Re: What we think of ourselves as Practitioners
tony barr
Description
Collection
Title:
Re: What we think of ourselves as Practitioners
Creator:
tony barr
Date:
1/27/2005
Text:
The on going issues Jan and Joyce have described are national and growing
under the umbrella of DURABLE MEDICAL EQUIPMENT COMPETITIVE BIDDING PROCESS.
The national O&P trade industry will not intervene to help you with this
encroachment, as it continues to have conflicts in representing the business
and financial interests of both DME and O&P manufactures and provdiers whom
are both dues paying members.
The overlapping of govt. relations representation, delegated by your
national 'professional organization for the industry to represent the
professional issues and DME interests, two distinquivetly health product and
service lines, adds to the dillima your profession continues and will
face.
The O&P profession will continued to be painted with the broad brush of
fraud and abuse and DME as long as one national trade industry represents
the interests of both.
How to Handle the Situation:
Express your concerns to the NEW Academy and its leadership that you
expect action from them as your national professional association of O&P
providers and to the below Advisory members.
Of course it doesnt help your cause to have the founder and CEO of DeRoyal
Industries, Pete DeBusk, longtime member of the supplier community, was
recently named for his second three-year term as a member of the Medicare
Payment Advisory Commission (MedPAC) by General David Walker, comptroller of
the General Accounting Office.
DeBusk:
I believe orthopedics is becoming a science instead of a craft. By that I
mean that braces and supports are more high tech than ever, more modular,
using all kinds of technology to measure and fit the device as well as newer
materials for patients who, quite frankly, need well-fitting orthotic
devices for longer periods of time. This is creating a new dynamic in our
marketplace, a new opportunity where we can elevate care for patients by
using newer, more modular bracing systems instead of older, very expensive,
custom-molded products.
See more:
<URL Redacted>
MEDICARE NEWS
FOR IMMEDIATE RELEASE
CMS Office of External Affairs
September 24, 2004
MEDICARE APPOINTS ADVISORY PANEL FOR NEW DURABLE MEDICAL EQUIPMENT
COMPETITIVE BIDDING PROCESS
The Centers for Medicare & Medicaid Services today announced the appointment
of a committee to advise the agency about the implementation of competitive
bidding for certain supplies and equipment provided to Medicare
beneficiaries, and about establishing standards for suppliers who want to
participate in the Medicare program.
Medicare anticipates that beneficiaries will have access to higher quality
at lower prices when it adopts a competitive bidding model for certain
durable medical equipment, prosthetics, orthotics, and supplies (also
referred to as DMEPOS). Because the beneficiary pays 20 percent of the
costs of these products and Medicare pays 80 percent, lower prices will help
both beneficiary and taxpayer.
We all want seniors and disabled individuals to have access to quality
health care at the best possible price, says CMS Administrator Mark B.
McClellan. This committee will help us get the process right.
The Medicare Modernization Act (MMA) requires CMS to make competitive
bidding a permanent part of Medicare. CMS demonstration projects in Florida
and Texas, involving such items as oxygen, hospital beds, manual wheelchairs
and simple orthotics, showed price reductions on average of 20 percent. The
MMA requires the new competitive bidding process to be phased in over a
period of years, beginning in 2007 in ten of the largest Metropolitan
Statistical Areas.
The advisory committee membership represents a broad range of stakeholders
in the outcome of the competitive bidding process:
beneficiary/consumer, physician/provider, manufacturer, supplier,
certification/standards, and federal and state programs. This committee
will ensure that CMS maintains an open communication process during the
implementation of this new program. Specifically, the committee will be
advising CMS on implementation of competitive bidding, beneficiary access
issues, appropriate educational strategies, and financial and quality
standards for suppliers under the program.
The committee is scheduled to hold its first meeting on Oct. 6 at CMS
headquarters in Baltimore. It will meet periodically until the end of 2009.
A list of the committee members is attached.
