US_Politics

US_Politics

Morris Gallo

10/2/1999

I have been informed by Mr. Tony Barr that the Wexler bill will have a
technical amendment to change the qualifications standards to CAAHEP. I
have attached a new comparison chart detailing this change.

Mr. VanHook and Mr. Schumann have both addressed the list server
advising us to not instigate or propagate controversy. I believe they
are correct. Attacking either of the pending bills only weakens their
positions. For anything to become law BOTH the House and Senate must
pass similar bills. It is my opinion we should be writing and phoning
our Representatives and Senators, giving them reasons to consider this
type legislation and educating them as to the salient reasons the
legislation is needed. You may have noticed I didn't include Email.
Because of the ease of sending mass mailings I think most politicians
tend to ignore this form of communication. It still takes effort to
move a mountain. Write a letter, send a fax, and call your
legislators. You should also inform your patients of the pending bills,
they will be the ultimate beneficiaries and should be involved in
helping to get something passed.

In reading both bills I am struck by how though they at first seem
similar, are addressing totally different problems. I interpret the
Harkin bill as an effort to protect the government's purse by certifying
providers of certain types of services and products, while the Wexler
bill intends to protect patients from unqualified practitioners by
requiring educational and training standards to participate in
government funded programs. This is further exemplified by Harkin's
certifying of facilities while Wexler only addresses practitioners.

Currently there are laws and regulations which make fraudulent and
improper billing illegal, but enforcement is difficult because of the
ease of obtaining a supplier number and the lack of standards as to who
should be able to treat and bill for O&P services. Passing another law
which will allow untrained individuals to treat and bill will not solve
the problem. Making individual practitioners accountable for both the
treatment and billing will help eliminate those companies and
individuals cited in the Inspector General's report as being fraudulent
and abusive billers of Medicare and Medicaid. And, more importantly
will provide patients with some assurance they are being treated by
qualified practitioners.

I have read comments of how making too many requirements will be
considered anti-trust or put the Federal government into the
licensing business. By making CAAHEP standards the requirements for
payment participation there is no limit as to who may participate, so
anti-trust should not a factor. Any organization may adopt CAAHEP
standards and certify their members, it is not limited to ABC.
Currently the government requires hospitals and physicians to meet
certain minimum standards before they may seek federal payments, they
are not licensing these providers only ascertaining that they have the
appropriate skills to furnish the service. As someone who is adamant
about States Rights I to would object to a Federal license scheme. I
believe it is both proper and prudent for the Feds to make stipulations
of providers who are seeking Federal money. It is up to each individual
state to license their practitioners.

Remember, CAAHEP standards are the MINIMUM education and training deemed
necessary to safely treat patients. These are not High Standards, but
are rather the minimum considered safe. Grandfather provisions
addresses the situation of existing practitioners who may not meet these
minimum standards, so the argument of not implementing standards because
many existing practitioners cannot meet them is bogus.

I urge all members of the O&P profession to lobby their legislators to
consider the protection of the disabled as well as the protection of the
public purse by passing legislation which adopts CAAHEP as the minimal
standards for inclusion in the Medicare program.

Morris Gallo