This is a question of definitions. The Canons of Ethical Conduct state
“It is unethical to provide an orthotic or prosthetic devise without a
duly issued prescription.” There are no definitions included in the
Canons about what is an “orthotic or prosthetic devise” nor is there a
definition of “duly issued.”
The Licensure law in the State of Texas states that “The term [orthosis]
does not include a fabric or elastic support, corset, arch support,
low-temperature plastic splint, truss, elastic hose, cane, crutch, soft
cervical collar, orthosis for diagnostic or evaluation purposes, dental
appliance, or any other similar device carried in stock and sold by a
drugstore, department store, or corset shop.”
I’m not sure what the Canons mean, but the State of Texas has defined it
for practitioners in our State.
John D. Hatch, CPO
Clinical Manager
Rehab Designs of America
Anderson Harold R. wrote:
>
> We(the orthotics and rehab department) are currently having a dispute with
> an insurance provider that has it’s own, on staff, PT department. The PT’s
> write a prescription for “simple” devices such as custom or OTC FO’s or
> corsets and send the patients to us to provide the device. We’ve been
> asking them for prescriptions signed by a physician. They are telling us
> that, 1. They are the insurance company and are willing to pay for the
> device(s) without the physicians’ signatures, therefore we should provide
> them and 2. Most of what they are sending to us can be purchased over the
> counter at a pharmacy, therefore a physician’s signature is not needed.
>
> It is my understanding that our code of ethics requires that we have a
> physician signed prescription in order to provide any orthotic device
> whether it can be purchased OTC at a pharmacy or not. Our last
> communications from them lists the following products as examples of what
> they want us to provide without a physician signature:
> “Daytimer splint (for carpal tunnel)
> Spica thumb splint
> Cockup splints
> lumbosacral support
> genutrain(sp?) and other patellar femoral supports
> AOL for the ankle”
>
> It’s interesting to note that FOs are not on the list, though they are what
> initially started this discussion. I don’t know if that means they are
> dropping them from the dispute.
>
> Am I incorrect in my understanding? What, if any, are the limits of what we
> can do without a physician signature? I, personally, don’t like to do
> anything without the signature. It seems that I would be opening myself up
> for liability problems by doing so.
>
> Comments?
>
> Harold Anderson, CO
