Tag: Tom Fise
MedPAC report takes CMS to task on orthotics
June 29, 2018Theresa Flaherty, Managing Editor
WASHINGTON - Although industry stakeholders disagree with a recent MedPAC recommendation to include off-the-shelf orthotics in Medicare's competitive bidding program, a recent report by the commission is, overall, on point, they say.
“It's obvious the bid program is still a threat,” Todd Eagen, president of the Orthotic Prosthetic Group of America. “But there is some good news in the report and some continued educational efforts that our community needs to continue to...
AOPA's Fise to step down
April 4, 2018HME News Staff
ALEXANDRIA, Va. - Tom Fise will step down from his role as executive director of the American Orthotic & Prosthetic Association when his contract expires at the end of 2018. “On behalf of AOPA, I would like to thank Tom for his dedication and commitment to the orthotic and prosthetic industry,” said Jim Weber, president of AOPA, in a press release. “His legislative and regulatory experience has been most valuable to AOPA as he has worked to champion our association's needs to...
Coding project reveals outdated guidelines
October 20, 2017Theresa Flaherty, Managing Editor
WASHINGTON - A coding redetermination project for custom diabetic inserts could be a sign of the times, where guidelines don't keep pace with technology.In August, the Pricing, Data Analysis, and Coding Contractor announced it would initiate the project for A5513 after the DME MACs issued a joint publication stating that, to meet the requirements of that particular code, the insert must be molded over an actual model of the patient's foot.Although many models are still made using older methods like...
Private payers 'exploit' O&P changes
April 22, 2016Theresa Flaherty, Managing Editor
WASHINGTON - It's no surprise to O&P stakeholders that private payers are picking up on a widely criticized proposed rule by Medicare to deny coverage for prosthetic devices that were previously covered.
“We predicted that the rule would, ultimately, be exploited by private health insurers,” said Michael Oros, president-elect of the American Orthotics and Prosthetics Association during a press call last week.
The four DME MACs in July released draft local coverage determinations...
President proposes bidding for O&P
March 21, 2016Theresa Flaherty, Managing Editor
WASHINGTON - Stakeholders say they'll stay vigilant, but the president's proposed plan to include all orthotics and prosthetics as part of Medicare's competitive bidding program shouldn't cause panic.“We just don't think that, overall, this is an environment in which we will see the government willing to mandate that amputees are going to receive their prosthetic devices from the UPS guy in a box to fit themselves,” said Tom Fise, executive director of the American Orthotics & Prosthetics...
Prosthetic community ups ante
August 28, 2015Theresa Flaherty, Managing Editor
LINTHICUM, Md. - O&P stakeholders commented at a public hearing, staged a protest and participated in a high-stakes meeting with CMS, all in one day, in their bid to reverse proposed coverage changes for lower limb prostheses.
“These changes are mean spirited,” said Charles Dankmeyer, president of the American Orthotics & Prosthetics Association, during a press call rallying stakeholders for the week's various events. “It is obviously designed to wear people down so they...
Proposed changes to lower limb policy 'race to bottom'
July 24, 2015Theresa Flaherty, Managing Editor
BALTIMORE - Proposed changes to coverage requirements for prostheses could severely limit the number of patients who could gain the greatest mobility, say O&P stakeholders.
“There are a fair number of leaps that are made that don't have any scientific backing,” said Tom Fise, executive director of the American Orthotics and Prosthetics Association. “We think a lot of people are going to be asking, 'Why would Medicare want to do this?'”
The four DME MACs released...
Lawmakers weigh in on O&P
May 29, 2015Theresa Flaherty, Managing Editor
WASHINGTON - Lawmakers recently sent a letter to CMS demanding the agency enforce long-established O&P licensure and certification requirements.The May 19 letter to Department of Health and Human Services Secretary Sylvia Burwell asks CMS to issue a proposed rule detailing its plans to allow only licensed and certified O&P providers to bill Medicare, as required by a law passed back in 2000.“It's been 15 years without anything being done,” said Tom Fise, executive director of the American...
O&P bill tackles accreditation, audit issues
March 27, 2015Theresa Flaherty, Managing Editor
WASHINGTON - Lawmakers in the House of Representatives and Senate introduced bills last week that seek to apply accreditation and licensure requirements to O&P providers who bill Medicare.About one-third of O&P providers aren't accredited, says Tom Fise, executive director of the American Orthotics and Prosthetics Association, which supports the bills.“Having bills introduced by members of both the House Ways and Means and the Senate Finance committees is a good marker, in my mind (of the strength...