OPINION - medicare survey follow up
cfairman
Description
Collection
Title:
OPINION - medicare survey follow up
Creator:
cfairman
Date:
2/12/2007
Text:
> Tony,
>
> My responses.
>
> With all due respect, I feel licensure is a valuable and necessary
> component in the future of o and p. However, that was not the topic
> of my post. I wanted the members of the list to know that my office
> was randomly selected to participate in a survey. I took the
> opportunity to express some displeasure with the handling of claims
> by our medicare contractor, CMS. It was a heads up everybody sort
> of post.
> By now, everyone knows, your primary adgenda is licensure and/or
> the Ertl procedure. In other internet lists that I've been on, your
> post would be considered hijacking a thread. Hijacking is when you
> change the original topic of the post and make it your own. Is
> your post relevant? sure, barely. Was it really necessary? Not
> very. By using each and every opportunity to chime in about the
> virtues of licensure, your message gets diluted. Sometimes less is
> more.
> At this years AOPA meeting I played a wonderful round of golf with
> a very seasoned practitioner who came from a state with licensure.
> I won't mention his name without his permission. His opinion was
> very eye opening to me, a youngish practitioner (at 35, certified
> for 6 years.)
>
> The most interesting piece of knowledge he handed down was that
> only the licensed practitioners were governed by the licensing
> bodies. The unlicensed practitioners were alive and well in the
> state and paying no dues, billing each and every insurance carrier,
> and operating out of the trunks of their cars. They were operating
> in a way that, we the true practitioners would be disgusted with.
> Oddly enough, if the licensed practitioners reported the unlicensed
> for unscrupulous practices they were told, since they are
> unlicensed we cannot oversee, fine, discipline them...etc. It
> served no immediate purpose in these cases. The practice owner/
> practitioner told me that the money spent licensing the state would
> have been much better spent in a marketing effort that educated the
> physicians and other referral sources on the values of seeking an
> educated and certified practitioner. Licensing their state
> essentially created a new body to pay dues to and created a new
> police force to enforce the laws on the people who didn't need it.
> My business partner likened it to gun control. The criminals don't
> register their guns anyway. The same people who use their guns
> responsibly, are the ones who register them. In O and P (so far),
> only the responsible practitioners seek licensure, the
> irresponsible seem to go on just fine without a license.
>
> Again, don't get me wrong. I certainly don't want to debate with
> you about the licensure topic, since I'm far less versed. I mainly
> wanted to point out that my post wasn't about licensure, yet you
> found a way to make it and every other post about licensure. It is
> not the answer to everything. Sure it is a step in the right
> direction. But in the future, please let some posts go on as they
> were intended. Please post about licensure when licensure is the
> topic.
>
> I apologize for the spelling and grammar since I'm on vacation and
> don't have the spell check at my disposal. I'm also posting late at
> night after a hearty meal complete with drinks, dessert, more
> drinks etc. Well, you get the idea.
>
> I continue to encourage the list to swap and share information on
> anything related to O and P. The soap boxing for personal agendas
> is very discouraging to read and dilutes the other valuable info we
> get here.
>
> Chris Fairman CPO
> Great Lakes P&O
> Michigan
>
> Tue, 6 Feb 2007 20:22:19 -0500
> Tony Barr < <Email Address Redacted> > wrote:
>
> IN MY HUMBLE OPINION AND VETERAN PARTICIPANT OF THE FAILED CMS
> NEGOTIATED RULES COMMITTEE HEARINGS, MY REPLIES ARE STATED IN CAPS
> BELOW.
