No New Medicare Rules!! For now.
Charles Barocas
Description
Collection
Title:
No New Medicare Rules!! For now.
Creator:
Charles Barocas
Date:
9/4/2008
Text:
Dear List,
Yesterday at 2PM EST, the future of Medicare O&P was decided. In a conference call, held by CMS, all those who called in were informed that all the new rules concerning O&P facility accreditation have been scrapped. All Physician's (includes podiatric), Orthotists, Prosthetists, C-peds and a few others are now exempt from the facility accreditation process. If you already paid to go through the process......sorry. If you are a DME facility you still need to go through the process. That's even if you have an Orthotist on staff. If you bill under the Orthotist, you are exempt. If you bill under the DME number you are not exempt. (any you DME's out there want to hire me?:). A CO just became more valuable in the marketplace.
Why the change? It seems the law states that the Secretary of HSS shall make no rules regulating O&P until they specifically define all the players. CMS needs to be specific on what certifications or training are needed to apply what brace before they can make any rules regulating O&P. In early 2009 they are going to hold meetings again with all the usual suspects (national organizations) and invite public comment and decide who can do what and then come up with new rules. But right now it is the Outback Era. NO RULES!!! No facility accreditation inspections required for O&P shops at this time. You will be able to listen to this conference call yourself when they post the download on the CMS website. It's 90 minutes long with the Q&A period. It should be up by September 10th. ABC/BOC will probably put the link on their websites.
A couple of good things....
1. It seems from what I heard, Stock&Bills still need to go through the accreditation process. The Doc is exempt if he is billing under his own name for his own patients. Stock and Bills that bill themselves (read Dj Ortho) are not. I don't know if one accreditation covers the Dj's of the world for the entire United States or if they will need to go through the process for every account they service.
2. The new rules that may come in 1009 or 2010 may or may not exempt Physician's and other certified/licensed O&P professionals. But the new rules will require (if I have anything to do with it...and I will) that anyone fitting a Medicare patient, in a facility that requires the facility accreditation or not, will need to have a minimum certification such as orthotic fitter. So even in a Physician's office, unless the Doc is fitting everyone himself, a trained and certified individual will have to fit the patient. CMS could say that Athletic Trainers, PA-C's, LPN's, CMA's, PT's, OT's, Orthopedic Technologists, etc. meet this new rule. They just don't want the receptionist fitting the patient. And isn't that how it should be?
Yes, CMS has caused us all to lose sleep. But you can be sure all the national organizations will be fighting for their turf and the new rules just might make (or maybe not) your ABC or BOC certification, from orthotic fitter on up, a more valuable entity. We have a second chance to help CMS get this right. Lets not blow it.
Charlie
Charles Barocas, CO (FL Lic-retired)
Yesterday at 2PM EST, the future of Medicare O&P was decided. In a conference call, held by CMS, all those who called in were informed that all the new rules concerning O&P facility accreditation have been scrapped. All Physician's (includes podiatric), Orthotists, Prosthetists, C-peds and a few others are now exempt from the facility accreditation process. If you already paid to go through the process......sorry. If you are a DME facility you still need to go through the process. That's even if you have an Orthotist on staff. If you bill under the Orthotist, you are exempt. If you bill under the DME number you are not exempt. (any you DME's out there want to hire me?:). A CO just became more valuable in the marketplace.
Why the change? It seems the law states that the Secretary of HSS shall make no rules regulating O&P until they specifically define all the players. CMS needs to be specific on what certifications or training are needed to apply what brace before they can make any rules regulating O&P. In early 2009 they are going to hold meetings again with all the usual suspects (national organizations) and invite public comment and decide who can do what and then come up with new rules. But right now it is the Outback Era. NO RULES!!! No facility accreditation inspections required for O&P shops at this time. You will be able to listen to this conference call yourself when they post the download on the CMS website. It's 90 minutes long with the Q&A period. It should be up by September 10th. ABC/BOC will probably put the link on their websites.
A couple of good things....
1. It seems from what I heard, Stock&Bills still need to go through the accreditation process. The Doc is exempt if he is billing under his own name for his own patients. Stock and Bills that bill themselves (read Dj Ortho) are not. I don't know if one accreditation covers the Dj's of the world for the entire United States or if they will need to go through the process for every account they service.
2. The new rules that may come in 1009 or 2010 may or may not exempt Physician's and other certified/licensed O&P professionals. But the new rules will require (if I have anything to do with it...and I will) that anyone fitting a Medicare patient, in a facility that requires the facility accreditation or not, will need to have a minimum certification such as orthotic fitter. So even in a Physician's office, unless the Doc is fitting everyone himself, a trained and certified individual will have to fit the patient. CMS could say that Athletic Trainers, PA-C's, LPN's, CMA's, PT's, OT's, Orthopedic Technologists, etc. meet this new rule. They just don't want the receptionist fitting the patient. And isn't that how it should be?
Yes, CMS has caused us all to lose sleep. But you can be sure all the national organizations will be fighting for their turf and the new rules just might make (or maybe not) your ABC or BOC certification, from orthotic fitter on up, a more valuable entity. We have a second chance to help CMS get this right. Lets not blow it.
Charlie
Charles Barocas, CO (FL Lic-retired)
Citation
Charles Barocas, “No New Medicare Rules!! For now.,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/229510.
