Re: OPINION - MEDICARE survey follow up
Tony Barr
Description
Collection
Title:
Re: OPINION - MEDICARE survey follow up
Creator:
Tony Barr
Date:
2/12/2007
Text:
Chris,
Thank you for posting your reply to the Listserve so I may respond.
With all due respect, you are incorrect in your statement posted today that
my post was hijacking a thread and I was soap boxing for personal
agendas and is very discouraging to read and dilutes the other valuable info
we get here.
On the contrary,asaccepted by many of your colleagues, my thread is indeed
most important and relative to your MEDICARE survey you posted intially.
There are no more than 8,000 credentialed O&P providers in the US. Yet
according to the Centers for MEDICARE & Medicaid Services (CMS), there are
more than 140,000 providers with the right to bill for L-Codes. The list
includes literally thousands of medical professionals and providers,
department stores, etc. It's a virtual potpourri of entities, very few of
which have any direct connections to O&P,.
Chris, In fact, if you are indeed sincere in your statement to continue to
encourage the list to swap and share information on ANYTHING related to O
and P, many of your colleagues comments below indicate a direct
relationship of MEDICARE and the absence of O&P regulation and maybe at the
root of many of your dilemmas, you and others are facing with MEDICARE.
Their comments (below) may very well compliment your survey.
A.J. Filippis, CPO, Wright & Filippis,:
Because of the direction that a handful of states have taken at this point,
prompting changes in some of the suppliers' standards, said Filippis, the
situation is changing: The Department of Veterans Affairs (VA) is reportedly
considering accepting state licensure as its required credentials for O&P.
That may force our hand here in Michigan. If MEDICARE and the suppliers'
standards come through that way, and the VA accepts the criterion, I think
it's going to be just a matter of time before we need to follow suit.
Otherwise we're going to be fighting that battle through ABC as well.
Jeff Fredrick, CPO, LPO,Hanger Prosthetics & Orthotics Inc., Tallahassee,
Florida, is now frustrated by those who promote a double standard by
opposing licensure: First of all, it's irrational because licensure is here
to stay, and once MEDICARE or some of these higher payers really start
dialing into it, you're going to have to be licensed in a state to provide
services, and that means further regulation. That's coming.
Jim Rogers, CPO,LPO FAAOP, Orthotic & Prosthetic Associates Inc.,
Chattanooga, Tennessee, and chair of the American Academy of Orthotists and
Prosthetists (the Academy) Licensure Task Force, noted that the Academy long
has been an advocate for licensure. We don't see it as a panacea, but as
one piece of a quilt that needs to be in place to protect the profession
over a whole range of areas. But that quilt is important. And licensure by
state is one of the very integral parts of the quilt.
Rogers pointed out that there are no more than 8,000 credentialed O&P
providers in the US. Yet according to the Centers for MEDICARE & Medicaid
Services (CMS), there are more than 140,000 providers with the right to bill
for L-Codes. The list includes literally thousands of medical professionals
and providers, department stores, etc. It's a virtual potpourri of
entities, very few of which have any direct connections to O&P, said
Rogers. So in the Academy's opinion, if you are licensed in your state, and
your state thus defines who can do what, then you have some measure of
protection against unscrupulous providers.
Although it may be true that licensure will protect practitioners, help to
delineate our scope of practice, and preserve our economic base, what we're
doing is protecting the patient, because ultimately, it is the patient
that's harmed the most when there is no licensure protection.
Lack of licensure protection also impacts the pocketbook of every taxpayer,
Rogers explained. When unqualified individuals provide care that does not
adequately serve MEDICARE or Medicaid patients, causing them to need further
services later that might not have been necessary had they been cared for
correctly the first time, the taxpayer pays more. In medically complex
patients, the potential for real harm exists as well. Insurance premiums
also can rise for the same reason, and individuals who are paying
out-of-pocket likewise are forced to pay more.
