<img style="float: right;" src="https://opedge.com/Content/OldArticles/images/2005-07_04/dc_1.jpg" hspace="4" vspace="4" /> Many professional orthotists and prosthetists spend time engaging their elected representatives in Washington DC on issues impacting reimbursement for diabetic foot services. Our arguments have assisted our lawmakers in better understanding the difficulties facing O&P providers when reimbursement fails to adequately compensate even the minimum costs to provide services. However, our efforts seem to have fallen on deaf ears and are filed away so deep that nothing happens. When will Congress get the message that their constituents - our patients - are not getting the care they need? The National Association for the Advancement of Orthotics & Prosthetics (NAAOP) is an important player in advising Congress and federal agencies on policies impacting O&P. But all providers appear self-serving when advocating forincreases in reimbursement. The patients we serve, however, are the ones whom our elected representatives depend on for votes. On the diabetic foot care issue, the time has come to engage our patients to send the message as well. <h4>Patients Get Results</h4> This process has already started at the University of Michigan Orthotics & Prosthetics Center (UMOPC). UMOPC has asked several patients who have benefited from orthotic intervention in order to save their limbs from amputation to assist us in telling the diabetic story from their viewpoint. Within six weeks of engaging these patients, a flurry of letters descended on their congressmen and women. They developed and planned meetings to meet with their lawmakers' staff, locally and nationally, to describe - from a patient's point of view - the seriousness of diabetic foot care and the need for immediate action.Rather than simply making one visit, these patients opened a longterm dialogue regarding diabetic foot care reimbursement issues and the impact that recent Medicare coding and reimbursement changes are having on patient access and outcomes. <h4>PFA Gains Ear of Congresswoman</h4> Recently, the Pedorthic Footwear Association (PFA) was able to portray the seriousness of the story to New York Congresswoman Carolyn McCarthy (D) who introduced legislation in the House of Representatives to study the restoration of reimbursements at the appropriate levels for the work it will take to help our diabetic population. Practitioners play an important role in the policymaking process in Washington DC by providing direct and informed counsel to Congress on issues impacting the O&P field. But there is no substitute for informed, consistent communication from patients when low reimbursement directly impacts the breadth and quality of services they receive. The message they bring is particularly relevant when it is easy for them to describe how care from a professional orthotist can prevent costly and life-altering amputation. As providers, we are acutely aware that Medicare provides greater reimbursement for services relating to the care of an amputee than more preventative care via diabetic foot orthoses. Thanks to the Medicare Prescription Drug, Improvement and Modernization Act of 2003, the cutbacks on certain diabetic foot procedure codes have gone too far to make routine care for the diabetic foot a reality for all patients who truly need it. But when provider organizations engage Congress, the practitioner argument can be dismissed as yet another provider group asking for more money. Thus, by combining a patient-oriented view of reimbursement issues with the practitioner arguments, legislators have many persuasive arguments with which to understand the issue and justify their support. <h4>Call on Educated Consumers</h4> So what do practitioners need to do? It is time to call on educated consumers of our orthotic and prosthetic care who understand better than anyone else the benefits of quality diabetic foot care and the time and effort involved in providing that level of care. Consumers of our O&P care are congressional constituents whose voices can collectively be very powerful in Congress and augment the efforts of NAAOP and other O&P groups. Let's work together to ask for the assistance of our patients to help tell the story with us. <i>For more information, visit </i><i></i><i><a href="https://opedge.com/289">www.naaop.org</a> or</i> e-mail <a href="mailto:info@naaop.org"><i>info@naaop.org</i></a>