# # #
1. ATTACHMENT
COMPETITIVE BIDDING PROGRAM ADVISORY AND OVERSIGHT COMMITTEE MEMBERSHIP
ROSTER
1. Cara Bachenheimer - Vice President of Government Relations,
Invacare Corporation.
2. Robert Baum - Program Manager for the Prosthetic and Sensory
Aids Service, Strategic Healthcare Group, Veterans Health Administration
(VA) Central office, Washington, DC.
3. Mary Benhardus - Founder and controlling owner, Handi Medical
Supply Inc.
4. Henry Claypool - Expert adviser to Social Security
Administration's Deputy Commissioner to advise on Interim Medical Benefits
5. Asela Cuervo - Senior Vice President, American Association for
Homecare.
6. David Gray - Associate Professor of Neurology and Associate
Professor of Occupational Therapy, Washington University School of Medicine.
7. Don Hawley, D.D.S. - Program Director, Utah Department of
Health, Division of Utah Health Care Financing.
8. Lawrence Higby - President and CFO, Apria Healthcare.
9. Rita Hostak - Vice President, Home Healthcare Group of Sunrise
Medical Inc.
10. Dave Kazynski - President, Van G. Miller & Associates's
HOMELINK division.
11. Anthony Filippis - President and CEO, Wright & Filippis.
Practicing certified prosthetist/orthotist.
12. Alan McMullen - Cost Reimbursement Analyst, Medical Assistance
Administration, Department of Social & Health Services, State of Washington.
13. Jean Minkel - Founder and President, Minkel Consulting.
Specializes in Assistive technology.
14. William Popomaronis - Vice President, Long-Term/Home Health
Care Pharmacy Services, The National Community Pharmacists Association
(NCPA).
15. Maryanne Popovich - Executive Director, Joint Commission on
Accreditation of Healthcare Organizations (JCAHO).
16. John Prassas - Director, Corporate Provider Development &
Contracting, PacifiCare Health Plans.
17. Chris Reisdorf - Manager, Benefit Policy Unit - Minnesota
Health Care Programs - Medical Assistance, General Assistance Medical Care,
and Minnesota Care programs.
18. David Van Sleet - VISN 1 Prosthetics Manager, Department of
Veterans Affairs, New England Healthcare System.
19. Ken Viste, M.D. - Medical Director, Physical Rehabilitation
Unit Mercy Medical Center and Staff Physician, St. Agnes Hospital.
20. Don Vliegenthart. M.D. - Medical Director, Hoveround
Corporation.
Daniel Waldmann- Director of Federal Affairs, Johnson & Johnson, Inc.
-----Original Message-----
From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>] On
Behalf Of Joyce Perrone
Sent: Thursday, January 27, 2005 7:55 AM
To: <Email Address Redacted>
Subject: [OANDP-L] What we think of ourselves as Practitioners
Jan - can you share w/ the list how you handled the situation? Did you just
not bid - or did you put in writing to the correct people why you did not
bid and what the flaws were in their thinking and pathways from a
scientifically proven aspect of patient safety ? I agree with you and get
extremely frustrated. It is important to always take the high road and
understand what the hospital is trying to do and do our best to help them do
the right thing for the patient first. It takes time and energy which I find
most practitioners do not have due the demands of seeing patients. Many
just take the easy road and try to be sly or cunning to get the deal and
then make up codes, add codes, whatever - on the backend. We all need to
approach the right people in the hospitals and educate them the best we
can-politely, energetically, helpfully - and do what we can to save them
money. They are crunched financially as are we - with Medicare/Medicaid
cuts and it is not getting better. So be encouraged and inspired to learn
what you can about them (Seek first to
understand) and how you can work with them. A very lofty but hopeful
article is A Theory of Leadership for the Transformation for Health Care
Organizations. I have it as a Word doc. If anyone is interested, just email
me and I'll be happy to send it to you. I believe that a lot of the 'cheap
is best' style of running a hospital will bury the bad ones in time and the
quality organizations that do not kill people with their accidents and
errors will rise up. I want to be aligned with the good guys. -JP
Joyce J. Perrone
De La Torre O&P, Inc and Promise Consulting 300 Alpha Drive Pittsburgh PA
15238
ph: 412-599-1112 fax: 412-599-1130
Date: Tue, 25 Jan 2005 18:36:49 EST
From: Saunders, Jan CPO < <Email Address Redacted> >
Subject: What we think of ourselves as Practitioners
I want to relate to all of you a scenario, we have a Hospital chain in
Florida which has 7 smaller hospitals it owns. They asked us all to submit
bids to come into there hospitals fit there patients within 3.5 hrs of the
called in order. All of the LSO/TLSO are stocked in a deal Deroyal has made
with the hospital, the problem is the hospital doesn't have any licensed
practitioners on staff, so they need licensed practitioners in Florida they
do over 350 LSO/TLSO's per year and they are asking us to bid on this
contract, to accept the liability, respond in 3.5 hrs without paying us for
our call, time, or responsibility and to my amazement 2 companies accepted
this deal.
