FW: [OANDP-L] Qualified Provider
tony barr
Description
Collection
Title:
FW: [OANDP-L] Qualified Provider
Creator:
tony barr
Date:
1/31/2005
Text:
For those of you who have not received this information yet from Medicare.
On January 21, 2005 Medicare released alert regarding who is a qualified
provider, earlier they have put in specialty codes for only prosthetist and
orthotist who are certified now with this new realse they have made PT, PT
and Physician as qualified provider to provide custom prosthetics and
orthotics.
Link:
<URL Redacted>
56F95004DD192?OpenDocument
Ashish Doshi, CPO, FAAOP
So You Want the Truth?
The national trade industry association, AOPA, remains in control of
provider qualification criteria , and pricing policies.
Although making artifical pretenses to better assure the Academy and its
members they are looking out for their interests, AOPA is backing any
legislation for expansion of as many providers as possible that would
lead to more buyers (however qualified, or not ) to purchase their products.
The patient looses in not having guarantees of qualification of whom is
qualified and whom is not.
One positive note is that at least PTs and OTs are required to have a state
license and subject to loosing a license in every state to provide O&P
services in and prosthetists and orthotists are only licensed in 10 states!
Perhaps the talents of O&P providers is not worthy of having a license ?
Go figure?
Read : <URL Redacted>
<URL Redacted>
http://www.oandp.com/edge/issues/articles/2005-02_13.asp
Old ABC certifees and diehards, some whom I respect highly, say they are
competent with no formal formal education requirements.
ABC was formed by AOPA in 1948 as the result of a formal investigation by
the Federal Trade Commission for possible violations of monopoly laws.They
formed this certification arm to appease investigators.
The founding of the Academy were under similar circumstances in the 1980's.
Latter BOC whom developed lesser qualifications, and subsequently revolved
from NARD ,National Association of Retail Druggists, an organization that
insisted O&P devices be allowed to be sold in drug stores!
In 1997 after Florida's O&P regulation was enacted as the first state with
mantatory licensure, I personally had US Congressman Robert Wexler (D-Fla)
sponsor The William G. Barr Amputee Protection Bill which basically
limited providers seeking reimbursement from Medicare/MedicAid for O&P
services to be exclusively ABC qualified as a minimum standard.
We met with AOPA,and NAAOP, the national trade industry associations.
Neither supported the legislation and it died in committee.
For years subsequent to ABC origin in 1948, ABC certifees were mailed ABC
certificates w/o regard to any education requirements, in exchange for
annual dues consideration,so ABC criteria for college ediucation didn't
evolve til much latter.
BOC certifies and leadership believes delivering comprehensive O&P services
does not require a level of mandatory formal education requirements and
touts their video exam as a fully acceptable education minimum standard.
Currently either ABC or BOC can qualify for membership to each either ,ABC
or BOC for $75 !
The O&P profession has been sold out by ABC/BOC and appears also the Academy
to the trade industry association made up of of O&P and DME manufacturing
interests.
Apparently recent CMS policy after being assured by industry leaders, it
isn't concerned about patients safety nor their ability to obtain qualified
O&P services.
What this means is that anyone, without license , criminal background check,
certification or education of any kind, can put their hands on children and
adults, diagnose ,design, fabricate and fit devices that could seriously
hurt patients.
In Florida alone, the post regulation/licensing application process for a
state license, discovered 3 long time O&P providers in the state were found
to be convicted on felonies and moral charges (including child molestation)
and were subsequently denied access to a state license.
What happens in the 40 unregulated states ? What's worse when insurance
providers and third party payers discover the providers are not
regulated/licensed to practise, they cut or eliminate O&P benefits for
everyone.
The good side of the equation is that only licensed or certified healthcare
providers can bill Medicare for O&P services.
However,unlicensed,noncertiifed and unqualified providers can still direct
bill patients and their insurance companies in 40 of 50 states !!
Who says life is fair! Where's ACA ? In Connecticut/Mass promoting to the
state legislations to provide mandatory O&P coverage (parity laws) from
insurance payers for unlicensed/untrained providers !!
Whose interests does ACA represent ?
Tony Barr
From: Wayne C. Renardson (Wayne C. Renardson)
...it was decided by Medicare that effective July 1, 2005 physicians,
physical therapists, occupational therapists, pedorthists, prosthetists,
orthotists, and medical supply houses with prosthetic and orthotic personal
may provide prostheses or orthoses and bill Medicare using the L-codes.
