FW: [OANDP-L] Prosthetic Parity effort has it's own blog!!
Tony Barr
Description
Collection
Title:
FW: [OANDP-L] Prosthetic Parity effort has it's own blog!!
Creator:
Tony Barr
Date:
3/28/2005
Text:
I have been asked to support the pending state legislation movements in
several states to force O&P coverage by insurers (parity laws). I have a
real problem when these specialized health care services can be legally
provided basically by anyone regardless of qualification in the initial
states you have targeted for parity legislation.
The legitimate O&P profession should also take a role in opposing this.
The intent is honorable but not practical and in my opinion will add to the
growing problem of additional unqualified providers including DME dealers,
the real culperts of fraud and abuse, delivering these services.
Perhaps the deliberate stall tactics of the Insurance Committee as
described, is a product generated by them knowing it is not a regulated
profession delivering these services. Perhaps you should align you efforts
of endorsing parity laws by stipulating meaningful educational qualification
language for the providers.
Every day I deal with amputees one on one (far too many and growing) whom
have no coverage. I would like nothing more than to see that change.The Barr
Foundation recieves every month hundreds of requests from amputees and
referrals from other non profit organizations: The Orthotic and Prosthetic
Assistance Fund, Limbs Of Life, National Amputee Foundation and ACA, all of
whom,inspite of having legitimate advocacy roles, do not provide actual
funding for prosthetic rehabilitation.
However, I would not support the concept of making mandatory prosthetic
coverage available to anyone if O&P services can be delivered by and
reimbursement made unqualified providers.
Those of you that have asked how to support parity laws or mandatory O&P
insurance coverage in each state, would be best served if you preempted and
requested support from ACA to regulate the O&P profession in every state
before introducing Parity legislation and requiring mandatory benefits from
insurance providers thru unlicensed providers.
The main issue at hand and cause of dwindling coverage,is that 40 of 50
states remain unregulated and basically ANYONE can bill Medicare/Medicaid
for O&P services. That fact has caused dramatic consequences on affordable
coverage for O&P treatment.
How long do you think any third party provider ( Medicaid,Medicare,Private)
coverage let alone mandatory O&P coverage legislation will last if
basically anyone can provide these specialized health services? It's an
invitation to entry of more scammers into the system and ultimate disaster
of the bill and more black eyes to the image of the profession.
A bill requiring mandatory coverage ,regardless of the qualifications of the
provider, would have a tremendous negative effect on coverage in the
future.
Now make it a requirement, in states where you are introducing Parity
legislation, that the provider must obtain a state license or ABC/BOC
certification to perform and deliver comprehensive O&P services, and I'm in
!
Even Hanger, whom operates the largest orthotic and prosthetic managed care
network in the country, recognizes the need of greater clinical
accountability for providers and will most likely in the future provide
insurance and financing for O&P services thru their subsidiary newly formed
subsidiary Linkia.
Currently, little more than half of the nation's O&P facilities are ABC
accredited, Hanger Orthopedic Group Chairman and CEO Ivan R. Sabel, CPO
said. In order to fulfill Linkia's mission of providing accountable and
differentiated healthcare to our patients, we believe qualification and
accreditation of every facility is not just a benefit; it is a necessity.
Accreditation of Linkia provider facilities will begin immediately with all
facilities achieving full accreditation by Q1 2007. ABC accreditation is
awarded to orthotic and prosthetic facilities following a successful on-site
evaluation by an independent surveyor. Facilities are assessed within four
standards categories -- patient care, organizational, facility safety, and
quality assessment and improvement -- and must employ a minimum of one ABC-
certified prosthetist and/or orthotist.
Linkia's alignment with ABC signifies a big step toward greater clinical
accountability in our network, Linkia's Chief Clinical Officer Deanna Fish,
CPO said. The ABC facility accreditation process ensures a quality physical
environment as well as a qualified provider for each and every patient. As a
result, our contracted payer organizations have confidence in the O&P care
provided throughout the Linkia network.
