Having just returned from last weeks AOPA’s Meeting in Las Vegas, as a paid
one day exhibit attendee this year , not exhibiting for the first time in 14
years.
It was very good to see all my friends, practitioners and manufactures whom
have graciously supported the Barr Foundation’s work over the last years. It
is always a time I look forward to and seeing personally thanking each one
of you.
I was very discouraged however, to learn of one of the national trade
associations, AOPA, continued lack of support for state licensure for the
O&P profession and what was allegedly referred to the lack of support by,
ABC, the Academy and NAAOP.
It is not the first time AOPA has misrepresented the Academy’s or another
organization’s views.
A issue of physical therapist Direct Access legislation ignited an exchange
of letters between the American Orthotic & Prosthetic Association (AOPA) and
the American Academy of Orthotists & Prosthetists last March at the Academy
meeting in Orlando .
“Triggering a letter March 11 from AOPA to its members was a letter written
by Academy President David Moretto, CP, FAAOP, February 11 to Ben F. Massey
Jr., PT, MA, president of the American Physical Therapy Association (APTA),
saying that the Academy, based on the recommendation of its Professional
Issues Council, would “not oppose APTA’s legislation at this time.” The
letter went on to suggest a collaborative project looking at the progress of
patients undergoing physical therapy after receiving orthotic and prosthetic
care.”
Kathy Dodson, AOPA’s Senior director of government affairs, stated at the
State Issue Roundtable presentation in Las Vegas, that although admitting
“state issues are playing a more prominent role in the practice of O&P”, she
stated she had her doubts as to the benefits of state licensure to providers
and patients receiving their services !
Even though she stated several times that that ” a one voice message on
qualified provider language must be delivered to CMS .. and not independent
competing messages ” this is not consistent with previous statements of
support for state and federal regulation by NAAOP and the Academy
leadership.
The ” message” recently sent to CMS in preparation of them writing new
regulations on quality standards and accrediadations in O&P, was allegedly
delivered by a group called the G-4, which was also published in the O&P
Almanac Sept 2005 edition, is actually a united voice of AOPA, ABC, NAAOP
and the Academy.
Kathy Dodson stated “AOPA firmly believes CMS needs to know who and what
they (CMS) are regulating.”
While the message remains inconsistent with the philosophies of at least
two the G-4 associations ,one thing is certain as reported by Walt Gorski
also of AOPA Government Affairs, in that same edition:
“Medicare spending for O&P devices has increased by 47 % between 2001 and
2003 ” and ” O&P would continue to face the possibility of an extended
payment freeze unless we are able to provide answers as to WHY Medicare
spending is on the rise. The basis for implementing the freeze was to
control over utilization of services”.
This cost was also eluded by Mr.Gorski at the Roundtable meeting to have
increased from a cost per Medicare beneficiary for O&P treatment of $6,535
to $12,320 over the same period! Whose making all this money ?
AOPA continues to not speak for the profession’s best interests but for only
some of their complex levels of confidential membership categories which can
be found in the O&P Almanac.
AOPA members are for the most part manufacture members that include Durable
Medical Equipment manufactures and suppliers, central fabrication
facilities, and a national chain of O&P providers, as well has some
independent providers.
AOPA’s recent solicitation to attend a AOPA seminar to “Increase the
Profitability of Your O&P Business, Today!” should be renamed to promote
attendance “Increase the Credibility of O&P Providers.”
Have you ever wondered why AOPA hasn’t ,at the very least, (if not in
support of state licensure) supported and suggested to CMS, mandatory ABC or
BOC accreditation to practitioner and all O&P facilities delivering
comprehensive O&P services ?
Currently ,a accreditation standard is being proposed by the covert
organization labeled G-4 to CMS to avoid the implementation of meaningful
requirement of licensure and regulation as required by all other legitimate
health care professions..
Certification, in relation to providing accountability and proper
qualification, is not a valid credential particularly when not any
credential nor state license is required in 40 of the 50 states to be
legally reimbursed by third party payers for custom O&P.
