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From the Editor: Credentials Help Consumers, Payers
By Miki Fairley  Recent events regarding fraud and abuse highlight
the long-standing need to separate DME providers from licensed (in
states where applicable), certified prosthetists and orthotists and
credentialed O&P facilities. More information about
high-profile fraud cases in Florida can be found in our news item
"Florida Fraud Costs Medicare."
While licensure and/or certification are not absolute guarantees
against fraud and abuse or poor practice standards by an individual
practitioner, they greatly increase the assurance of competent care
for amputees and orthotic patients. They help prevent financial
loss to government and private payers. These avenues also provide a
mechanism for fraudulent or substandard providers to lose their
license and/or certification. Now, though, in many areas, almost
anyone can hang out their shingle, put an ad in the Yellow Pages,
and start practicing.
O&P may face an identity crisis in the eyes of patients,
payers, and the public, but the future definitely looks bright if
the field can get through the next few tough years. This is the
conclusion of some experts in the field, as discussed in the
feature article, "O&P: Who Are We?"
PT Direct Access: A Bad Idea?
Why do legislative affairs experts consider the Physical
Therapist Direct Access legislation a bad idea for O&P? Walt
Gorski, director of legislative and regulatory affairs for the
American Orthotic & Prosthetic Association (AOPA), and Peter
Thomas, general counsel for the National Association for the
Advancement of Orthotics & Prosthetics (NAAOP) explain their
views in our feature PT Direct Access article.
Lobbying: Patients Help
"Thanks to the Medicare Prescription Drug, Improvement and
Modernization Act of 2003, the cutbacks on certain diabetic foot
procedure codes have gone too far to make routine care for the
diabetic foot a reality for all patients who truly need it," points
out NAAOP Vice President Mark Taylor, MLS, CPO. But when it comes
to getting the ear of legislators, patients can help, Taylor
observes in the DC Direct article.
Murderball!
And anyone who might think "disabled" equals "weak" will likely
change his mind after seeing a murderball game. This fast, tough
sport, also known as "quad rugby," is the subject of a film and
also the sports article "Murderball: Quad Rugby Wheels onto the Big
Screen."
Well, those summer days may not be "hazy" or "lazy" as the song
says, and they may be a bit "crazy," but we hope everyone is
enjoying some fun in the sun.
Table Of Contents - July 2005
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