Re: US_Politics
Morris Gallo
Description
Collection
Title:
Re: US_Politics
Creator:
Morris Gallo
Date:
1/13/2000
Text:
Dear Mr. Webber
You ask the question Why would you want to get licensure?, and then use a
wild concoction of unsubstantiated evidence, rants of not being able to exclude
this group or that, and how we must fight for reimbursement to stave off
extinction of the profession.
I will try to address your concerns and misconceptions, but speaking
specifically with reference to our experience in Florida where we have had
licensure for just over two years.
I will begin with your last statement as to the effect of consolidation of
the industry, the effects of competition, and adequate reimbursement. You are
correct in the assertion our reimbursements are being lowered but not because of
your stated reasons. I feel the main cause of the downward slide of
reimbursement has been the eagerness with which many in our field bid for
contracts, not using sound business practices to arrive at a competitive bid
but rather a cutthroat win at any cost mentality. How can someone make a profit
with a bid of 50% of the Medicare UCR? The only way to do this is to use
sub-standard labor and treatment practices. This means hiring a warm body,
giving them a white coat and a few minutes of instruction on how to make sure
reimbursement is achieved, and letting them practice on an unsuspecting public.
Licensure will put an end to this. Consolidation of the industry should not
produce a reduction in reimbursement, but may in fact stabilize or increase
these payments, as the chains grow they can exert a more monopolistic effect on
the bid process. What consolidation will do is to make it more difficult for
the small practitioner to receive bid requests, as they are squeezed out of the
market by the regional contracts. Licensure will insure that everyone treating
patients has a minimum of education and training, thereby equalizing labor costs
for both the chains and the mom and pop's.
Your claim that the PT's, OT's, BOC, Dr's, and WalMart will not be exclude
implies you would be for licensing if they were. Licensing is being instituted
to protect the patient by assuring that everyone practicing P&O has met the
minimum standard determined to be required to practice safely. It is not, nor
should it be, an instrument to exclude one group or give preference to another.
If the Legislature or the appropriate regulatory Boards have determined a group
meets the minimum education and training for safe practice, there is no reason
to prevent them from practicing no matter their credentials.
The statement there is no evidence that a license protects the consumer...
is not only not true, but logically indefensible. Florida Medicaid has
determined the curtailing of fraud and abuse to its programs from the licensing
of P&O practitioners is of such a magnitude they were able to increase benefits
to a whole class of people. Prior to licensing Florida Medicaid funded P&O
only for children. They have now extended coverage to those over 18.
Additionally, the Office of the Inspector General did a study of P&O fraud and
abuse and determined MILLIONS of dollars could be saved by requiring some sort
of certification or registration for practitioners. Logically, how can you
argue that licensing will not protect the consumer? If all practitioners are
forced to prove they have met a minimum standard, then the consumer is assured
of a better chance for proper treatment.
The last part of the quote as the most highly educated are the ones
statistically that are the most fraudulent is really laughable. Show me the
statistics! Do you REALLY mean that the more educated you are the more you are
prone to fraud? If so, which do YOU fall under, less educated or more
fraudulent? Maybe this is why our public schools are dumbing-down our kids,
they are trying to prevent fraud.
In closing, I have not written this to insult or demean you, only to answer
some very common questions and misconceptions. When we were working for
licensure in Florida there were many who made similar comments, several who went
as far as to donate time and money to defeat the proposed law. I recently spoke
with one gentleman who invested many hours traveling to Tallahassee to testify
against the bill, donated substantial money, and helped organize the anti
forces. One of his comments was that it seemed the license law was working out
okay after all! Anytime the status quo is changed we all get apprehensive and
unsure, but if licensure is used as a means to insure that patients receive a
minimal standard of care our profession can only benefit. There will be a few
bumps and curves as the law and rules are developed, but these will be worked
out for the betterment of the patient and profession.
Morris Gallo
.