> TONY BARR
>
> Dear List
> It took about 20 minutes, but I just participated in a survey about
> Medicare contractors, representatives, the appeals process, audits,
> etc. I expressed several times that I felt the representatives had
> little knowledge about prosthetics and orthotics when it comes to
> the appeals and audit processes.CF CPO
>
> AS A PARTICIPANT IN THE NEG REG COMMITTEE HEARINGS, MEDICARE/
> MEDICAID AND CMS DO HAVE A LITTLE KNOWLEDGE IN COMPREHENSIVE O&P
> BUT SO DO MANY PROSTHETISTS AND ORTHOTISTS WHOM ARE LEGALLY
> PERMITTED TO PRACTICE 'YOUR PROFESSION'IN THE USA, WITH OR WITH OUT
> CREDENTIALS OR A STATE LICENSE IN 39 STATES, INCLUDING MICHIGAN.TB
> WHAT COMPLICATES IDEOLOGIES EVEN MORE ,ARE THAT CERTIFIED
> ORTHOTISTS ARE ABLE AND PERMITTED BY BOTH CREDENTIALING
> ASSOCIATIONS, TO PROVIDE AND BILL FOR PROSTHETIC SERVICES AND VISA
> VERSA AS LONG AS CERTIFEES DON'T REPRESENT THEMSELVES AS
> 'CERTIFIED' IN THAT PARTICULAR DISCIPLINE TO THE PATIENT RECEIVING
> THE SERVICES!!TB
> THE RESULT IS CROSS CREDENTIALLING IS CONDONED AND NO OVERSIGHT OR
> ACCOUNTABILITY IS PROVIDED BY EITHER CREDENTIALING ASSOCIATIONS.TB
> ONLY OBTAINING A STATE LICENSE IN EITHER O OR P WOULD NOT LEGALLY
> PERMIT CROSSING OVER INTO ANOTHER DISCIPLINE THAT YOU ARE NOT
> PROPERLY AND DULY LICENSED IN.TB
>
> I also expressed that our field is very incorrectly categorized
> under DME. We are not leg and brace stores, but practitioners who
> provide very unique and custom services. Sometimes those services
> are very difficult to describe and the representatives in turn deny
> our claims.CF CPO
> O&P SERVICES ARE CLASSIFIED AS DME SINCE YOUR NATIONAL TRADE
> ASSOCIATIONS HAVE MEMBERS OF BOTH.TB
>
> My responses here were based on my own attendance at some local
> meetings. 99% of the meeting dealt with wheelchair rentals, and
> oxygen supplies. The educators were very well versed in equipment
> rental, but had extreme difficulty answering any O and P questions.
> (they even wondered why we were in attendance) Again, DME is very
> different from O and P.CF CPO
>
> I AGREE BUT NOTHING WILL CHANGE UNTIL YOUR 'PROFESSION' IS
> LICENSED BY THE STATE IN WHICH YOU PRACTICE AND COMPREHENSIVE O&P
> IS SEPARATED FROM DME WITHIN THE NATIONAL TRADE O & P ASSOCIATIONS.TB
> THERE ARE WHEEL CHAIR AND OXYGEN EQUIPMENT MANUFACTURES WITHIN THE
> MEMBERSHIP RANKS OF AOPA.TB
> COINCIDENTLY THE RAMPANT FRAUD AND ABUSE HAS BEEN IN THIS AREA OF
> DME, NOT O&P.
>
> HOWEVER YOU ARE AND WILL CONTINUE TO BE, ALL LUMPED TOGETHER AS DME
> PROVIDERS.
> Here are three more survey questions for O& P providers
> AND FOR CMS:
>
> 1) DO YOU THINK A 'CERTIFIED PROSTHETIST' IS PROPERLY TRAINED AND
> HAS RECEIVED ADEQUATE EDUCATION TO PROPERLY EVALUATE, FABRICATE AND
> FIT A SCOLIOSIS ORTHOSIS TO A PATIENT?
>
> 2) DO YOU THINK A 'CERTIFIED ORTHOTIST' IS PROPERLY TRAINED AND HAS
> RECEIVED ADEQUATE EDUCATION TO PROPERLY AND SAFELY AND SAFELY
> EVALUATE, FABRICATE AND FIT A A/K ,B/K OR U/E PROSTHESIS TO A PATIENT?
>
> 3) WHAT IS THE POINT OF CERTIFICATION WHEN IT IS ONLY OPTIONAL AT
> BEST IN 39 STATES, TO DELIVER AND BILL FOR COMPREHENSIVE O&P
> TREATMENT AND PROVIDERS WHOM CROSS CREDENTIAL INTO ANOTHER ALLIED
> HEALTH CARE SCIENCE THAT THEYU ARE NOT TRAINED IN, IS PERMITTED BY
> THE CREDENTIALING ASSOCIATION AND CMS AND OTHER THIRD PARY PAYERS ?
>
> Anthony T. Barr
> President
> Barr Foundation
> www.oandp.com/barr
> www.ErtlReconstruction.com
Chris Fairman CPO
Great Lakes P&O
3075 Clark Rd.
Suite 100
Ypsilanti, MI 48108
734-528-5200
<Email Address Redacted>
>
> My responses.
