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Patients Are Key to Educating Congress on Diabetic Foot Care Reimbursement
By Mark Taylor, MLS, CPO  Many professional orthotists and prosthetists
spend time engaging their elected representatives in Washington DC
on issues impacting reimbursement for diabetic foot services. Our
arguments have assisted our lawmakers in better understanding the
difficulties facing O&P providers when reimbursement fails to
adequately compensate even the minimum costs to provide
services.
However, our efforts seem to have fallen on deaf ears and are
filed away so deep that nothing happens. When will Congress get the
message that their constituents - our patients - are not getting
the care they need? The National Association for the Advancement of
Orthotics & Prosthetics (NAAOP) is an important player in
advising Congress and federal agencies on policies impacting
O&P. But all providers appear self-serving when advocating
forincreases in reimbursement. The patients we serve, however, are
the ones whom our elected representatives depend on for votes. On
the diabetic foot care issue, the time has come to engage our
patients to send the message as well.
Patients Get Results
This process has already started at the University of Michigan
Orthotics & Prosthetics Center (UMOPC). UMOPC has asked several
patients who have benefited from orthotic intervention in order to
save their limbs from amputation to assist us in telling the
diabetic story from their viewpoint. Within six weeks of engaging
these patients, a flurry of letters descended on their congressmen
and women. They developed and planned meetings to meet with their
lawmakers' staff, locally and nationally, to describe - from a
patient's point of view - the seriousness of diabetic foot care and
the need for immediate action.Rather than simply making one visit,
these patients opened a longterm dialogue regarding diabetic foot
care reimbursement issues and the impact that recent Medicare
coding and reimbursement changes are having on patient access and
outcomes.
PFA Gains Ear of Congresswoman
Recently, the Pedorthic Footwear Association (PFA) was able to
portray the seriousness of the story to New York Congresswoman
Carolyn McCarthy (D) who introduced legislation in the House of
Representatives to study the restoration of reimbursements at the
appropriate levels for the work it will take to help our diabetic
population. Practitioners play an important role in the
policymaking process in Washington DC by providing direct and
informed counsel to Congress on issues impacting the O&P field.
But there is no substitute for informed, consistent communication
from patients when low reimbursement directly impacts the breadth
and quality of services they receive. The message they bring is
particularly relevant when it is easy for them to describe how care
from a professional orthotist can prevent costly and life-altering
amputation.
As providers, we are acutely aware that Medicare provides
greater reimbursement for services relating to the care of an
amputee than more preventative care via diabetic foot orthoses.
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. But
when provider organizations engage Congress, the practitioner
argument can be dismissed as yet another provider group asking for
more money. Thus, by combining a patient-oriented view of
reimbursement issues with the practitioner arguments, legislators
have many persuasive arguments with which to understand the issue
and justify their support.
Call on Educated Consumers
So what do practitioners need to do? It is time to call on
educated consumers of our orthotic and prosthetic care who
understand better than anyone else the benefits of quality diabetic
foot care and the time and effort involved in providing that level
of care. Consumers of our O&P care are congressional
constituents whose voices can collectively be very powerful in
Congress and augment the efforts of NAAOP and other O&P groups.
Let's work together to ask for the assistance of our patients to
help tell the story with us.
For more information, visit www.naaop.org
or e-mail info@naaop.org 
Table Of Contents - July 2005
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