John N. Billock, CPO/LPO, FAAOP, Orthotics & Prosthetics Rehabilitation
Engineering Centre, Warren, Ohio,
Unfortunately, Billock continues, in hindsight we see that licensure
would have been much easier to achieve then, and would have been better
accepted for its real purpose, which is to protect the consumers of O&P
services and assure that care was being provided by truly qualified
practitioners, I.e. practitioners who met standards consistent among allied
healthcare providers and standards that ensured appropriate training and
educating in the provision of O&P care--not the confusing situation
consumers find in today's practice of orthotics and prosthetics
Miki Fairley Editor - Licensure: Setting O&P Apart
Licensure helps authenticate a profession and in many industries is a
hallmark of recognized expertise. For instance, what the engineering
profession says about licensure also can be applied to orthotics and
prosthetics:
The profession regulates itself by setting high standards for professional
engineers, and by law, many jurisdictions require engineers to be licensed
in order to practice. These requirements and high standards help protect the
public's safety and welfare--National Council of Examiners for Engineering
and Surveying (NCEES).
Licensure not only protects the welfare of the public, it helps protect the
livelihood of the bearer.
Licensure in O&P got off to a late start relative to other healthcare
professions and it's been traveling a rocky road. Although there are only
about 8,000 credentialed O&P providers, there are more than 140,000
providers with the right to bill L-Codes, according to the Centers for
MEDICARE & Medicaid Services (CMS). That's a lot of potential competition.
Tony Barr, Barr Foundation , agrees, The fact remains that, in most states
anyone--without regard to any qualification-- can still continue to provide
O&P services and bill MEDICARE. Those unqualified, non-certified,
non-licensed providers in 39 states can continue to bill Medicaid (in
California you must be ABC to bill Medical) and private insurers. We failed
to take an opportunity to stop this at the Negotiated Rules Committee
meeting in 2003 ! The O&P industry has been slow to embrace the need to
define and regulate its own profession and, as a result, is now facing
multiple issues of attempting to compete with unequally qualified O&P
service providers for equal (or potentially greater) reimbursements. As long
as your O&P field remains unlicensed its not a legitimate health care
'profession'.Yeah, we continue to beat the licensure drum but and we average
adding one state a year to the states that have been regulated since
1995.The truth is that many don't want the accountability and oversight of
state regulation and both credentialing association do neither. Can you
blame MEDICARE and third party payers from pulling back coverage's when
providers in approx 40 states are not even required to have a meaningless
and optional credential let alone any accountability or oversight of the
faulty workmanship you have pointed out. Every provider in every state is
aware of the crap that is being made out there by some providers. They have
seen it and laughed but not gotten angry enough to expose it or do anything
about it ?
We need folks to expose the fact that your field is infiltrated by many
incompetent, untrained providers, who are insulated from any accountability
and oversight by requirements of a optional educational requirement,
qualifications and accreditations.
The requirement of license not only better protects the patient, provides
much needed credibility to the provider, but most importantly provides
better oversight and accountability to the profession who is currently
viewed as a DME provider.
Barr hopes the O&P state associations will press O&P providers in all states
to enact state regulation and eventually a federal statute that addresses
who is clinically qualified to provide O&P services: From the prosthetic
patient perspective, wouldn't more protection have been accomplished from
adoption of legislation that established a federal standard for who is
qualified to provide care, replacing the present zero regulation existing in
40 states?
We tried that with the introduction of the William G.Barr Amputee
Protection Bill in 1998, where all providers would be mandated by national
compliance to be ABC/BOC certified. AOPA would not support it. In hindsight
it may of been a blessing since it would of delayed further the need of
regulation via a state license not what is revolving into a water downed
credential.
There is no mandatory requirement, nor accountability, nor oversight
provided by the two credentialing associations. Legitimate O&P providers
should view licensure as a means to survive and provide longevity to their
profession and .....to improve provider credibility and justify proper
reimbursement from MEDICARE and other third party payers.
Every job is a self-portrait of the person who does it. Autograph your work
with excellence.
Keep in mind you maybe held accountable to its integrity. Author Unknown
Good day,
Anthony T. Barr
President
Barr Foundation
www.oandp.com/barr
www.ErtlReconstruction.com
********************
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.