We are extremely pleased that, through a clinical evaluation process,
Linkia has selected the ABC accreditation process as its new standard of
care, ABC President William DeToro, CO, FAAOP said. For a managed care
company, requiring ABC accreditation helps guarantee the orthotic and
prosthetic facilities have met the most widely used standards of
organizational and clinical O&P care. In the absence of national regulation
and state licensure laws, this is an extremely important tool in improving
patient care.
About Linkia:
A wholly-owned subsidiary of parent company Hanger Orthopedic Group, Inc.
HGR, Linkia is the first managed care organization (MCO) dedicated solely to
serving the orthotic and prosthetic market. Linkia coordinates and manages
all O&P services and needs of its contracted healthcare partners through a
customized network of O&P patient care facilities. Linkia's customized
network is selected from among independent O&P practices nationwide, as well
as from the 600 patient care centers owned and operated by Hanger
Prosthetics and Orthotics (HPO), the patient care division of Hanger
Orthopedic Group. Linkia's mission is to deliver accountable healthcare
services, through a dedication to clinical outcomes, science-based
guidelines, and sound medical reasoning. For more information on Linkia,
please visit <URL Redacted>.
About Hanger:
Hanger Orthopedic Group, Inc., headquartered in Bethesda, Maryland, is the
world's premier provider of orthotic and prosthetic patient care services.
Hanger is the market leader in the United States, owning and operating 632
patient care centers in 44 states and the District of Columbia, with 3,385
employees including 1,016 practitioners. Hanger is organized into two
business segments: patient care which consists of nationwide orthotic and
prosthetic practice centers and distribution which consists of distribution
centers managing the supply chain of orthotic and prosthetic componentry to
Hanger and third party patient care centers. In addition, Hanger operates
the largest orthotic and prosthetic managed care network in the country. For
more information on Hanger, please visit <URL Redacted>.
The delivery of O&P services is the only legitimate (?) health care
profession (?) that remains unregulated in this country today.
Only 10 of 50 states are regulated. Connecticut ,New York,Pennsyvania and
California where Pariy laws have been introduced, and Colorado where there
is a bill, are all states that are not regulated.
Don't you feel that Parity legislation would have the best chance of success
if directed FIRST to states that were already regulated? There would a
better chance to model parity and regulation laws to the other unregulated
states?
Why hasn't that occurred?
Since Hanger controls over 25% share of the national $2.1 billion market of
O&P in a fragmented industry (see Feb 2002 Hanger Offering Memorandum) and
is such a big supporter of providing accountable and differentiated
healthcare to our patients, perhaps they could use their influence and $$
along with ACA to support and inspire state regulation of the profession via
ABC criteria guidelines in the remaining 40 unregulated states and Parity
laws?
Tony Barr
Barr Foundation
www.oandp.com/barr
www.ertlreconstruction.com
-----Original Message-----
From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>] On
Behalf Of Elizabeth Mansfield
Sent: Thursday, March 24, 2005 10:59 AM
To: <Email Address Redacted>
Subject: [OANDP-L] CT Prosthetic Parity effort has it's own blog!!
Never have I learned how to use new technology so fast as I did today when -
needing an outlet to vent after the ridiculous run around we experienced
with the deliberate stall tactics of the Insurance Committee - I became...a
blogger.
Welcome to 2005 and the Parity Now Blog.
<URL Redacted>
Thanks to everyone who made calls today. Don't worry - you'll get the
opportunity to make more calls - we will be attempting to add an amendment
(consisting of the parity language) to a bill on the floor - you'll get all
the details asap. Thanks again!
Elizabeth
-----Original Message-----
From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>] On
Behalf Of Elizabeth Mansfield
Sent: Thursday, March 24, 2005 10:59 AM
To: <Email Address Redacted>
Subject: [OANDP-L] CT Prosthetic Parity effort has it's own blog!!
Never have I learned how to use new technology so fast as I did today when -
needing an outlet to vent after the ridiculous run around we experienced
with the deliberate stall tactics of the Insurance Committee - I became...a
blogger.
Welcome to 2005 and the Parity Now Blog.
http://paritynow.blogspot.com/
Thanks to everyone who made calls today. Don't worry - you'll get the
opportunity to make more calls - we will be attempting to add an amendment
(consisting of the parity language) to a bill on the floor - you'll get all
the details asap. Thanks again!
