Setting a New Standard

Over the last 40 years, the percentage of total healthcare spending as a percentage of the gross domestic product (GDP) has nearly tripled. In addition, a short-term spending spike will result from healthcare reform, with the Congressional Budget Office (CBO) estimating nearly $1 trillion in new costs over the next decade. In light of that, is it surprising that we're seeing the government employ increasingly aggressive methods to try and recoup money already spent on healthcare? What I facetiously call the "triangle of death"—the Office of the Inspector General (OIG), Recovery Audit Contractors (RACs), and Medicare Administrative Contractors (MACs)—has focused its sights on O&P. Like it or not, we're being scrutinized. Closely. In that environment, manufacturer-supplier activities that might not have raised an eyebrow nine or five or even two years ago suddenly create risk. The current standard in the medical-device industry for how to safely navigate manufacturer-supplier interactions is the Advanced Medical Technology Association (AdvaMed) Code of Ethics on Interactions with Health Care Professionals. (In the interest of full disclosure, Össur follows AdvaMed's code.) AdvaMed's guidance is clear. Gifts from manufacturers to suppliers for "life events" (births, deaths) are not appropriate. Other gifts, such as iPods and digital picture frames are prohibited because they don't serve a purely business purpose. Tickets to sporting or concert events can't be offered or accepted. Branded items—for example, T-shirts, golf shirts, notepads, pens, and mugs—are prohibited under AdvaMed's code. Finally, meals between manufacturers and suppliers are permitted, but only if they are modest, occasional, and there is a documented legitimate business purpose. (The American Orthotic & Prosthetic Association [AOPA] has its own Code of Interactions with Healthcare Professionals. While AOPA's code focuses only on O&P practitioner and healthcare professional [i.e. , physician] interactions, its key guidelines are equally progressive, largely mirroring AdvaMed's.) On the one hand, we want to take the "P&O" out of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). We push for and implement new educational requirements. We talk about the work that only a certified and/or licensed O&P professional can provide. We emphasize that much of what we do is customized, and that no one else in the DMEPOS alphabet soup can deliver these services. On the other hand, I hear the following question all the time: "Why can't I have an [insert name of manufacturer] polo shirt? Everyone else is giving me one, and the rules you're talking about don't apply to me. I'm not a doctor." That position is flat-out wrong. If anyone can show me the language in the Federal Anti-Kickback Law and its regulatory "safe harbors" stating that it applies only to physicians, I'll sing Celine Dion tunes in the hotel lobby of next year's AOPA National Assembly. We can't have it both ways. We can't say, "We provide unique and transformative care like a physician," on the one hand, and, "Don't treat me like a doctor when it comes to getting swag from manufacturers," on the other. We can't send Peter Thomas, JD, the Orthotic & Prosthetic Alliance counsel, to Capitol Hill to discuss the finer points of regulations to define a "qualified supplier" and then undercut that by saying that the rules that apply to other medical professionals don't apply to us. The way we elevate the profession is by voluntarily adopting the highest possible standards—especially those involving ethical manufacturer-supplier interactions—and trumpeting them to the world. David McGill, JD, is the vice president of legal affairs for Össur Americas, Foothill Ranch, California, vice chairman of the National Association for the Advancement of Orthotics and Prosthetics (NAAOP) board of directors, and a former Amputee Coalition chairman of the board and board member. He also maintains a blog for the limb-loss community called "less is more" at limblogger.wordpress.com

Setting a New Standard

Face to Face: Ulrike Entwistle, CFm, Juzo-Certified Fitter

TMR Technically Feasible for Transfemoral Amputees

TMR Technically Feasible for Transfemoral Amputees

O&P JOBS

Certified Prosthetist/Orthotist (CPO)

Now Hiring: Certified Prosthetist Orthotist (CPO)

ABC Certified Orthotic Fitter / Orthotic Assistant

Get unlimited access!

EDGE DIRECT

Welcome Back!

Retrieve your password

Not enough quota to unlock this post

Setting a New Standard

Support authors and subscribe to content.

Subscribe

Related posts:

Face to Face: Ulrike Entwistle, CFm, Juzo-Certified Fitter

TMR Technically Feasible for Transfemoral Amputees

TMR Technically Feasible for Transfemoral Amputees

O&P JOBS

Certified Prosthetist/Orthotist (CPO)

Now Hiring: Certified Prosthetist Orthotist (CPO)

ABC Certified Orthotic Fitter / Orthotic Assistant

Get unlimited access!

EDGE DIRECT

Welcome Back!

Retrieve your password

Not enough quota to unlock this post