Re: APTA Comments on DMEPOS Quality Standards
Tony Barr
Description
Collection
Title:
Re: APTA Comments on DMEPOS Quality Standards
Creator:
Tony Barr
Date:
12/8/2005
Text:
My friend Terry Supan's comment below is correct stating that the lack of
compromise on the part of the APTA, those of us that participated in Neg Reg
never got to the discussion on what the educational of an orthotist or
prosthetist must be.
However he does not elude to the fact that majority of PTs in the US think
that APTA does not represent the majority of the PTS in the country nor to
their philosophy of being fully qualified to deliver all comprehensive O*P
services.
Lee than 50% of all the PTs belong to APTA and most felt uncomfortable
providing comprehensive O&P services without further training i.e.
qualification.
His comments also do not indicate that not all O&P providers delivering
comprehensive O&P services today, are qualified to do so and that most whom
are certified , have no formal education in the field of O&P.
Not only was it Dr.Fishman's opinion that a licensed physical therapist
would not equate a qualified O&P provider but he would be the first to
agree there were many others in the O&P field that were also not qualified
to do so.
The two O&P credentialing association's position that they would not
interfere with a provider cross credentialing into a field that he is not
trained nor certified is an example of the non compliance and lack of
oversight both credentialing boards have in curbing fraud ,abuse and
delivery of qualified O&P services.
Quote:
ABC/BOC can not restrict the free trade of a certified practitioner. If a
person can legally practice orthotics and or prosthetics without any
qualifications in their jurisdiction, we will not interfere with the right
of a certified prosthetist to perform orthotic work, so long as that person
does not imply that he/she is certified as an orthotist. The reverse holds
true as well.
Fact is, there are still 39 states that permit even uncertified providers to
practice and receive reimbursement for the deliver of O&P Services from
Medicare/Medicaid and third party payers.
AOPA is only concerned with the flow of the product. O and P is just a
product to them just like DME .
Professionalism and minimal educational standards stands in the way of the
free flow of the products hence why would AOPA support licensure with
definitive educational standards, a free for all in the market place is
their dream and licensure is their nightmare.AOPA is about small, medium and
large that anyone can fit and the $$$$$$$ it brings in. ABC is housed in
AOPA's office , seriously, do you expect them to stand up and do the right
thing? They sold their soul for $75 supporting AOPA's philosophy of anyone
can do this. What say do you have as an ABC certifee about them selling the
credential?.......none, you are not a member of ABC you are just certificate
holders. a devalued certificate I might add).
Academy is the only professional organization. However they also are tied to
ABC certification through membership rules.
I have seen many positive changes within the Academy in recent years .They
have emerged as the true leader of the profession but they will need to
continue to move away from ABC and the strong influence of AOPA and to
continue to strongly advocate for high standards of care for persons needing
o and p. For progress to continue to be made we the membership need to be
acutely aware of the possible influential and incestuous leadership
relationships that could exist in the future between these organizations .
I think AAOP is on the right track and currently doing great things, but
continued progress will depend on the resolve of future leadership.
My friends, your enemy is not the PTS,it is those that retain the power over
you and yourselves who don't see the big picture. Wake up and smell the
monopoly.
Tony Barr
-----Original Message-----
From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>] On
Behalf Of Terry Supan
Sent: Thursday, December 08, 2005 11:14 AM
To: <Email Address Redacted>
Subject: Re: [OANDP-L] APTA Comments on DMEPOS Quality Standards
Ms. Sheredos,
I can assure you that if Dr. Fishman advocated the dental model
earlier in his tenure at NYU it was NOT his sentiment in the last years of
his life. Dr Fishman was a personal friend of mine and as one of his last
official functions I had the distinction of serving on the Negotiated
Rulemaking Committee with him. He was one of the representatives of the
AAOS and I was there representing O&P State Licensure Boards.
The APTA's opinion at the NRM that licensed physical therapist would equate
a qualified O&P provider was not shared by Dr. Fishman. Several times he
repeated that the amount of education that a therapist receives on O&P at
any PT program would expose the student to the theory of O&P but was never
enough for them to be trained in the design, fabrication, fitting and even
the assessment of the present day custom orthosis or prosthesis.
In my official opinion, the APTA's letter does not adequately present the
outcome of the NRM. The APTA's unwillingness to compromise on the fact that
a therapist needed more education and training to be qualified was the
demise of the consensus. A national maximum of 6 credit hours in O&P theory
does not equal a minimum of 60 credit hours for a fully CAAHEP accredited
O&P program. That was what caused the failure of the committee to come to
an agreement. The ruling that CMS has come up with reflects the majority of
the committee members including the physicians and consumer members of the
committee.
Because of the lack of compromise on the part of the APTA, we never got to
the discussion on what the educational of an orthotist or prosthetist must
be. That was very unfortunate because as most of us know, Dr.
Fishman created the first under graduate program in O&P and in his later
years was a very vocal advocate of post graduate program for my profession.
Terry Supan, CPO, FAAOP, FISPO
Sheredos, Carol (NIH/NICHD) wrote:
>In my unofficial response to Paul Oswald's comments concerning the APTA
statement to CMS regarding PT qualifications ...
>
>The late Sidney Fishman, Ph.D., had a very workable solution to all of this
-- The dental model. The PT would measure and take a cast of the residual or
affected limb, as a dentist would take an impression of the mouth/teeth to
be fitted. The casting and measurements would be sent to the
prosthetist/orthotist for fabrication of the ...