Elizabeth
Outsource Marketing Solutions, LLC (570) 357-4416
several states to force O&P coverage by insurers (parity laws). I have a
real problem when these specialized health care services can be legally
provided basically by anyone regardless of qualification in the initial
states you have targeted for parity legislation.
The legitimate O&P profession should also take a role in opposing this.
The intent is honorable but not practical and in my opinion will add to the
growing problem of additional unqualified providers including DME dealers,
the real culperts of fraud and abuse, delivering these services.
Perhaps the deliberate stall tactics of the Insurance Committee as
described, is a product generated by them knowing it is not a regulated
profession delivering these services. Perhaps you should align you efforts
of endorsing parity laws by stipulating meaningful educational qualification
language for the providers.
Every day I deal with amputees one on one (far too many and growing) whom
have no coverage. I would like nothing more than to see that change.The Barr
Foundation recieves every month hundreds of requests from amputees and
referrals from other non profit organizations: The Orthotic and Prosthetic
Assistance Fund, Limbs Of Life, National Amputee Foundation and ACA, all of
whom,inspite of having legitimate advocacy roles, do not provide actual
funding for prosthetic rehabilitation.
However, I would not support the concept of making mandatory prosthetic
coverage available to anyone if O&P services can be delivered by and
reimbursement made unqualified providers.
Those of you that have asked how to support parity laws or mandatory O&P
insurance coverage in each state, would be best served if you preempted and
requested support from ACA to regulate the O&P profession in every state
before introducing Parity legislation and requiring mandatory benefits from
insurance providers thru unlicensed providers.
The main issue at hand and cause of dwindling coverage,is that 40 of 50
states remain unregulated and basically ANYONE can bill Medicare/Medicaid
for O&P services. That fact has caused dramatic consequences on affordable
coverage for O&P treatment.
How long do you think any third party provider ( Medicaid,Medicare,Private)
coverage let alone mandatory O&P coverage legislation will last if
basically anyone can provide these specialized health services? It's an
invitation to entry of more scammers into the system and ultimate disaster
of the bill and more black eyes to the image of the profession.
A bill requiring mandatory coverage ,regardless of the qualifications of the
provider, would have a tremendous negative effect on coverage in the
future.
Now make it a requirement, in states where you are introducing Parity
legislation, that the provider must obtain a state license or ABC/BOC
certification to perform and deliver comprehensive O&P services, and I'm in
!
Even Hanger, whom operates the largest orthotic and prosthetic managed care
network in the country, recognizes the need of greater clinical
accountability for providers and will most likely in the future provide
insurance and financing for O&P services thru their subsidiary newly formed
subsidiary Linkia.
Currently, little more than half of the nation's O&P facilities are ABC
accredited, Hanger Orthopedic Group Chairman and CEO Ivan R. Sabel, CPO
said. In order to fulfill Linkia's mission of providing accountable and
differentiated healthcare to our patients, we believe qualification and
accreditation of every facility is not just a benefit; it is a necessity.
Accreditation of Linkia provider facilities will begin immediately with all
facilities achieving full accreditation by Q1 2007. ABC accreditation is
awarded to orthotic and prosthetic facilities following a successful on-site
evaluation by an independent surveyor. Facilities are assessed within four
standards categories -- patient care, organizational, facility safety, and
quality assessment and improvement -- and must employ a minimum of one ABC-
certified prosthetist and/or orthotist.
Linkia's alignment with ABC signifies a big step toward greater clinical
accountability in our network, Linkia's Chief Clinical Officer Deanna Fish,
CPO said. The ABC facility accreditation process ensures a quality physical
environment as well as a qualified provider for each and every patient. As a
result, our contracted payer organizations have confidence in the O&P care
provided throughout the Linkia network.
We are extremely pleased that, through a clinical evaluation process,
Linkia has selected the ABC accreditation process as its new standard of
care, ABC President William DeToro, CO, FAAOP said. For a managed care
company, requiring ABC accreditation helps guarantee the orthotic and
prosthetic facilities have met the most widely used standards of
organizational and clinical O&P care. In the absence of national regulation
and state licensure laws, this is an extremely important tool in improving
patient care.