What is wrong with us, do we have so little respect for our time, knowledge,
and education? When are we going to stand up and say NO! Our profession is
in the worst times there have been in 32 years I have be in practice, the
Manufactures are cutting us out, competing against us.... And yet we still
support them. If we don't start to learn to say no to unreasonable DEALS it
will be our demise as a profession. Don't wait for your national
organizations to help you as they are feed off of the advertising money from
the manufactures and they are not going to do anything to create a drop in
revenue. PAY ATTENTION IT IS YOUR PROFESSION, STOP SITTING ON THE SIDELINES
AND GET
INVOLVED, NOW, TODAY! DO SOMETHING TO STOP THE DEMISE OF OUR
PROFESSION.
Greatly concerned;
Jan Saunders CPO ,LPO
-
********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.
under the umbrella of DURABLE MEDICAL EQUIPMENT COMPETITIVE BIDDING PROCESS.
The national O&P trade industry will not intervene to help you with this
encroachment, as it continues to have conflicts in representing the business
and financial interests of both DME and O&P manufactures and provdiers whom
are both dues paying members.
The overlapping of govt. relations representation, delegated by your
national 'professional organization for the industry to represent the
professional issues and DME interests, two distinquivetly health product and
service lines, adds to the dillima your profession continues and will
face.
The O&P profession will continued to be painted with the broad brush of
fraud and abuse and DME as long as one national trade industry represents
the interests of both.
How to Handle the Situation:
Express your concerns to the NEW Academy and its leadership that you
expect action from them as your national professional association of O&P
providers and to the below Advisory members.
Of course it doesnt help your cause to have the founder and CEO of DeRoyal
Industries, Pete DeBusk, longtime member of the supplier community, was
recently named for his second three-year term as a member of the Medicare
Payment Advisory Commission (MedPAC) by General David Walker, comptroller of
the General Accounting Office.
DeBusk:
I believe orthopedics is becoming a science instead of a craft. By that I
mean that braces and supports are more high tech than ever, more modular,
using all kinds of technology to measure and fit the device as well as newer
materials for patients who, quite frankly, need well-fitting orthotic
devices for longer periods of time. This is creating a new dynamic in our
marketplace, a new opportunity where we can elevate care for patients by
using newer, more modular bracing systems instead of older, very expensive,
custom-molded products.
See more:
<URL Redacted>
MEDICARE NEWS
FOR IMMEDIATE RELEASE
CMS Office of External Affairs
September 24, 2004
MEDICARE APPOINTS ADVISORY PANEL FOR NEW DURABLE MEDICAL EQUIPMENT
COMPETITIVE BIDDING PROCESS
The Centers for Medicare & Medicaid Services today announced the appointment
of a committee to advise the agency about the implementation of competitive
bidding for certain supplies and equipment provided to Medicare
beneficiaries, and about establishing standards for suppliers who want to
participate in the Medicare program.