Thank you for posting your reply to the Listserve so I may respond.
With all due respect, you are incorrect in your statement posted today that
my post was hijacking a thread and I was soap boxing for personal
agendas and is very discouraging to read and dilutes the other valuable info
we get here.
On the contrary,asaccepted by many of your colleagues, my thread is indeed
most important and relative to your MEDICARE survey you posted intially.
There are no more than 8,000 credentialed O&P providers in the US. Yet
according to the Centers for MEDICARE & Medicaid Services (CMS), there are
more than 140,000 providers with the right to bill for L-Codes. The list
includes literally thousands of medical professionals and providers,
department stores, etc. It's a virtual potpourri of entities, very few of
which have any direct connections to O&P,.
Chris, In fact, if you are indeed sincere in your statement to continue to
encourage the list to swap and share information on ANYTHING related to O
and P, many of your colleagues comments below indicate a direct
relationship of MEDICARE and the absence of O&P regulation and maybe at the
root of many of your dilemmas, you and others are facing with MEDICARE.
Their comments (below) may very well compliment your survey.
A.J. Filippis, CPO, Wright & Filippis,:
Because of the direction that a handful of states have taken at this point,
prompting changes in some of the suppliers' standards, said Filippis, the
situation is changing: The Department of Veterans Affairs (VA) is reportedly
considering accepting state licensure as its required credentials for O&P.
That may force our hand here in Michigan. If MEDICARE and the suppliers'
standards come through that way, and the VA accepts the criterion, I think
it's going to be just a matter of time before we need to follow suit.
Otherwise we're going to be fighting that battle through ABC as well.
Jeff Fredrick, CPO, LPO,Hanger Prosthetics & Orthotics Inc., Tallahassee,
Florida, is now frustrated by those who promote a double standard by
opposing licensure: First of all, it's irrational because licensure is here
to stay, and once MEDICARE or some of these higher payers really start
dialing into it, you're going to have to be licensed in a state to provide
services, and that means further regulation. That's coming.
Jim Rogers, CPO,LPO FAAOP, Orthotic & Prosthetic Associates Inc.,
Chattanooga, Tennessee, and chair of the American Academy of Orthotists and
Prosthetists (the Academy) Licensure Task Force, noted that the Academy long
has been an advocate for licensure. We don't see it as a panacea, but as
one piece of a quilt that needs to be in place to protect the profession
over a whole range of areas. But that quilt is important. And licensure by
state is one of the very integral parts of the quilt.
Rogers pointed out that there are no more than 8,000 credentialed O&P
providers in the US. Yet according to the Centers for MEDICARE & Medicaid
Services (CMS), there are more than 140,000 providers with the right to bill
for L-Codes. The list includes literally thousands of medical professionals
and providers, department stores, etc. It's a virtual potpourri of
entities, very few of which have any direct connections to O&P, said
Rogers. So in the Academy's opinion, if you are licensed in your state, and
your state thus defines who can do what, then you have some measure of
protection against unscrupulous providers.
Although it may be true that licensure will protect practitioners, help to
delineate our scope of practice, and preserve our economic base, what we're
doing is protecting the patient, because ultimately, it is the patient
that's harmed the most when there is no licensure protection.
Lack of licensure protection also impacts the pocketbook of every taxpayer,
Rogers explained. When unqualified individuals provide care that does not
adequately serve MEDICARE or Medicaid patients, causing them to need further
services later that might not have been necessary had they been cared for
correctly the first time, the taxpayer pays more. In medically complex
patients, the potential for real harm exists as well. Insurance premiums
also can rise for the same reason, and individuals who are paying
out-of-pocket likewise are forced to pay more.