>
>-- Carol A. Sheredos, PT, MA
>
>
>
compromise on the part of the APTA, those of us that participated in Neg Reg
never got to the discussion on what the educational of an orthotist or
prosthetist must be.
However he does not elude to the fact that majority of PTs in the US think
that APTA does not represent the majority of the PTS in the country nor to
their philosophy of being fully qualified to deliver all comprehensive O*P
services.
Lee than 50% of all the PTs belong to APTA and most felt uncomfortable
providing comprehensive O&P services without further training i.e.
qualification.
His comments also do not indicate that not all O&P providers delivering
comprehensive O&P services today, are qualified to do so and that most whom
are certified , have no formal education in the field of O&P.
Not only was it Dr.Fishman's opinion that a licensed physical therapist
would not equate a qualified O&P provider but he would be the first to
agree there were many others in the O&P field that were also not qualified
to do so.
The two O&P credentialing association's position that they would not
interfere with a provider cross credentialing into a field that he is not
trained nor certified is an example of the non compliance and lack of
oversight both credentialing boards have in curbing fraud ,abuse and
delivery of qualified O&P services.
Quote:
ABC/BOC can not restrict the free trade of a certified practitioner. If a
person can legally practice orthotics and or prosthetics without any
qualifications in their jurisdiction, we will not interfere with the right
of a certified prosthetist to perform orthotic work, so long as that person
does not imply that he/she is certified as an orthotist. The reverse holds
true as well.
Fact is, there are still 39 states that permit even uncertified providers to
practice and receive reimbursement for the deliver of O&P Services from
Medicare/Medicaid and third party payers.
AOPA is only concerned with the flow of the product. O and P is just a
product to them just like DME .
Professionalism and minimal educational standards stands in the way of the
free flow of the products hence why would AOPA support licensure with
definitive educational standards, a free for all in the market place is
their dream and licensure is their nightmare.AOPA is about small, medium and
large that anyone can fit and the $$$$$$$ it brings in. ABC is housed in
AOPA's office , seriously, do you expect them to stand up and do the right
thing? They sold their soul for $75 supporting AOPA's philosophy of anyone
can do this. What say do you have as an ABC certifee about them selling the
credential?.......none, you are not a member of ABC you are just certificate
holders. a devalued certificate I might add).
Academy is the only professional organization. However they also are tied to
ABC certification through membership rules.
I have seen many positive changes within the Academy in recent years .They
have emerged as the true leader of the profession but they will need to
continue to move away from ABC and the strong influence of AOPA and to
continue to strongly advocate for high standards of care for persons needing
o and p. For progress to continue to be made we the membership need to be
acutely aware of the possible influential and incestuous leadership
relationships that could exist in the future between these organizations .
I think AAOP is on the right track and currently doing great things, but
continued progress will depend on the resolve of future leadership.
My friends, your enemy is not the PTS,it is those that retain the power over
you and yourselves who don't see the big picture. Wake up and smell the
monopoly.
Tony Barr
-----Original Message-----
From: Orthotics and Prosthetics List [mailto:<Email Address Redacted>] On
Behalf Of Terry Supan
Sent: Thursday, December 08, 2005 11:14 AM
To: <Email Address Redacted>
Subject: Re: [OANDP-L] APTA Comments on DMEPOS Quality Standards
Ms. Sheredos,
I can assure you that if Dr. Fishman advocated the dental model
earlier in his tenure at NYU it was NOT his sentiment in the last years of
his life. Dr Fishman was a personal friend of mine and as one of his last
official functions I had the distinction of serving on the Negotiated
Rulemaking Committee with him. He was one of the representatives of the
AAOS and I was there representing O&P State Licensure Boards.
The APTA's opinion at the NRM that licensed physical therapist would equate
a qualified O&P provider was not shared by Dr. Fishman. Several times he
repeated that the amount of education that a therapist receives on O&P at
any PT program would expose the student to the theory of O&P but was never
enough for them to be trained in the design, fabrication, fitting and even
the assessment of the present day custom orthosis or prosthesis.
In my official opinion, the APTA's letter does not adequately present the
outcome of the NRM. The APTA's unwillingness to compromise on the fact that
a therapist needed more education and training to be qualified was the
demise of the consensus. A national maximum of 6 credit hours in O&P theory
does not equal a minimum of 60 credit hours for a fully CAAHEP accredited
O&P program. That was what caused the failure of the committee to come to
an agreement. The ruling that CMS has come up with reflects the majority of
the committee members including the physicians and consumer members of the
committee.
Because of the lack of compromise on the part of the APTA, we never got to
the discussion on what the educational of an orthotist or prosthetist must
be. That was very unfortunate because as most of us know, Dr.
Fishman created the first under graduate program in O&P and in his later
years was a very vocal advocate of post graduate program for my profession.
Terry Supan, CPO, FAAOP, FISPO
Sheredos, Carol (NIH/NICHD) wrote:
>In my unofficial response to Paul Oswald's comments concerning the APTA
statement to CMS regarding PT qualifications ...
>
>The late Sidney Fishman, Ph.D., had a very workable solution to all of this
-- The dental model. The PT would measure and take a cast of the residual or
affected limb, as a dentist would take an impression of the mouth/teeth to
be fitted. The casting and measurements would be sent to the
prosthetist/orthotist for fabrication of the ...
>
>-- Carol A. Sheredos, PT, MA
>
>
>
Citation
Tony Barr, “Re: APTA Comments on DMEPOS Quality Standards,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/225787.