Now I do not investigate licensing in Tennessee and other states for PTs,
MDs, and OTs, but I suspect all three require a level of education,
training, and licensing compatible with the requirements of the profession.
I have checked on Tennessee and
there is nothing---zip---for prosthetics.
Tony Barr, who sat on the NegReg. Committee, kept us on AMP-L abreast of the
sad state of developments and the lack of consensus by the committee, which
I believe may have been top-heavy with industry representatives or those who
had and have a vested interest in maximizing the sale of devices rather than
the quality of those fitting and making them.
Tennessee is merely one of dozens of states that require no license or
qualifications to call yourself a prosthetist. Which means tomorrow I can
rent a storefront, hang a sign 'Beevis' Prosthetics', and send Medicare the
bill for shoddy work. Not quite that simple, but I can register as a
'qualified provider' and fleece not only anyone who enters my shop but
Medicare as well. Ahhhhhh...sweet.
Of those providers ONLY Certified Practitioners certified by the American
Board for Certification in Orthotics and Prosthetics are required to have a
university level education in the art/sciences of orthotics and prosthetics.
Indeed sir. But this does not prevent me or anyone in other than ten or so
states from fitting the ill-informed with a prosthesis or orthotic device.
Even a PT with an MA (I was once a model at Belmont University in Nashville
for PT classes. Most of the students had never had honest-to-god face time
with a walkin' talkin' amputee before I removed my clothes in the classroom)
is not necessarily qualified to fit me for a new rig. If I try to open up a
PT or a barber shop I will be closed within a week. But if I do the same
with a different name, prosthetist, I can party on.
Delightful !!
It don't take a weatherman, to know which way the wind blows.
-----apologies to Bob Dylan
Wayne C. Renardson
-----Original Message-----
From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>] On
Behalf Of James Mc Coy, C.P., L.P., FAAOP
Sent: Friday, January 28, 2005 10:36 PM
To: <Email Address Redacted>
Subject: Re: [OANDP-L] Qualified Provider
If I am not mistaken, the new ruling regarding the provision of O and P
services by PT's should not apply in states where there is licensure of O
and P practitioners, AND the provision of O and P is not stated in the scope
of practice of the PT's licensure act in that state. Am I wrong?
James Mc Coy, C.P., L.P., FAAOP
*
On January 21, 2005 Medicare released alert regarding who is a qualified
provider, earlier they have put in specialty codes for only prosthetist and
orthotist who are certified now with this new realse they have made PT, PT
and Physician as qualified provider to provide custom prosthetics and
orthotics.
Link:
<URL Redacted>
56F95004DD192?OpenDocument
Ashish Doshi, CPO, FAAOP
So You Want the Truth?
The national trade industry association, AOPA, remains in control of
provider qualification criteria , and pricing policies.
Although making artifical pretenses to better assure the Academy and its
members they are looking out for their interests, AOPA is backing any
legislation for expansion of as many providers as possible that would
lead to more buyers (however qualified, or not ) to purchase their products.
The patient looses in not having guarantees of qualification of whom is
qualified and whom is not.
One positive note is that at least PTs and OTs are required to have a state
license and subject to loosing a license in every state to provide O&P
services in and prosthetists and orthotists are only licensed in 10 states!
Perhaps the talents of O&P providers is not worthy of having a license ?
Go figure?
Read : <URL Redacted>
<URL Redacted>
http://www.oandp.com/edge/issues/articles/2005-02_13.asp
Old ABC certifees and diehards, some whom I respect highly, say they are
competent with no formal formal education requirements.
ABC was formed by AOPA in 1948 as the result of a formal investigation by
the Federal Trade Commission for possible violations of monopoly laws.They
formed this certification arm to appease investigators.
The founding of the Academy were under similar circumstances in the 1980's.
Latter BOC whom developed lesser qualifications, and subsequently revolved
from NARD ,National Association of Retail Druggists, an organization that
insisted O&P devices be allowed to be sold in drug stores!
In 1997 after Florida's O&P regulation was enacted as the first state with
mantatory licensure, I personally had US Congressman Robert Wexler (D-Fla)
sponsor The William G. Barr Amputee Protection Bill which basically
limited providers seeking reimbursement from Medicare/MedicAid for O&P
services to be exclusively ABC qualified as a minimum standard.
We met with AOPA,and NAAOP, the national trade industry associations.
Neither supported the legislation and it died in committee.