John N. Billock, CPO/LPO, FAAOP, Orthotics & Prosthetics Rehabilitation
Engineering Centre, Warren, Ohio,
Unfortunately, Billock continues, in hindsight we see that licensure
would have been much easier to achieve then, and would have been better
accepted for its real purpose, which is to protect the consumers of O&P
services and assure that care was being provided by truly qualified
practitioners, I.e. practitioners who met standards consistent among allied
healthcare providers and standards that ensured appropriate training and
educating in the provision of O&P care--not the confusing situation
consumers find in today's practice of orthotics and prosthetics
Miki Fairley Editor - Licensure: Setting O&P Apart
Licensure helps authenticate a profession and in many industries is a
hallmark of recognized expertise. For instance, what the engineering
profession says about licensure also can be applied to orthotics and
prosthetics:
The profession regulates itself by setting high standards for professional
engineers, and by law, many jurisdictions require engineers to be licensed
in order to practice. These requirements and high standards help protect the
public's safety and welfare--National Council of Examiners for Engineering
and Surveying (NCEES).
Licensure not only protects the welfare of the public, it helps protect the
livelihood of the bearer.
Licensure in O&P got off to a late start relative to other healthcare
professions and it's been traveling a rocky road. Although there are only
about 8,000 credentialed O&P providers, there are more than 140,000
providers with the right to bill L-Codes, according to the Centers for
MEDICARE & Medicaid Services (CMS). That's a lot of potential competition.
Tony Barr, Barr Foundation , agrees, The fact remains that, in most states
anyone--without regard to any qualification-- can still continue to provide
O&P services and bill MEDICARE. Those unqualified, non-certified,
non-licensed providers in 39 states can continue to bill Medicaid (in
California you must be ABC to bill Medical) and private insurers. We failed
to take an opportunity to stop this at the Negotiated Rules Committee
meeting in 2003 ! The O&P industry has been slow to embrace the need to
define and regulate its own profession and, as a result, is now facing
multiple issues of attempting to compete with unequally qualified O&P
service providers for equal (or potentially greater) reimbursements. As long
as your O&P field remains unlicensed its not a legitimate health care
'profession'.Yeah, we continue to beat the licensure drum but and we average
adding one state a year to the states that have been regulated since
1995.The truth is that many don't want the accountability and oversight of
state regulation and both credentialing association do neither. Can you
blame MEDICARE and third party payers from pulling back coverage's when
providers in approx 40 states are not even required to have a meaningless
and optional credential let alone any accountability or oversight of the
faulty workmanship you have pointed out. Every provider in every state is
aware of the crap that is being made out there by some providers. They have
seen it and laughed but not gotten angry enough to expose it or do anything
about it ?
We need folks to expose the fact that your field is infiltrated by many
incompetent, untrained providers, who are insulated from any accountability
and oversight by requirements of a optional educational requirement,
qualifications and accreditations.
The requirement of license not only better protects the patient, provides
much needed credibility to the provider, but most importantly provides
better oversight and accountability to the profession who is currently
viewed as a DME provider.
Barr hopes the O&P state associations will press O&P providers in all states
to enact state regulation and eventually a federal statute that addresses
who is clinically qualified to provide O&P services: From the prosthetic
patient perspective, wouldn't more protection have been accomplished from
adoption of legislation that established a federal standard for who is
qualified to provide care, replacing the present zero regulation existing in
40 states?
We tried that with the introduction of the William G.Barr Amputee
Protection Bill in 1998, where all providers would be mandated by national
compliance to be ABC/BOC certified. AOPA would not support it. In hindsight
it may of been a blessing since it would of delayed further the need of
regulation via a state license not what is revolving into a water downed
credential.
There is no mandatory requirement, nor accountability, nor oversight
provided by the two credentialing associations. Legitimate O&P providers
should view licensure as a means to survive and provide longevity to their
profession and .....to improve provider credibility and justify proper
reimbursement from MEDICARE and other third party payers.
Every job is a self-portrait of the person who does it. Autograph your work
with excellence.
Keep in mind you maybe held accountable to its integrity. Author Unknown
Good day,
Anthony T. Barr
President
Barr Foundation
www.oandp.com/barr
www.ErtlReconstruction.com
********************
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: OPINION - MEDICARE survey follow up,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/227789.
