Saturday, May 21, 2022

Re: Donjoy bypassing orthotist?

Tony Barr

Interesting discussion here.

This mark up is also typical for prosthetic supplies.

I ,(as a partial foot amp) recently asked for pricing for a 3-ply 10 ”
gel sock from a major national O&P distributor who quoted me $7.50 for each
gel sock , thinking I was a provider.

When I informed him I was not a provider, the price leaped to $22.50 each
!! I was still able to buy it from them.

Pretty outrageous profiting considering there isn’t a lot of harm a stump
sock or one with with a gel insert, can expose a consumer/patient to if he
wants to direct order.

Besides the industry’s national trade association, there is a crucial need
to distinguish and separate DME from comprehensive O&P products.

How long can R&D justify high prices to third party payers and end users?

On yet another related note, as per ABC, it matters not whether the
certified provider is a certified prosthetist or Orthotist to deliver
comprehensive orthotic or prosthetic services since cross credentialing is
not restricted by either credentialing association.

ABC has taken the position that it can not restrict the free trade of a
certified practitioner.

“If a person can legally practice orthotics and or prosthetics without any
qualifications in their jurisdiction, ABC will not interfere with the right
of a certified prosthetist to perform orthotic work, so long as that person
does not imply that he/she is certified by ABC as an Orthotist. The reverse
holds true as well. ABC will NOT credential the practitioner in that second
discipline unless they meet our eligibility criteria.” ABC spokesperson.

So my question, related to the above post “Don Joy bypassing Orthotist”, If
40 states and two credentialing associations don’t restrict any provider
from delivery and billing for services of comprehensive orthotic or
prosthetic services, why are manufactures prohibited from marketing their
products directly to patients?

If cross credentialing or O&P services are delivered In a licensure
(regulated) state : the ABC Canons say (C1.2) that an ABC credential holder
must abide by the law. If the state has a licensure law and the person is
practicing outside their scope, they are violating the law. That would be a
violation of the Canons. Rule R3.1 also speaks to this issue and may be
applied.

Inquiring minds want to know ,who protects the patient from harm and fixed
pricing in a unregulated profession and industry?

The manufacture, the credentialing associations, the profession ?

Tony Barr

—–Original Message—–
From: Orthotics and Prosthetics List [mailto:[email protected]] On
Behalf Of Joyce Perrone
Sent: Thursday, February 09, 2006 7:56 AM
To: [email protected]
Subject: [OANDP-L] Bypassing Orthotists

EBI, Donjoy, Marquis — all have put items on patients using non-certified
orthotists. This has been going on for a very long time.
And not just low-level devices (stock and bill) but more complex items, as
well. Donjoy in Pittsburgh has been great with working together with the
orthotist community, but I’ve not seen as great an effort Nationally. As
long as they can bill Medicare, and every other provider out there, I’m sure
they will do this. My question to the group – WILL LICENSURE HELP THIS???
For those of you in states that have licensure – has it helped you and HOW
has it helped?? I think it is important for everyone to have a clear
understanding of this and if it is of help, then to get on the bandwagon and
pay to get licensure in your state. We do not have it yet – and I am
curious as what those of you with it have experienced.

Joyce J Perrone
De La Torre O&P, Inc & PROMISE Consulting 300 Alpha Drive Pgh PA 15238
412-599-1112

—–Original Message—–
From: Orthotics and Prosthetics List [mailto:[email protected]] On
Behalf Of Barry W Raborn
Sent: Wednesday, February 08, 2006 6:45 PM
To: [email protected]
Subject: [OANDP-L] Donjoy bypassing Orthotist?

I had an adolescent patient who has been wearing a donjoy 4titude for 4
years now. 2 years ago I fit him in a small from an extra small. he plays
multiple sports and has required new straps and adjustments periodically.
all of which we provide at no charge. he has completely worn the brace out.
mainly the hinge. his mother inquired about purchasing another one.
insurance is not paying for a new one, so we offered to fit him at the
medicare rate. his mother called donjoy direct and explained the situation
and they offered the brace to him a for a humdred dollars less. i discussed
this with donjoy and they confirmed that they had no issue with selling
directly to the patient, especially a cash pay patient.

i was just wondering if anyone else has had this issue with donjoy?

barry raborn co

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