Re: ABC and BOC Letter of Explaination on Suspended Negotiations

Re: ABC and BOC Letter of Explaination on Suspended Negotiations

Karl Lindborg CPO

3/10/2004

-----Original Message-----
From: Lindborg, Karl
Sent: Wednesday, March 10, 2004 2:13 PM
To: <Email Address Redacted>
Subject: ABC and BOC Letter of Explaination on Suspended Negotiations



With discussion regarding the Suspension of ABC/B0C Negotiations on the O&P
List, I have not seen a posting of the official Suspension of ABC/BOC
Negotiations letters from either of these agencies for us to reference. It
seems only appropriate to post the actual letters provided by ABC and BOC.
The following are what was on each of these agencies web page.

I find that the BOC letter provides a bit more information for the reader to
get an idea of why things broke down and would urge ABC to provide more
information for the reader to assess where ABC stands.

Karl J. Lindborg CPO





Copy of ABC Letter found at their web site:

ABC believes that the future of the orthotics and prosthetics profession
depends on unity. With an uncertain healthcare environment, continuing
changes in Medicare's payment policies, and competition from outside, less
qualified health professionals, the O&P profession needs the strength,
voice, and recognition of a single certification board.

Efforts initiated last fall to unify the American Board for Certification
and the Board for Orthotist/Prosthetist Certification through negotiations
have proven unsuccessful. This regretful announcement leaves our profession
divided, our patients confused, and our referral sources and regulatory
bodies unclear on the qualifications of providing O&P care.

Both organizations agree that the long term benefits to unification are
overwhelmingly positive. As a result of action by legislative bodies and
numerous third party payors who make no distinction between us, a 'leveling
of the playing field' has occurred between the ABC and BOC. It is now time
for O&P practitioners to accept our alternative certifications as equal, and
move forward together to protect our patients and our profession.

As of March 5, 2004, ABC is inviting all BOC orthotist/prosthetists in good
standing to become ABC Certified Practitioners, with all associated rights
and privileges.

We understand that these actions do not immediately bring about the complete
unification of our profession. However, with the addition of large numbers
of qualified practitioners to the ranks of ABC certified practitioners, we
believe that our certification board is strengthened, and thus closer to the
goal of establishing one single certification body, recognized as such by
the entire medical community. ABC continues to look forward to the day in
which all professional providing O&P patient care are educated, trained, and
certified by one set of standards. We believe that the actions undertaken
today are an important step towards this goal.




Copy of BOC Letter found at their web site:

Orthotics and Prosthetics Certifying Agencies Suspend Unification
Negotiations after ABC Cancels Joint ABC/BOC Board Meeting

The ABC Board of Directors abruptly cancelled a meeting with the BOC Board
of Directors scheduled for March 5, 2003 leading to the suspension of
negotiations for the present. Contrary to expectations of many in the
profession, vital differences exist between the Board for
Orthotist/Prosthetist Certification (BOC) and the American Board for
Certification in Orthotics and Prosthetics (ABC), which came into sharp
focus during the frequent negotiation sessions that began in earnest on
January 12, 2004 in Baltimore, Maryland.

ABC initiated unification talks, stating it had an interest in promoting a
single set of standards for qualified O&P practitioners, [so that] both the
profession and our patients will benefit. BOC certainly agreed with the
sentiment of this statement. However, as talks progressed, it became
apparent that ABC desired an unconditional takeover of BOC, requiring BOC to
abandon much of what has been most valuable to the public health and
certification process. BOC was especially concerned that too many
non-credentialed persons were being used almost universally as extenders for
the certified practitioners. Under the ABC scenario, most would never be
eligible to become certified even though permitted to practice under the
delegated authority of their employer.

BOC believes that any person who provides direct patient care should be
either certified or be in training for certification under the direct
supervision of a credentialed professional.

Core principles, such as this, maintain an exceptionally high professional
standard and are vital to protecting the public interest. BOC will continue
to move forward to uphold the principles that have made it the profession's
standard of excellence. The dramatic growth of BOC's certificant base is
evidence of the profession's determination to keep more than one path open
to certification, ensure the proper certification of all levels of O & P
practitioners (including orthotic and mastectomy fitters), and maintain the
public trust it has achieved.

Some of the key issues that led to talks breaking off are:

1. The ABC Board of Directors elects its own successors and as such is
subject to no oversight or review. In contrast, the BOC Board is elected
from and by the BOC certificant body. ABC refused to consider BOC's system
of democratic governance. In addition, ABC demanded they have majority on
any new, reconstituted board.

FACT: As certifying agencies, neither ABC nor BOC, has members in the
sense that professional and trade associations do. Thus, certificants
cannot vote on specific governance or other certification issues. ABC has
used this fact as the basis for prohibiting its certificants from voting for
its Board of Directors (BOD), the policy-making entity that controls the
entire form and structure of the organization. Thus, there is no oversight
or review process for the ABC Board's actions. BOC, to the contrary,
recognizes the right of the certificant body to elect its Board directly.
ABC insisted on continuing its system of board self-selection, which would
deprive BOC-certified practitioners of the fair representation they have
now, and would ensure the current ABC system of entrenched board member
control. In fact, claiming it was older, ABC wanted a numerical majority
of ABC certificants on the newly constituted Board. Further, ABC does not
consider Certified Orthotic Fitters (COF) or Certified Mastectomy Fitters
(CMF) to be practitioners and therefore ineligible for Board membership.
BOC recognizes that every certificant class (including COF/CMF) must be
represented on the Board.

2. ABC's certification requirements are not adequate to serve current and
especially future patient needs.

FACT: Although ABC claims it has the profession's most rigorous educational
requirements for certification (i.e., Gold Standard) there are not
sufficient NCOPE accredited programs to meet growing patient demand. ABC's
response to this shortfall of certificants has been to promote a
privileging system that allows non-certified persons (i.e., extenders),
trained by their employers or supervisors, to treat patients with minimum to
no supervision. Moreover, ABC has created an alternate certification
pathway, Unique Qualification, that permits ten years of patient care
experience before even becoming eligible to apply for certification.

BOC believes that people who have been immersed in the practice of orthotics
and/or prosthetics for years, providing direct patient care, should not only
be permitted to apply for certification, but, at some point should be
required to, as a condition to continue to practice.

BOC's recognizes that competence is measured ultimately by a demonstrated
ability to meet rigorous performance standards. BOC is resolved that
comprehensive, objectively developed examinations and periodic
re-certifications are the proper standards for measuring and maintaining
competency.


3. ABC hedged with respect to assuring equal standing of BOC and ABC.

FACT: Both ABC and BOC share similar missions of credentialing professionals
and accrediting facilities, and have achieved equal status in the eyes of
the Congress of the United States, the Centers for Medicare/Medicaid
Services (CMS), the Department of Veterans Affairs, most insurance
companies, as well as prescribers and and their patients. The National
Commission for Certifying Agencies (NCCA) accredits both BOC and ABC
certification programs. Despite this parity, there was no guarantee in
unification talks to ensure the survival of current BOC pathways. Further,
in the discussions, ABC was unwilling to give equal consideration to the use
of BOC's more efficient certification examinations processes.

BOC philosophies are maintained so that patients and physicians can place
their confidence in its certifications and will have access to comprehensive
and safe orthotic, prosthetic and habilitative services. Given its serious
philosophical differences with ABC, BOC has chosen to continue its
independent status, protecting the certification process, and the BOC
representational form of governance. Stay tuned for continuing
developments.