Five of the major national organizations representing the clinical, business, and quality-improvement aspects of the O&P profession announced an agreement regarding the minimum education and training requirements that providers and suppliers of custom orthotic and prosthetic devices must satisfy in order to provide custom O&P care. This agreement, signed by the leadership of the American Academy of Orthotists and Prosthetists (the Academy), the American Board for Certification in Orthotics, Prosthetics & Pedorthics (ABC), the American Orthotic and Prosthetic Association (AOPA), the Board for Certification/Accreditation, International (BOC), and the National Association for the Advancement of Orthotics and Prosthetics (NAAOP), delineates, for the first time, a consensus position in the profession regarding the minimum education and training that O&P professionals must have to demonstrate competency.
The announcement comes as the Centers for Medicare & Medicaid Services (CMS) is drafting proposed regulations to prohibit payment to any provider or supplier who is not qualified through specific education and training to treat patients requiring custom orthoses and prostheses. Currently, the Medicare program does not require any specific education and training for providers and many suppliers who provide O&P care.
"This is a great day for Medicare patients with amputations or other physical disabilities requiring O&P care," said Tom Guth, CP, president of NAAOP.
James Rogers, CPO, FAAOP, president of the Academy, said, "This consensus position stems from legislation enacted in 2000, the Benefits Improvement and Protection Act (BIPA), that sought to protect Medicare patients from unqualified practitioners and suppliers while limiting the potential for fraud and abuse. We are hopeful that CMS will seriously consider this consensus position from the O&P profession as they determine which providers and suppliers have specific education and training sufficient to warrant payment by Medicare for custom orthotics and prosthetics."
He added, "This [agreement] is nothing short of historic, and I commend ABC, BOC, and the executive committees. This decision&unifies our profession and will enable us to do a lot of things that we couldn't do before. The trickle down effect will be profound."
The agreement establishes specific education requirements by mandating a bachelor's degree, as well as specific formalized instruction from accredited O&P schools as the only standard in the United States for providers and suppliers of custom O&P care. Accredited schools must require that students pass a comprehensive set of O&P-specific courses before being qualified to sit for the ABC and/or BOC orthotist and/or prosthetist certification exams. A training requirement stipulates that candidates must engage in supervised patient care for at least one year in each discipline (orthotics or prosthetics). Finally, a "grandfathering" provision will phase in the consensus requirements.
Specifically, the agreement states that "with respect to grandfathering, any individual seeking BOC certification under the requirements existing as of December 31, 2008, would have four (4) years until January 1, 2013 to complete the requirements and apply for the BOC orthotist and/or prosthetist certification exam(s)."
Preston Madler, BOCO, chairman of the BOC Board of Directors, said, "The grandfathering provision will ensure that eligible candidates who wish to take our O&P competency exams are not penalized as these requirements come into effect."
Greg Safko, president of the BOC, agreed. "It was important to us that there be no negative impact on those who are pursuing BOC certification," he said. "BOC will maintain its current eligibility requirements through January 1, 2013, for those individuals who wish to pursue BOC orthotist and/or prosthetist certification." According to Safko, after December 31, 2008, BOC certificant candidates will have the choice of pursuing BOC certification either under the BOC's current eligibility requirements or the new requirements, which are detailed in the full agreement between BOC and the four other O&P organizations. January 1, 2013, he said, marks the date in which BOC will only accept certificant candidates who have fulfilled the new minimum education and training requirements.
Robert Lin, CPO, FAAOP, president of ABC, said, "With O&P technology becoming more complex and the wide array of knowledge and skills needed to provide quality care, these consensus education and training requirements establish a benchmark for quality into the future."
The five organizations believe that this agreement will help CMS implement appropriate education and training standards for O&P patient care through the regulations they plan to propose in the near future. "We see these education and training requirements as the long-term standard that should be adopted by all public programs and private payers of custom orthotic and prosthetic care, including state licensure initiatives," said Brian L. Gustin, president of AOPA. "We expect that CMS will adhere to the congressional intent of the statute they are regulating and do the right thing for Medicare patients requiring O&P care."
To read the agreement, visit www.naaop.org/assets/pdf/joint_statement_boc_alliance.pdf ; to read the cover letter that the five organizations sent to CMS, visit www.naaop.org/assets/pdf/cms_cover_letter_boc_alliance.pdf