Medicare anticipates that beneficiaries will have access to higher quality
at lower prices when it adopts a competitive bidding model for certain
durable medical equipment, prosthetics, orthotics, and supplies (also
referred to as DMEPOS). Because the beneficiary pays 20 percent of the
costs of these products and Medicare pays 80 percent, lower prices will help
both beneficiary and taxpayer.
We all want seniors and disabled individuals to have access to quality
health care at the best possible price, says CMS Administrator Mark B.
McClellan. This committee will help us get the process right.
The Medicare Modernization Act (MMA) requires CMS to make competitive
bidding a permanent part of Medicare. CMS demonstration projects in Florida
and Texas, involving such items as oxygen, hospital beds, manual wheelchairs
and simple orthotics, showed price reductions on average of 20 percent. The
MMA requires the new competitive bidding process to be phased in over a
period of years, beginning in 2007 in ten of the largest Metropolitan
Statistical Areas.
The advisory committee membership represents a broad range of stakeholders
in the outcome of the competitive bidding process:
beneficiary/consumer, physician/provider, manufacturer, supplier,
certification/standards, and federal and state programs. This committee
will ensure that CMS maintains an open communication process during the
implementation of this new program. Specifically, the committee will be
advising CMS on implementation of competitive bidding, beneficiary access
issues, appropriate educational strategies, and financial and quality
standards for suppliers under the program.
The committee is scheduled to hold its first meeting on Oct. 6 at CMS
headquarters in Baltimore. It will meet periodically until the end of 2009.
A list of the committee members is attached.
# # #
1. ATTACHMENT
COMPETITIVE BIDDING PROGRAM ADVISORY AND OVERSIGHT COMMITTEE MEMBERSHIP
ROSTER
1. Cara Bachenheimer - Vice President of Government Relations,
Invacare Corporation.
2. Robert Baum - Program Manager for the Prosthetic and Sensory
Aids Service, Strategic Healthcare Group, Veterans Health Administration
(VA) Central office, Washington, DC.
3. Mary Benhardus - Founder and controlling owner, Handi Medical
Supply Inc.
4. Henry Claypool - Expert adviser to Social Security
Administration's Deputy Commissioner to advise on Interim Medical Benefits
5. Asela Cuervo - Senior Vice President, American Association for
Homecare.
6. David Gray - Associate Professor of Neurology and Associate
Professor of Occupational Therapy, Washington University School of Medicine.
7. Don Hawley, D.D.S. - Program Director, Utah Department of
Health, Division of Utah Health Care Financing.
8. Lawrence Higby - President and CFO, Apria Healthcare.
9. Rita Hostak - Vice President, Home Healthcare Group of Sunrise
Medical Inc.
10. Dave Kazynski - President, Van G. Miller & Associates's
HOMELINK division.
11. Anthony Filippis - President and CEO, Wright & Filippis.
Practicing certified prosthetist/orthotist.
12. Alan McMullen - Cost Reimbursement Analyst, Medical Assistance
Administration, Department of Social & Health Services, State of Washington.
13. Jean Minkel - Founder and President, Minkel Consulting.
Specializes in Assistive technology.
14. William Popomaronis - Vice President, Long-Term/Home Health
Care Pharmacy Services, The National Community Pharmacists Association
(NCPA).
15. Maryanne Popovich - Executive Director, Joint Commission on
Accreditation of Healthcare Organizations (JCAHO).
16. John Prassas - Director, Corporate Provider Development &
Contracting, PacifiCare Health Plans.
17. Chris Reisdorf - Manager, Benefit Policy Unit - Minnesota
Health Care Programs - Medical Assistance, General Assistance Medical Care,
and Minnesota Care programs.
18. David Van Sleet - VISN 1 Prosthetics Manager, Department of
Veterans Affairs, New England Healthcare System.
19. Ken Viste, M.D. - Medical Director, Physical Rehabilitation
Unit Mercy Medical Center and Staff Physician, St. Agnes Hospital.
20. Don Vliegenthart. M.D. - Medical Director, Hoveround
Corporation.