>
> With all due respect, I feel licensure is a valuable and necessary
> component in the future of o and p. However, that was not the topic
> of my post. I wanted the members of the list to know that my office
> was randomly selected to participate in a survey. I took the
> opportunity to express some displeasure with the handling of claims
> by our medicare contractor, CMS. It was a heads up everybody sort
> of post.
> By now, everyone knows, your primary adgenda is licensure and/or
> the Ertl procedure. In other internet lists that I've been on, your
> post would be considered hijacking a thread. Hijacking is when you
> change the original topic of the post and make it your own. Is
> your post relevant? sure, barely. Was it really necessary? Not
> very. By using each and every opportunity to chime in about the
> virtues of licensure, your message gets diluted. Sometimes less is
> more.
> At this years AOPA meeting I played a wonderful round of golf with
> a very seasoned practitioner who came from a state with licensure.
> I won't mention his name without his permission. His opinion was
> very eye opening to me, a youngish practitioner (at 35, certified
> for 6 years.)
>
> The most interesting piece of knowledge he handed down was that
> only the licensed practitioners were governed by the licensing
> bodies. The unlicensed practitioners were alive and well in the
> state and paying no dues, billing each and every insurance carrier,
> and operating out of the trunks of their cars. They were operating
> in a way that, we the true practitioners would be disgusted with.
> Oddly enough, if the licensed practitioners reported the unlicensed
> for unscrupulous practices they were told, since they are
> unlicensed we cannot oversee, fine, discipline them...etc. It
> served no immediate purpose in these cases. The practice owner/
> practitioner told me that the money spent licensing the state would
> have been much better spent in a marketing effort that educated the
> physicians and other referral sources on the values of seeking an
> educated and certified practitioner. Licensing their state
> essentially created a new body to pay dues to and created a new
> police force to enforce the laws on the people who didn't need it.
> My business partner likened it to gun control. The criminals don't
> register their guns anyway. The same people who use their guns
> responsibly, are the ones who register them. In O and P (so far),
> only the responsible practitioners seek licensure, the
> irresponsible seem to go on just fine without a license.
>
> Again, don't get me wrong. I certainly don't want to debate with
> you about the licensure topic, since I'm far less versed. I mainly
> wanted to point out that my post wasn't about licensure, yet you
> found a way to make it and every other post about licensure. It is
> not the answer to everything. Sure it is a step in the right
> direction. But in the future, please let some posts go on as they
> were intended. Please post about licensure when licensure is the
> topic.
>
> I apologize for the spelling and grammar since I'm on vacation and
> don't have the spell check at my disposal. I'm also posting late at
> night after a hearty meal complete with drinks, dessert, more
> drinks etc. Well, you get the idea.
>
> I continue to encourage the list to swap and share information on
> anything related to O and P. The soap boxing for personal agendas
> is very discouraging to read and dilutes the other valuable info we
> get here.
>
> Chris Fairman CPO
> Great Lakes P&O
> Michigan
>
> Tue, 6 Feb 2007 20:22:19 -0500
> Tony Barr < <Email Address Redacted> > wrote:
>
> IN MY HUMBLE OPINION AND VETERAN PARTICIPANT OF THE FAILED CMS
> NEGOTIATED RULES COMMITTEE HEARINGS, MY REPLIES ARE STATED IN CAPS
> BELOW.