About Linkia:
A wholly-owned subsidiary of parent company Hanger Orthopedic Group, Inc.
HGR, Linkia is the first managed care organization (MCO) dedicated solely to
serving the orthotic and prosthetic market. Linkia coordinates and manages
all O&P services and needs of its contracted healthcare partners through a
customized network of O&P patient care facilities. Linkia's customized
network is selected from among independent O&P practices nationwide, as well
as from the 600 patient care centers owned and operated by Hanger
Prosthetics and Orthotics (HPO), the patient care division of Hanger
Orthopedic Group. Linkia's mission is to deliver accountable healthcare
services, through a dedication to clinical outcomes, science-based
guidelines, and sound medical reasoning. For more information on Linkia,
please visit <URL Redacted>.
About Hanger:
Hanger Orthopedic Group, Inc., headquartered in Bethesda, Maryland, is the
world's premier provider of orthotic and prosthetic patient care services.
Hanger is the market leader in the United States, owning and operating 632
patient care centers in 44 states and the District of Columbia, with 3,385
employees including 1,016 practitioners. Hanger is organized into two
business segments: patient care which consists of nationwide orthotic and
prosthetic practice centers and distribution which consists of distribution
centers managing the supply chain of orthotic and prosthetic componentry to
Hanger and third party patient care centers. In addition, Hanger operates
the largest orthotic and prosthetic managed care network in the country. For
more information on Hanger, please visit <URL Redacted>.
The delivery of O&P services is the only legitimate (?) health care
profession (?) that remains unregulated in this country today.
Only 10 of 50 states are regulated. Connecticut ,New York,Pennsyvania and
California where Pariy laws have been introduced, and Colorado where there
is a bill, are all states that are not regulated.
Don't you feel that Parity legislation would have the best chance of success
if directed FIRST to states that were already regulated? There would a
better chance to model parity and regulation laws to the other unregulated
states?
Why hasn't that occurred?
Since Hanger controls over 25% share of the national $2.1 billion market of
O&P in a fragmented industry (see Feb 2002 Hanger Offering Memorandum) and
is such a big supporter of providing accountable and differentiated
healthcare to our patients, perhaps they could use their influence and $$
along with ACA to support and inspire state regulation of the profession via
ABC criteria guidelines in the remaining 40 unregulated states and Parity
laws?
Tony Barr
Barr Foundation
www.oandp.com/barr
www.ertlreconstruction.com
-----Original Message-----
From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>] On
Behalf Of Elizabeth Mansfield
Sent: Thursday, March 24, 2005 10:59 AM
To: <Email Address Redacted>
Subject: [OANDP-L] CT Prosthetic Parity effort has it's own blog!!
Never have I learned how to use new technology so fast as I did today when -
needing an outlet to vent after the ridiculous run around we experienced
with the deliberate stall tactics of the Insurance Committee - I became...a
blogger.
Welcome to 2005 and the Parity Now Blog.
<URL Redacted>
Thanks to everyone who made calls today. Don't worry - you'll get the
opportunity to make more calls - we will be attempting to add an amendment
(consisting of the parity language) to a bill on the floor - you'll get all
the details asap. Thanks again!
Elizabeth
-----Original Message-----
From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>] On
Behalf Of Elizabeth Mansfield
Sent: Thursday, March 24, 2005 10:59 AM
To: <Email Address Redacted>
Subject: [OANDP-L] CT Prosthetic Parity effort has it's own blog!!
Never have I learned how to use new technology so fast as I did today when -
needing an outlet to vent after the ridiculous run around we experienced
with the deliberate stall tactics of the Insurance Committee - I became...a
blogger.
Welcome to 2005 and the Parity Now Blog.
http://paritynow.blogspot.com/
Thanks to everyone who made calls today. Don't worry - you'll get the
opportunity to make more calls - we will be attempting to add an amendment
(consisting of the parity language) to a bill on the floor - you'll get all
the details asap. Thanks again!
Elizabeth
Outsource Marketing Solutions, LLC (570) 357-4416
Citation
Tony Barr, “FW: [OANDP-L] Prosthetic Parity effort has it's own blog!!,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 26, 2024, https://library.drfop.org/items/show/224506.
