Medicare "qualified" providers
Ed Roman, CP
Description
Collection
Title:
Medicare "qualified" providers
Creator:
Ed Roman, CP
Date:
2/2/2005
Text:
Hello all.On today's AdminaStar Federal DMERC List Serve, there was another
message concerning the restriction of Medicare payments for prosthetic and
custom orthotic codes. After reading this message, I am wondering if the
following has any bearing on our future:
* Today's message includes the language Medical Supply Company
with Orthotics Personnel-Specialty Code 51, yet the Region B DMERC Supplier
Bulletin, Dec. 2004, Vol04/Issue 04 states Medical Supply Company with
Certified Orthotist-Specialty Code 51. The difference is the word
Certified. The difference is the same for the Specialty codes 52 through 57
listed in both articles. Now my questions are: Is the term used Certified
XXX the trademarked/copyrighted ABC term or is it the generic term for
either Certifying bodies? Which message/notice/policy is the correct
language?
* The following was in today's message. To explain, CMS has deemed
that certain specialties (who are licensed or certified by the State, when
applicable) are qualified to furnish prosthetics and certain
custom-fabricated orthotics, and may bill for Medicare services when State
law permits them to furnish a prosthetic or orthotic. Illinois currently
issues licenses for Orthotists, Prosthetists, Pedorthists, Physical
Therapists, Occupational Therapists and Athletic Trainers. The key words in
my mind are when State law permits. A long time ago, I did read the IL
Licensing law for OTs which allows OTs to custom fabricate splints. The PT
law allows a PT to furnish assistive devices and I believe that the AT law
is similar. Should Medicare be made aware of these Illinois restrictions
and will this then restrict PT, OT and AT from billing Medicare? (Please do
not quote me on the IL law. This is from an old man's memory.)
* Will this argument work for all states with licensing laws for any
and all of the listed professions?
* Will a national organization research each state law and present
this to Medicare?
* Should every state association research this and present it to
Medicare?
* Will any state present a legal opinion as to what each profession
is allowed to custom fabricate?
* Will any one really care?
* Did I get hit with too many snowballs last Saturday?
I do not know if the above makes sense or it is the rambling of some one who
sniffed to much acetone.
Ed Roman CP/LPO Merrick Hopkins Prosthetics Chicago, IL
********************
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.
message concerning the restriction of Medicare payments for prosthetic and
custom orthotic codes. After reading this message, I am wondering if the
following has any bearing on our future:
* Today's message includes the language Medical Supply Company
with Orthotics Personnel-Specialty Code 51, yet the Region B DMERC Supplier
Bulletin, Dec. 2004, Vol04/Issue 04 states Medical Supply Company with
Certified Orthotist-Specialty Code 51. The difference is the word
Certified. The difference is the same for the Specialty codes 52 through 57
listed in both articles. Now my questions are: Is the term used Certified
XXX the trademarked/copyrighted ABC term or is it the generic term for
either Certifying bodies? Which message/notice/policy is the correct
language?
* The following was in today's message. To explain, CMS has deemed
that certain specialties (who are licensed or certified by the State, when
applicable) are qualified to furnish prosthetics and certain
custom-fabricated orthotics, and may bill for Medicare services when State
law permits them to furnish a prosthetic or orthotic. Illinois currently
issues licenses for Orthotists, Prosthetists, Pedorthists, Physical
Therapists, Occupational Therapists and Athletic Trainers. The key words in
my mind are when State law permits. A long time ago, I did read the IL
Licensing law for OTs which allows OTs to custom fabricate splints. The PT
law allows a PT to furnish assistive devices and I believe that the AT law
is similar. Should Medicare be made aware of these Illinois restrictions
and will this then restrict PT, OT and AT from billing Medicare? (Please do
not quote me on the IL law. This is from an old man's memory.)
* Will this argument work for all states with licensing laws for any
and all of the listed professions?
* Will a national organization research each state law and present
this to Medicare?
* Should every state association research this and present it to
Medicare?
* Will any state present a legal opinion as to what each profession
is allowed to custom fabricate?
* Will any one really care?
* Did I get hit with too many snowballs last Saturday?
I do not know if the above makes sense or it is the rambling of some one who
sniffed to much acetone.
Ed Roman CP/LPO Merrick Hopkins Prosthetics Chicago, IL
********************
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
Ed Roman, CP, “Medicare "qualified" providers,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 6, 2024, https://library.drfop.org/items/show/224333.
