Is this allowed? RESPONSES

Is this allowed? RESPONSES

Randy McFarland

7/21/2014

ORIGINAL POST

I have seen orthotic manufacturers print up and distribute Prescription pads
including pictures of their products and a place for the physician's
signature. Does anyone know if there are any regulations regarding this
practice? Randy McFarland, CPO

 

 RESPONSES

We do it in Canada all the time - I have my own with a map to my clinic and
a list of all the devices so the Dr just needs to check one. I have never
had a problem with reimbursement - I think prescriptions are like checks -
you can actually write one on a blank piece of paper and as long as all the
info is there and the Dr signs - it is legal.

 

Someone sent an email out on this list similar to this on June 12th.

 

It is NOT allowed any more. It was always a questionable thing to do, but

now it is clearly against policies.

 

I lost count how many of those pads, of various design, I have seen

from all kinds of O&P practices. Makes it easy to chose for the

referral sources. I think, they simply picked on OUR idea.

 

Also remember, a manufacturer can print and distribute anything...You.the
one that Medicare pays is solely responsible for everything, no the
prescriber, not the patient, not the manufacturer.

 

I have heard that pre printed prescription pads are not illegal and can be
used BUT...

What was said at a Medicare workshop held by Region C is that a preprinted
prescription or superbill with check boxes next to specific devices would be
viewed by an auditor as leading the physician to prescribe something they
may not otherwise prescribe

Examples given was a check box for a L1845 knee orthosis but nothing for a
simpler/lower cost L1820, or custom molded insoles A5513 and no selection
available for heat moldable insoles A5512.

 

I am not sure if this is illegal, it might be. Also being certified as a
Pharmaceutical sales rep, this is regarded as illegal as it is looked at as
buying referrals and product placement. Whether this is the same in P and O,
I'm not 100% positive. I know the MD scripts must have certain info on them
and possibly need to be watermarked, but that is a different matter that may
vary from state to state.

 

It is my belief that those pads are just the beginning of the process. The
patient brings the padded script to your office, then the office needs to
get a certificate of medical necessity due to the insurance companies needs
as well as notes and doctors documentation of need Don't you guys need
Certificates of medical necessity ?

 

This is what we have done for our Orthotist Pedorthist and there are several
of our regular ordering physicians who use our pads at their offices. Very
similar to what you are asking about the orthotic manufacturer's. It's just
a way of keeping your name 'out there'.

 This one needs an overhaul to meet standards. Next time we are having some
printed we have to add a line for the patients name (because there have been
too many times when the dr. doesn't even write the patients name on the Rx.
We will also be adding a line for the dr. to print their name which will
give us all the eliments to stay up on Medicare standards, with that we hope
it eliminates the use of an Attestation Statement back to the dr. to sign
and then get back to us before we bill.

 Actually, whatever the dr. writes on and has all the elements an Rx should
have (discription of the item, beneficiary's name, prescribing dr.'s name,
date of order (start and stop dates, if applicable) and dr.'s signature) is
considered acceptable.

 

I worked in the pharmaceutical industry many years ago and this was very
common. As far as I can tell this is still a common practice in
pharmaceuticals and is likely still completely legal in O&P. On the pharmacy
side it is argued that it prevents physicians from making errors and easier
for pharmacists to decipher.

 

I doubt it. Many practitioners have their own. However I tend to fill out
mine, give it to the patient and have him or her bring it to the physician
for their face to face exam. Some physicians want my recommendations. The
ones I've seen practitioners use generally have no brands of any kind. They
just list types of devices and corresponding L-codes. Where the regulations
would come in is if the physician faxes the script to say, Donjoy and they
fill it with no practitioner doing any measuring our fitting. If it's a
state with licensing rules then regulations would apply. Such would not
work in Florida.

 

It's called inducement for referral...Medicare doesn't take to lightly with
that..also..Medicare doesn't take prescriptions anyway...for now on, the
want..Detailed Written Orders And with the extended work up on the
patient, the medical necessity will be in the FACE TO FACE documentation.
I don't think the commercial carriers are really looking into this matter at
this point. Some of them are following the Medicare rules..like Humana,
United, Wellcare, Amerigroup, the others are slow to follow. Here in this
practice, we just make it a rule to follow the Medicare