Re: U.S. Politics: AOPA Position on Legislation

Re: U.S. Politics: AOPA Position on Legislation

Tony Barr

Bob,perhaps AOPA could of attempted to address some of the more sensitive issues,of the Wexler's draft by suggesting grandfathering all practitioners who have are considered competent and who have practised their profession for the last ten years.My understanding, that the current guidelines established by CAAHEP,if enforced, could of eliminated many of the ABC certified practitioners that did not have two years of college education.
This grandfather clause could allow those in business for an extended period to become certified even though they are not able to meet the formaleducational or training.This subclause substitutes 5 to 10 years experience for education byother criteria such asgood moral character.

SInce it is improper to allow ,even encourage rural Americans to be treated by unqualified practitioners,rural area O&P practitioners,would also become covered under this concept.
It also seem it would be very difficult to force DMERCs to monitor the supplier located in a rural area,insuring that they are not treating non rural patients!!

AOPA has gone on record in support of eradicating fraud and abuse and to encourage the federal government to develop and pass legilation requiring federal standards for all practitioner providing custom O&P services.What is required now is to come to agreement on those standards,the grandfathering issues and whether suppliers of O&P services should also be required to be in compliance when providing CUSTOM O&P services.

The January 5 1999 memorandum titled Citizens Petition and circulated to AOPA board members and HCFA Administrator Nancy -Ann Min Deparle, should be titled Industry's Petition!

It does not go far enough in requiring all O&P suppliers to satisfy certain professional standards of education,integrrity and reliability.Those DME dealers and DMEPOS suppliers are billing improperly for O&P devices.
Are some them members of your association,AOPA.??
It is these unqualified suppliers who are promoting fraud waste and abuse within the medicare system and has resulted in major reductions of medicare reimbursement levels.

In my opinion ,your recent attempt to merely seperate regulations and medicare carrier manual instructions developed for DME from those of professionals of the O&P profession has not been recieved well by HCFA and lawmakers.
You must apply across the board standards to the industry as well.The same standards.

Your commitment in compromise would be appreciated by the profession and the consumer.


Let's get back to basics and propose meaningfull legislation to bring qualification and accountability back to the profession.As a result of the national's office support educating HCFA as to proper L- code reimbursement levels in accordance to degree of customization can be revisted. We might also have a chance at reducing or eliminating
 the proposed O&P Medicare reductions!

Anthony T. Barr
President
The Barr Foundation
www.oandp.com/barr

   ----------

Bob VanHook wrote:

I think I can speak for the AOPA board when I say that we are fully
supportive of ABC certification and accreditation. However, AOPA operates
in a political environment. Just as it has proven difficult for state
licensure advocates to restrict licensure to ABC practitioners, we find
that Congress is reluctant to give exclusive payment status to ABC folks.

This issue is even more complex since Medicare payments are made to
facilities, not practitioners. This is one of the distinguishing features
of this field. This means that the fortunes of the facilities and
professionals are inextricably tied together. It is not an either or
situation. As I have often said, you have to do well to do good. In other
words, the business has to do well before the professionals in the field
can do the good work they are trained to do.

Also, in a former life I ran the National Rural Health Association.
 Scarcity is a fact of life in rural areas. Not every place can have
certified people on staff, that's why ABC set the requirement for having
the care supervised by certified practitioners, and why AOPA supports that
notion.

AOPA is trying to weed out the people that are not remotely qualified to do
custom O&P care -- pharmacist, DME companies, department stores, grocery
stores, etc. Recently, AOPA's legislative counsel suggested a metaphor.
 He said if you have 100 rats eating your grain and you can get rid of 99
of them, isn't that a victory? Politics is the art of compromise. If you
aren't willing to compromise, you will not get even a portion of what you
want. AOPA is committed to pushing the ABC credentials and accreditation
standards and NCOPE's (CAAHEP) educational standards as far as we possibly
can.

Bob Van Hook

On Friday, March 12, 1999 9:41 PM, <Email Address Redacted> [SMTP: <Email Address Redacted> ]
wrote:
> In a message dated 3/12/99 5:18:09 PM Central Standard Time,
> <Email Address Redacted> writes:
>
> << AOPA's draft legislation says that a qualified supplier is an
organization
> accredited by ABC (which requires that care be supervised by an ABC
certified
> practitioner) or other programs
> with standards essentially similar to those of ABC. Alternatively, an
> organization may also qualify for payment if it has a practitioner
licensed by
> the State in which the service is delivered or has at least 10 years
> experience in relevant practice.>>
>
> Thanks for the reply, Bob.
>
> I read this to mean NO to my question. That the AOPA statement means that
> qualified proffesonals includes BOC and others that may have been
> grandfathered in by state licensing.
>
> I think to often those of us in the profession mistakenly assume that
when a
> statement says qualified professionals: we think this only means ABC
> certified practitioners. I read this to mean that AOPA 's statement
supports
> anyone with any kind of qualification to provide O&P services and does
not
> exclusively support ABC whereas full Academy membership is exclusive to
ABC
> certification.
>
> Al Pike, CP
>
>
>
>
>
>