> TONY BARR
>
> Dear List
> It took about 20 minutes, but I just participated in a survey about
> Medicare contractors, representatives, the appeals process, audits,
> etc. I expressed several times that I felt the representatives had
> little knowledge about prosthetics and orthotics when it comes to
> the appeals and audit processes.CF CPO
>
> AS A PARTICIPANT IN THE NEG REG COMMITTEE HEARINGS, MEDICARE/
> MEDICAID AND CMS DO HAVE A LITTLE KNOWLEDGE IN COMPREHENSIVE O&P
> BUT SO DO MANY PROSTHETISTS AND ORTHOTISTS WHOM ARE LEGALLY
> PERMITTED TO PRACTICE 'YOUR PROFESSION'IN THE USA, WITH OR WITH OUT
> CREDENTIALS OR A STATE LICENSE IN 39 STATES, INCLUDING MICHIGAN.TB
> WHAT COMPLICATES IDEOLOGIES EVEN MORE ,ARE THAT CERTIFIED
> ORTHOTISTS ARE ABLE AND PERMITTED BY BOTH CREDENTIALING
> ASSOCIATIONS, TO PROVIDE AND BILL FOR PROSTHETIC SERVICES AND VISA
> VERSA AS LONG AS CERTIFEES DON'T REPRESENT THEMSELVES AS
> 'CERTIFIED' IN THAT PARTICULAR DISCIPLINE TO THE PATIENT RECEIVING
> THE SERVICES!!TB
> THE RESULT IS CROSS CREDENTIALLING IS CONDONED AND NO OVERSIGHT OR
> ACCOUNTABILITY IS PROVIDED BY EITHER CREDENTIALING ASSOCIATIONS.TB
> ONLY OBTAINING A STATE LICENSE IN EITHER O OR P WOULD NOT LEGALLY
> PERMIT CROSSING OVER INTO ANOTHER DISCIPLINE THAT YOU ARE NOT
> PROPERLY AND DULY LICENSED IN.TB
>
> I also expressed that our field is very incorrectly categorized
> under DME. We are not leg and brace stores, but practitioners who
> provide very unique and custom services. Sometimes those services
> are very difficult to describe and the representatives in turn deny
> our claims.CF CPO
> O&P SERVICES ARE CLASSIFIED AS DME SINCE YOUR NATIONAL TRADE
> ASSOCIATIONS HAVE MEMBERS OF BOTH.TB
>
> My responses here were based on my own attendance at some local
> meetings. 99% of the meeting dealt with wheelchair rentals, and
> oxygen supplies. The educators were very well versed in equipment
> rental, but had extreme difficulty answering any O and P questions.
> (they even wondered why we were in attendance) Again, DME is very
> different from O and P.CF CPO
>
> I AGREE BUT NOTHING WILL CHANGE UNTIL YOUR 'PROFESSION' IS
> LICENSED BY THE STATE IN WHICH YOU PRACTICE AND COMPREHENSIVE O&P
> IS SEPARATED FROM DME WITHIN THE NATIONAL TRADE O & P ASSOCIATIONS.TB
> THERE ARE WHEEL CHAIR AND OXYGEN EQUIPMENT MANUFACTURES WITHIN THE
> MEMBERSHIP RANKS OF AOPA.TB
> COINCIDENTLY THE RAMPANT FRAUD AND ABUSE HAS BEEN IN THIS AREA OF
> DME, NOT O&P.
>
> HOWEVER YOU ARE AND WILL CONTINUE TO BE, ALL LUMPED TOGETHER AS DME
> PROVIDERS.
> Here are three more survey questions for O& P providers
> AND FOR CMS:
>
> 1) DO YOU THINK A 'CERTIFIED PROSTHETIST' IS PROPERLY TRAINED AND
> HAS RECEIVED ADEQUATE EDUCATION TO PROPERLY EVALUATE, FABRICATE AND
> FIT A SCOLIOSIS ORTHOSIS TO A PATIENT?
>
> 2) DO YOU THINK A 'CERTIFIED ORTHOTIST' IS PROPERLY TRAINED AND HAS
> RECEIVED ADEQUATE EDUCATION TO PROPERLY AND SAFELY AND SAFELY
> EVALUATE, FABRICATE AND FIT A A/K ,B/K OR U/E PROSTHESIS TO A PATIENT?
>
> 3) WHAT IS THE POINT OF CERTIFICATION WHEN IT IS ONLY OPTIONAL AT
> BEST IN 39 STATES, TO DELIVER AND BILL FOR COMPREHENSIVE O&P
> TREATMENT AND PROVIDERS WHOM CROSS CREDENTIAL INTO ANOTHER ALLIED
> HEALTH CARE SCIENCE THAT THEYU ARE NOT TRAINED IN, IS PERMITTED BY
> THE CREDENTIALING ASSOCIATION AND CMS AND OTHER THIRD PARY PAYERS ?
>
> Anthony T. Barr
> President
> Barr Foundation
> www.oandp.com/barr
> www.ErtlReconstruction.com
Chris Fairman CPO
Great Lakes P&O
3075 Clark Rd.
Suite 100
Ypsilanti, MI 48108
734-528-5200
<Email Address Redacted>
Citation
cfairman, “OPINION - medicare survey follow up,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/227790.