For years subsequent to ABC origin in 1948, ABC certifees were mailed ABC
certificates w/o regard to any education requirements, in exchange for
annual dues consideration,so ABC criteria for college ediucation didn't
evolve til much latter.
BOC certifies and leadership believes delivering comprehensive O&P services
does not require a level of mandatory formal education requirements and
touts their video exam as a fully acceptable education minimum standard.
Currently either ABC or BOC can qualify for membership to each either ,ABC
or BOC for $75 !
The O&P profession has been sold out by ABC/BOC and appears also the Academy
to the trade industry association made up of of O&P and DME manufacturing
interests.
Apparently recent CMS policy after being assured by industry leaders, it
isn't concerned about patients safety nor their ability to obtain qualified
O&P services.
What this means is that anyone, without license , criminal background check,
certification or education of any kind, can put their hands on children and
adults, diagnose ,design, fabricate and fit devices that could seriously
hurt patients.
In Florida alone, the post regulation/licensing application process for a
state license, discovered 3 long time O&P providers in the state were found
to be convicted on felonies and moral charges (including child molestation)
and were subsequently denied access to a state license.
What happens in the 40 unregulated states ? What's worse when insurance
providers and third party payers discover the providers are not
regulated/licensed to practise, they cut or eliminate O&P benefits for
everyone.
The good side of the equation is that only licensed or certified healthcare
providers can bill Medicare for O&P services.
However,unlicensed,noncertiifed and unqualified providers can still direct
bill patients and their insurance companies in 40 of 50 states !!
Who says life is fair! Where's ACA ? In Connecticut/Mass promoting to the
state legislations to provide mandatory O&P coverage (parity laws) from
insurance payers for unlicensed/untrained providers !!
Whose interests does ACA represent ?
Tony Barr
From: Wayne C. Renardson (Wayne C. Renardson)
...it was decided by Medicare that effective July 1, 2005 physicians,
physical therapists, occupational therapists, pedorthists, prosthetists,
orthotists, and medical supply houses with prosthetic and orthotic personal
may provide prostheses or orthoses and bill Medicare using the L-codes.
Now I do not investigate licensing in Tennessee and other states for PTs,
MDs, and OTs, but I suspect all three require a level of education,
training, and licensing compatible with the requirements of the profession.
I have checked on Tennessee and
there is nothing---zip---for prosthetics.
Tony Barr, who sat on the NegReg. Committee, kept us on AMP-L abreast of the
sad state of developments and the lack of consensus by the committee, which
I believe may have been top-heavy with industry representatives or those who
had and have a vested interest in maximizing the sale of devices rather than
the quality of those fitting and making them.
Tennessee is merely one of dozens of states that require no license or
qualifications to call yourself a prosthetist. Which means tomorrow I can
rent a storefront, hang a sign 'Beevis' Prosthetics', and send Medicare the
bill for shoddy work. Not quite that simple, but I can register as a
'qualified provider' and fleece not only anyone who enters my shop but
Medicare as well. Ahhhhhh...sweet.
Of those providers ONLY Certified Practitioners certified by the American
Board for Certification in Orthotics and Prosthetics are required to have a
university level education in the art/sciences of orthotics and prosthetics.
Indeed sir. But this does not prevent me or anyone in other than ten or so
states from fitting the ill-informed with a prosthesis or orthotic device.
Even a PT with an MA (I was once a model at Belmont University in Nashville
for PT classes. Most of the students had never had honest-to-god face time
with a walkin' talkin' amputee before I removed my clothes in the classroom)
is not necessarily qualified to fit me for a new rig. If I try to open up a
PT or a barber shop I will be closed within a week. But if I do the same
with a different name, prosthetist, I can party on.
Delightful !!
It don't take a weatherman, to know which way the wind blows.
-----apologies to Bob Dylan
Wayne C. Renardson
-----Original Message-----
From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>] On
Behalf Of James Mc Coy, C.P., L.P., FAAOP
Sent: Friday, January 28, 2005 10:36 PM
To: <Email Address Redacted>
Subject: Re: [OANDP-L] Qualified Provider
If I am not mistaken, the new ruling regarding the provision of O and P
services by PT's should not apply in states where there is licensure of O
and P practitioners, AND the provision of O and P is not stated in the scope
of practice of the PT's licensure act in that state. Am I wrong?
James Mc Coy, C.P., L.P., FAAOP
*
Citation
tony barr, “FW: [OANDP-L] Qualified Provider,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 4, 2024, https://library.drfop.org/items/show/224299.
