O&P gets some respect

Todd Eagen is not an O&P practitioner, but in his role as president of the Orthotic Prosthetic Group of America, he advocates as much for recognition of the important role they play in patient care as he does for regulatory changes to improve the profession. Case in point: the recent decision to include O&P providers' notes as part of the patient's medical record, which addressed a “Dear Physician” letter in 2011 that changed the standards for approving a claim by disregarding the prosthetist's notes as part of the medical record.

“That was a very big win for the profession,” he said. “That letter was the start of the onslaught of Medicare RAC audits, which had a very negative impact on a lot of legitimate, quality providers.”

Eagen spoke with HME News recently about his upcoming goals and why O&P professionals need to be viewed as medical professionals, not widget makers.

HME:Many payer requirements seem to overlook the professional qualifications of O&P providers. How has that impacted patient access?

Todd Eagen:It's a travesty that there are organizations out there that would be satisfied with taking a once active individual, where there is an opportunity to restore a certain level of function to that patient, and deny that coverage and confine them to a life of inactivity.

HME:How would you like to see that change?

Eagen:Certified O&P professionals manage prosthetic care to improve the function and the health and the overall quality of life of the patients they serve. We're trying to create a paradigm shift in how providers view themselves, not as a widget maker or a leg and arm maker—it is viewing yourself as the medical professional you are.

HME:What else is on your agenda?

Eagen:We have two very pressing issues. We are still advocating for implementation of BIPA 427, which was passed in 2000 and defines a certified O&P professional and has never been implemented by CMS. The second is clarification of (the definition) of minimally self-adjusted for orthotics and is tied directly to the expanded threat of competitive bidding to both beyond the 30 some codes for OTS that are part of it now into the potential area of what we believe are custom orthoses.