Daniel Waldmann- Director of Federal Affairs, Johnson & Johnson, Inc.
-----Original Message-----
From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>] On
Behalf Of Joyce Perrone
Sent: Thursday, January 27, 2005 7:55 AM
To: <Email Address Redacted>
Subject: [OANDP-L] What we think of ourselves as Practitioners
Jan - can you share w/ the list how you handled the situation? Did you just
not bid - or did you put in writing to the correct people why you did not
bid and what the flaws were in their thinking and pathways from a
scientifically proven aspect of patient safety ? I agree with you and get
extremely frustrated. It is important to always take the high road and
understand what the hospital is trying to do and do our best to help them do
the right thing for the patient first. It takes time and energy which I find
most practitioners do not have due the demands of seeing patients. Many
just take the easy road and try to be sly or cunning to get the deal and
then make up codes, add codes, whatever - on the backend. We all need to
approach the right people in the hospitals and educate them the best we
can-politely, energetically, helpfully - and do what we can to save them
money. They are crunched financially as are we - with Medicare/Medicaid
cuts and it is not getting better. So be encouraged and inspired to learn
what you can about them (Seek first to
understand) and how you can work with them. A very lofty but hopeful
article is A Theory of Leadership for the Transformation for Health Care
Organizations. I have it as a Word doc. If anyone is interested, just email
me and I'll be happy to send it to you. I believe that a lot of the 'cheap
is best' style of running a hospital will bury the bad ones in time and the
quality organizations that do not kill people with their accidents and
errors will rise up. I want to be aligned with the good guys. -JP
Joyce J. Perrone
De La Torre O&P, Inc and Promise Consulting 300 Alpha Drive Pittsburgh PA
15238
ph: 412-599-1112 fax: 412-599-1130
Date: Tue, 25 Jan 2005 18:36:49 EST
From: Saunders, Jan CPO < <Email Address Redacted> >
Subject: What we think of ourselves as Practitioners
I want to relate to all of you a scenario, we have a Hospital chain in
Florida which has 7 smaller hospitals it owns. They asked us all to submit
bids to come into there hospitals fit there patients within 3.5 hrs of the
called in order. All of the LSO/TLSO are stocked in a deal Deroyal has made
with the hospital, the problem is the hospital doesn't have any licensed
practitioners on staff, so they need licensed practitioners in Florida they
do over 350 LSO/TLSO's per year and they are asking us to bid on this
contract, to accept the liability, respond in 3.5 hrs without paying us for
our call, time, or responsibility and to my amazement 2 companies accepted
this deal.
What is wrong with us, do we have so little respect for our time, knowledge,
and education? When are we going to stand up and say NO! Our profession is
in the worst times there have been in 32 years I have be in practice, the
Manufactures are cutting us out, competing against us.... And yet we still
support them. If we don't start to learn to say no to unreasonable DEALS it
will be our demise as a profession. Don't wait for your national
organizations to help you as they are feed off of the advertising money from
the manufactures and they are not going to do anything to create a drop in
revenue. PAY ATTENTION IT IS YOUR PROFESSION, STOP SITTING ON THE SIDELINES
AND GET
INVOLVED, NOW, TODAY! DO SOMETHING TO STOP THE DEMISE OF OUR
PROFESSION.
Greatly concerned;
Jan Saunders CPO ,LPO
-
********************
To unsubscribe, send a message to: <Email Address Redacted> with
the words UNSUB OANDP-L in the body of the
message.
If you have a problem unsubscribing,or have other
questions, send e-mail to the moderator
Paul E. Prusakowski,CPO at <Email Address Redacted>
OANDP-L is a forum for the discussion of topics
related to Orthotics and Prosthetics.
Public commercial postings are forbidden. Responses to inquiries
should not be sent to the entire oandp-l list. Professional credentials
or affiliations should be used in all communications.
Citation
tony barr, “Re: What we think of ourselves as Practitioners,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/224239.
