Fellow Colleagues Please read complete document.SBA is helping

Fellow Colleagues Please read complete document.SBA is helping

Jake Wood, CP

8/22/2012

My fellow colleagues,
Please read complete information I am sending you. SBA is responding.
Please send your own story.
The following is what I submitted to SBA Ombudsmen office in Washington,
DC. at _ <URL Redacted>
( <URL Redacted>)

___________________
Medicare within the last year and half has established and implemented a
system to uncover fraud (great idea). Unfortunately, in doing so, they have
targeted honest, ethical, decent , tax paying Americans and flag waving
Americans. I am referring to the Orthotic and Prosthetic (artificial limbs for
amputees) professions in the U.S.
I attended a documentation program from Medicare University approximately 3
 weeks ago. The program in the AM provided information, the repeat program
in the afternoon provided completely different information, contradicting
the morning session. If Medicare cannot agree amongst themselves, how can
they implement fairness nationally.
Where is due process? Medicare established that the Prescribing Physician
must evaluate the amputee functional level. My job for 33 years has been to
establish functional level and report back to the physician with my
recommendation; then the Prescribing Physician must approve (functional level
determines the cost of foot, knee). Medicare established the Prescribing
Physician must determine and have this information in their files (the
information cannot be provided by us the professionals). The problem is the
physicians knew nothing about this requirement, additional my profession knew
nothing about these rules.
So now Medicare implements prepayment audits and post payment audits. When
the audits ask for this information, no one has the documents. They hold up
 payment until the audits are completed (months and I mean months). When
the system cannot obtain these documents, Medicare keeps the money on work
done or they want the payments back. In the interim, I go out of business,
like a lot of my fellow colleagues in small practices.The
government/Medicare/whomever is devastating my profession. Where is due process?
________________________________
 
From : Office of the national Ombudsman (U.S. Small Business
Administration)
    August 20, 2012
 
Dear Mr. Wood:
I received your Federal Agency Comment Form dated August 18, 2012,
regarding prepayment and post payment audits conducted by Medicare on Orthotics
and Prosthetic companies.
 
I referred your case to the Centers for Medicare and Medicaid Services
(CMS) for a high-level review and response. When I receive a response, I will
forward a copy to your attention.
 
The Office of the National Ombudsman was created by Congress under the
Small Business Regulatory Enforcement Fairness Act (SBREFA) to receive
comments from small business regarding concerns of unfair or excessive Federal
regulatory actions.
 
Should you have any questions or concerns in this matter, please contact
Ellie Zahirieh, Case Management Specialist of my staff by telephone at
202-205-2417. fax at 202-481-5719 or e-mail at <Email Address Redacted>
(mailto:<Email Address Redacted>)
 
Sincerely,
   Esther H. Vassar
   National Ombudsman and Assistant Administrator for Regulatory
Enforcement Fairness
________________________
 
I will be more then happy to send you the original e-mail(official
document with SBA letter head). I could not copy of send an attachment to the list
 server.
 
If you are AOPA member or small business O&P, respond and send your own
experiences. NOW!
 
Jake R. Wood C.P., FAAOP
O&P Associates, Inc.
10506 W. Bluemound Rd.
Milwaukee, WI 53226
414-257-2727
414-257-9898 (Fax)
414-315-9749 (Cell)