Did you know also :
1)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. a ABC or
BOC certified prosthetist,not trained nor certified in delivering orthotic
services can legally and without violating any of ABC’ s “cannons of ethics
“, provide the full range of orthotic serves and be reimbursed for them and
visa versa?
2)there is no ABC status “Board Eligible.” some people refer to themselves
that way, but we have no recognition for that status. Those people are
considered NOT CERTIFIED.
3)In a licensure state: the ABC Cannons 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.
Unlike the physical therapists and occupational therapists and their
respective national professional trade associations, APTA, AOTA, whom have
successfully obtained regulation in every state, ABC ,the Academy ,AOPA and
NAAOP (if indeed they endorsed the G-4 submission of a new accrediadation
standard ) have done nothing to promote and support meaningful state or
federal regulation, outside of ABC endorsing the “concept” of state
licensure.
ABC position on state regulation ” is that they will serve as recourse for
and provide public and aggressive assistance to local ABC-certified
practitioner groups who have taken organized efforts to seek state licensure
requirements and include ABC credentialing standards as the basis for
licensure.”
Self serving at best but ABC willingness to support crossovers into another
allied health care science without additional training and qualification in
each specific healthcare science, is not only contrary to achieving state
and federal regulation and safety to patients, but also will lend itself to
an the recent addition of 5,000 lesser qualified providers of O&P if the
unification of BOC practitioners were permitted into the arms of ABC.
Pretty scary to think your 10 year old daughter could legally receive a
halo, polio or scoliosis device by a certified prosthetist , let alone non
certified providers of with no professional designation, in 38 states.
The industry continues to provide smoke screens at the profession as
arguments against regulating O&P and any constructive suggestions to
increase the badly needed credibility of O&P.
Whom are exclusively credentialed ,accredited or licensed would reducing the
number of buyers of some of their members products ,reduce their bottom line
of profitability and loose Level 4 members (more than $5 million in gross
sales).
First they challenged and instigated ABC VS BOC wars, now the alphabet soup
war continues with their warning to BOC and ABC that PTs and OTs and even
ATs will encroach your turf if they support licensure. Nonsense !
This has always been about money and not about specific guidelines for
provider and supplier qualification nor facilities buying their products.
Traditional O&P business is losing market share to other “healthcare
professionals,” and why they will not prevent it from continuing.
O&P technology has advanced to a point to where it is no longer the domain
of those skilled in the art. The O&P practitioner has gone the way of the
typesetter in the computer age, and the art of prosthetics is not being
passed to the next generation.
(O&P) no longer custom fit and fabricate O&P devices. You now buy them
massed produced or designed by a computer and say our skill is in “custom
fitting”. Given the results we are getting in keeping the customer happy
others are giving it a try as well.
The biggest fools in thinking things have not changed, is the independent
O&P provider , and how much longer can you survive fooling yourselves that
the trade association knows what’s best for the “profession”.
One solution is to recognize the need of legitimizing the only unregulated
health care ” profession “and ask AOPA to amend AOPA’s bylaws and endorse
sate and federal regulation by corporate resolution.
The requirement of 10% of the voting members are required to be present, in
person or by proxy, in order to constitute the quorum necessary to conduct a
business meeting.
Although , “voting members” under the bylaws are not defined as all members
(?) – i.e. a company member casts one vote and its affiliates are not
entitled to vote, a quorum can be duly certified and, majority of the
voting membership can issue of bylaw amendment. Article VII of the AOPA
Bylaws requires a two-thirds (2/3) affirmative vote of those present and
voting, in person or by proxy, in order to amend the bylaws.
Lots of Luck!
As John Billock LPO , past president of ABC, so accurately pointed out “it
is the patient that is the real loser in reducing the qualification
requirements of providers. State and federal regulation is now more
necessary than ever to maintain accountability, qualifications for O&P
providers and better ensure proper coverage for those patients requiring
O&P services.”
Sounds more like an endorsement of regulation not just supporting the
concept of it ! Would you agree?
Good day,
Tony Barr
—–Original Message—–