Paul T Webber wrote:
> Why would you want to get licensure? You are only going to incur more costs
> to you and you patients as the licensing board will not be self supporting
> unless the fee is extravagant. You are not going to be able to exclude PTs
> & OTs. The tax payers, you included, will have to come up with the cost of
> running a licensure board. You won't keep BOC Certifies from getting
> licenses, the grandfather clause is going to include the very people you
> want to exclude, there is no evidence that a license protects the consumer
> as the most highly educated are the ones statistically that are the most
> fraudulent. Wal-mart & other DME outfits are still going to sell OTS type
> stuff. PAs and Docs will still sell orthoses as they are already licensed to
> that most likely. You cannot afford to come up with a test as it costs over
> $150,000 just to support the exam effort per year at least and 1/2 a mil to
> make one up, and who has that amount of time in OHIO, you? If so times must
> be slow for you. You still must pay your dues to the ABC and the Academy I
> would hope. If you have this amount of time and money why don't you
> volunteer at the national level to see if the testing parameters for O&P are
> fair and reasonable and that the consumer or patient is properly cared for?
> What are the advantages of a license? I am a loss to see how it benefits
> anybody. As an employer the costs are going to go up as the license cost
> must be born by someone, and how are you going to get new practitioners in
> your state. I have the choice to work in a state without a license or one
> where I have to pay a license fee on top of my national dues, unless I am
> missing something wonderful in Ohio my choice economically is pretty easy to
> make. That makes your pool of candidates smaller and hence more expensive
> in an era where reimbursements are going down. I would like this license
> effort to be spent on getting the whole field reimbursed at a reasonable
> level, that is the main fight we need not license lets band together to see
> if we can save this field from extinction with only the national chains
> providing service and then being able to call the shots when it comes to
> the Mom & Pop provider, and contracts, without the competition the ability
> to control reimbursement rates climbs. Their ability to control our
> national office and our representative organization climbs as well. I am
> not fearful of their influence yet but I see that they are growing stronger
> in their influence in out national offices.
> Paul <Email Address Redacted>
> ----- Original Message -----
> From: < <Email Address Redacted> >
> To: < <Email Address Redacted> >
> Sent: Wednesday, January 12, 2000 4:14 PM
> Subject: US_Politics
>
> > I am happy to announce that Ohio House Bill 238, A Licensure Bill for
> > Orthotists, Prosthetists and Pedorthitists, was introduced to the Ohio
> Senate
> > today by Senator Doug White.
> > Thanks to all the Ohio O&P practitioners who have assisted in this effort
> to
> > date with both sweat and dollars. With a little luck, (and a few more
> bucks)
> > the bill should become law by June of this year.
> > Ron Kidd, CPO
> > Columbus, Ohio
> >
> >
You ask the question Why would you want to get licensure?, and then use a
wild concoction of unsubstantiated evidence, rants of not being able to exclude
this group or that, and how we must fight for reimbursement to stave off
extinction of the profession.
I will try to address your concerns and misconceptions, but speaking
specifically with reference to our experience in Florida where we have had
licensure for just over two years.
I will begin with your last statement as to the effect of consolidation of
the industry, the effects of competition, and adequate reimbursement. You are
correct in the assertion our reimbursements are being lowered but not because of
your stated reasons. I feel the main cause of the downward slide of
reimbursement has been the eagerness with which many in our field bid for
contracts, not using sound business practices to arrive at a competitive bid
but rather a cutthroat win at any cost mentality. How can someone make a profit
with a bid of 50% of the Medicare UCR? The only way to do this is to use
sub-standard labor and treatment practices. This means hiring a warm body,
giving them a white coat and a few minutes of instruction on how to make sure
reimbursement is achieved, and letting them practice on an unsuspecting public.
Licensure will put an end to this. Consolidation of the industry should not
produce a reduction in reimbursement, but may in fact stabilize or increase
these payments, as the chains grow they can exert a more monopolistic effect on
the bid process. What consolidation will do is to make it more difficult for
the small practitioner to receive bid requests, as they are squeezed out of the
market by the regional contracts. Licensure will insure that everyone treating
patients has a minimum of education and training, thereby equalizing labor costs
for both the chains and the mom and pop's.
Your claim that the PT's, OT's, BOC, Dr's, and WalMart will not be exclude
implies you would be for licensing if they were. Licensing is being instituted
to protect the patient by assuring that everyone practicing P&O has met the
minimum standard determined to be required to practice safely. It is not, nor
should it be, an instrument to exclude one group or give preference to another.
If the Legislature or the appropriate regulatory Boards have determined a group
meets the minimum education and training for safe practice, there is no reason
to prevent them from practicing no matter their credentials.
