Manufacturers Becoming Our Direct Competitors Comments Part 3

Manufacturers Becoming Our Direct Competitors Comments Part 3

Jon Hess

4/22/2014

Part 3

 

 

 

Jon,

This process has been eroding our industry for years! It all started with
Don-Joy, I hated it then, and it is even worse now! Arizona has targeted
Podiatrists for years along with Richie. It would be much easier to list the
companies that are not competing with us. I think I can do it on one hand,
Sure step, Orthomerica, Medi, and Allard. Those are the only manufacturers
of OTS products that are commercially available that are not competing with
us. I just wished this was the worse thing facing our industry. We are not
in Kansas anymore.





 

 

Dear Mr. Hess:

 

Unfortuately, this has been happening for years! About 10 years ago, just
about anyone with an off-the-shelf product put the bug in 100's of 1000's of
doctors minds that CMS will allow them to bill for O & P. Hely & Weber,
Cybertech, OTC, Ossur to name a few sold upwards of $100,000.00 of stock to
individual doctors and said Why send the patient to the O & P professional?
You can bill for your office visit AND the device. I have docs call me
every week wanting a Lcode under the guise of we are sending you a
referral..meaning: Thanks now I know what to bill under. We have one doc
up here with so much inventory from Cybertech, to unload it, he insists upon
getting the referral back from the IPA. IPA wants a better deal and asks us
to do it. Unfortunately Cybertech doesn't make that particular brace
anymore, so we can't supply that exact one. I think it was one of those
braces that was an inch short of the CMS standards for TLSO and Cybertech
had to go back to the drawing board, hence the doc got the old stuff.

 

Heck you (anybody) can buy Cybertech Minerva on Amazon for $264.99. I called
AOPA and Cybertech on this one. AOPA said it wasn't illegal, can't stop
them. I retorted that Cybertech was an AOPA member, what happened to
ethical standards? The Cybertech sales rep I spoke with was flabbergasted,
couldn't believe that BraceAbility was selling the brace so cheaply.HUH?

 

I have asked the list serve to go back and read the other Dobson & Davanzo
report about illegal payments CMS has been making to providers and nobody
seems to get it. If you look at the data it clearly shows that docs in 2007
have a good third of the Orthotic payments from CMS and by 2011 they are
approaching 43%. This is 2014, by extrapolation they should have at least
50%. The data is even more stark in Texas, a licensure State!

 

One of my staff went to a CMS seminar 2 weeks ago and CMS said straight up
that only accredited facilities with certified O & P personnel could bill
for O & P. Everyone there was stymied. O & P practitioners spoke up and said
that is not the case. The CMS rep dismissed the comments and went to the
next topic. In the crowd was several Physician PODS.silence. The subject of
physician documentation was a hot topic. Practitioners were complaining that
getting docs to pony with the neccessary notes was frustrating. However,
again the PODS were silent. The point was that the docs can fabricate
anything at all for documentation for their own devices, but O & P
practitioners were held accountable for the same documentation. Of course
over-utilization, Stark Law, and upcoding were all discussed as problematic
when docs do O& P. Again the CMS rep dismissed those talking points and
continued the scripted outline. Does anybody know if pharmacists need all
clinical notes from the docs for prescription meds?

 

Listen folks, there are only 7800 of us ( numbers are going down since 2000)
and 888,000 physicians looking to find other revenue streams. Don't think
someone is coming up with Pop-n-Click Prosthetic componetry? There is
absolutely no loyalty from these manufactures and AOPA doesn't care.

 

As far as Sabel and Hanger are concerned, they're gearing up for ACA, where
eventually payments will be doled out by Preferred Hospitals that will act
as an umbrella for doctors groups and specialities. The language is already
in the contracts. We have Health Net and Conifer arguing back and forth
about who has financial responsibility for authorized services. Depending
who you talk to in claims, Alliance Hospital comes up as the at risk party.
At first I thought this was a clear case of Claims is out of their mind
again...but add 2 + 2 and you see where this is going.

 

You may print any or all or none.

 

 

Jon,

 

I read your post on the oandp list serv and couldn't help but comment. It is
a sad commentary on what has happened to this industry and ironic that the
very guy that built the largest player in the O&P industry, is now turning
against the field for his personal gain. But this isn't a new phenomena!
Companies like DJO, Breg, DeRoyal, Ossur, and Aspen have been doing this to
the O&P practitioner for years, yet every orthotist and prosthetist I know
continues to support these companies!

 

Wake up! As long as you continue to feed them your business, they will
continue to place more reps on the street to find your referring physicans
and hospitals and take them direct. When and if, the O&P practitioners ever
unite to stop this movement, and stop supporting these companies, the
profession might be able to be saved, but right now it is at a very high
risk of going away.

 

Aspen has taken a majority of the spinal braces away from the orthotist and
placed them and the revenue in the hands of the physician. And lately, they
have been contracting with hospitals, further cutting you out of the action.
It's time the field supports those companies that support them. Companies
like Townsend Brace, Orthomerica, Endolite, to name a few have always
supported the O&P practitioner and should be recognized that way.

 

A major disappointment. Especially in Arizona AFO. I am extremely
disappointed. I have touted their expertise in the field and been an
exclusive user of their services vs the knockoffs. Time to sharpen my
skills as a fry cook.