost of regulation to stay in business and add the much needed credibility to their ‘profession’.”
To all, and with all due respect to Mr Barr,
The sad reality is that the New York State budget had a surplus this year and is discussing refunds, in the form of tax givebacks, because of these surpluses. Bottom line, they have taken way too much of our money…as if that’s actually possible from the NYS govt’s perspective. NYS is one of the most taxed, and regulated states in the nation!!! Is there no where in all this excessive taxation and regulation for the state to “belly up” for what will essentially become another unfunded mandate? With that said…
My concern is that during a time when seemingly ALL insurance carriers, including NYS Medicaid and related NYS insurance programs are forcing us into significantly lower reimbursements, while at the same time cutting covered services to the patient, we are being asked to “belly up to the bar” and absorb the additional costs of licensure. These costs will be significant. They will be in addition to all the other costs that will be placed on us once the Medicare quality standards are finalized. If competitive bidding in orthotic’s becomes part of the new Medicare standards, all of this may have a significant negative impact on smaller facilities and their ability to remain viable. Add all these additional expenses together with the continual decrease in reimbursements, and for some, it could tip the scales. Has ANYONE been effective at addressing reimbursements to help offset all these new expenses resultant of all these new regulations that are supposed to be so good for the!
patient and the profession?
Now this is not a treatise against licensure. My concern with licensure is that it’s potential is to be an expensive paper tiger. An additional regulation that has significant cost’s associated with it. A regulation that does not address the real O&P and/or patient issues that need to be on the table, and in actuality only serves as an added burden in the face of decreasing reimbursements. I do not buy into the notion that because we are licensed, the patients will be automatically better protected, or that we will be better positioned to leverage more appropriate reimbursements. Have any of the licensed states seen their state medicaid rates, or coverage for patients adjusted to reflect their new found level of professionalism, and was that a direct result of licensure? Which license bill that presently exists is proving effective in reducing the incidences of incompetent and/or inappropriate professional behavior? I ask these questions with all sincerity and not knowing th!
e answers. Have their been effective licensure bills where licensing boards have actually “taken action” against unscrupulous providers and thus protected the patient? Has there been a licensure law that has prevented unqualified providers from providing O&P services? Florida’s obviously didn’t. Have there been licensure bills that have effectively protected patients, which is what their primary purpose should be? There is an awful lot of emotion, and an awful lot of political posturing around this issue, but can anyone document the results of licensure…or show the examples of effective licensure. Before assuming another form of regulation will be beneficial, can anyone verify licensure is an effective way to protect the patient, and not serve only to enhance ones “profile” as a professional?
Maybe licensure is the way to go. Maybe licensure should become the “standard” for the O&P profession in the US. Maybe the day of O&P certifications is fading. Though the two can for a time exist simultaneously, they will eventually become mutually exclusive. One will become the standard. Is a hodge-podge of state licensure bills the answer? Especially when most licensure bills, from the outside, appear to be paper tigers…expensive window dressing…more tile to hang on the wall?
I guess all of this is to ask the question; if your going to pursue licensure in NYS, or elsewhere, why bother unless it has teeth? Why bother if it does not prevent “unqualified” providers from providing O&P services? Why bother if it is not truly protecting the patient, and providing them a venue to appropriate recompense for unprofessional actions. After the fact, will all the same unqualified people be providing the same services while the “qualified” providers will be saddled with an additional regulation, which equates to an additional expense? This weakens the position of those who operate within the rules, and strengthens the position of those who skirt the rules. Will there be a stronger protection for the patients?
Is there a licensure bill that is truly working? Are there tangible examples of the “process” of liscensure working? Are we designing a Trojan horse built on anecdotal information, or is there substance to this implied gift of professional recognition?
The bottom line for me is…
If you pass a licensure bill that really protects patients, and truly upholds professional recognition, and creates an environment of accountability…I can see the light…
If licensure becomes another pseudo-standard, another place we need to drop more coin to continue on the ride…why bother?
Be kind with the responses please…
Mike Madden, CPO
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