The statement there is no evidence that a license protects the consumer...
is not only not true, but logically indefensible. Florida Medicaid has
determined the curtailing of fraud and abuse to its programs from the licensing
of P&O practitioners is of such a magnitude they were able to increase benefits
to a whole class of people. Prior to licensing Florida Medicaid funded P&O
only for children. They have now extended coverage to those over 18.
Additionally, the Office of the Inspector General did a study of P&O fraud and
abuse and determined MILLIONS of dollars could be saved by requiring some sort
of certification or registration for practitioners. Logically, how can you
argue that licensing will not protect the consumer? If all practitioners are
forced to prove they have met a minimum standard, then the consumer is assured
of a better chance for proper treatment.
The last part of the quote as the most highly educated are the ones
statistically that are the most fraudulent is really laughable. Show me the
statistics! Do you REALLY mean that the more educated you are the more you are
prone to fraud? If so, which do YOU fall under, less educated or more
fraudulent? Maybe this is why our public schools are dumbing-down our kids,
they are trying to prevent fraud.
In closing, I have not written this to insult or demean you, only to answer
some very common questions and misconceptions. When we were working for
licensure in Florida there were many who made similar comments, several who went
as far as to donate time and money to defeat the proposed law. I recently spoke
with one gentleman who invested many hours traveling to Tallahassee to testify
against the bill, donated substantial money, and helped organize the anti
forces. One of his comments was that it seemed the license law was working out
okay after all! Anytime the status quo is changed we all get apprehensive and
unsure, but if licensure is used as a means to insure that patients receive a
minimal standard of care our profession can only benefit. There will be a few
bumps and curves as the law and rules are developed, but these will be worked
out for the betterment of the patient and profession.
Morris Gallo
.
Paul T Webber wrote:
> Why would you want to get licensure? You are only going to incur more costs
> to you and you patients as the licensing board will not be self supporting
> unless the fee is extravagant. You are not going to be able to exclude PTs
> & OTs. The tax payers, you included, will have to come up with the cost of
> running a licensure board. You won't keep BOC Certifies from getting
> licenses, the grandfather clause is going to include the very people you
> want to exclude, there is no evidence that a license protects the consumer
> as the most highly educated are the ones statistically that are the most
> fraudulent. Wal-mart & other DME outfits are still going to sell OTS type
> stuff. PAs and Docs will still sell orthoses as they are already licensed to
> that most likely. You cannot afford to come up with a test as it costs over
> $150,000 just to support the exam effort per year at least and 1/2 a mil to
> make one up, and who has that amount of time in OHIO, you? If so times must
> be slow for you. You still must pay your dues to the ABC and the Academy I
> would hope. If you have this amount of time and money why don't you
> volunteer at the national level to see if the testing parameters for O&P are
> fair and reasonable and that the consumer or patient is properly cared for?
> What are the advantages of a license? I am a loss to see how it benefits
> anybody. As an employer the costs are going to go up as the license cost
> must be born by someone, and how are you going to get new practitioners in
> your state. I have the choice to work in a state without a license or one
> where I have to pay a license fee on top of my national dues, unless I am
> missing something wonderful in Ohio my choice economically is pretty easy to
> make. That makes your pool of candidates smaller and hence more expensive
> in an era where reimbursements are going down. I would like this license
> effort to be spent on getting the whole field reimbursed at a reasonable
> level, that is the main fight we need not license lets band together to see
> if we can save this field from extinction with only the national chains
> providing service and then being able to call the shots when it comes to
> the Mom & Pop provider, and contracts, without the competition the ability
> to control reimbursement rates climbs. Their ability to control our
> national office and our representative organization climbs as well. I am
> not fearful of their influence yet but I see that they are growing stronger
> in their influence in out national offices.
> Paul <Email Address Redacted>
> ----- Original Message -----
> From: < <Email Address Redacted> >
> To: < <Email Address Redacted> >
> Sent: Wednesday, January 12, 2000 4:14 PM
> Subject: US_Politics
>
> > I am happy to announce that Ohio House Bill 238, A Licensure Bill for
> > Orthotists, Prosthetists and Pedorthitists, was introduced to the Ohio
> Senate
> > today by Senator Doug White.
> > Thanks to all the Ohio O&P practitioners who have assisted in this effort
> to
> > date with both sweat and dollars. With a little luck, (and a few more
> bucks)
> > the bill should become law by June of this year.
> > Ron Kidd, CPO
> > Columbus, Ohio
> >
> >
Citation
Morris Gallo, “Re: US_Politics,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/213579.
