Sponsoring NC Residents Welcome Reception at the Amputee Coalition National Conference

The North Carolina Orthotic and Prosthetic Trade Association will be sponsoring the North Carolina Residents Welcome Reception at the Amputee Coalition National Conference.  from 5:00pm to 6:30pm, Thursday June 9th in Colony B, located on the 3rd floor directly above the Exhibit Hall.

For more information please email Ashlie.White@ncopta.org

Breaking News from NAAOP

BREAKING NEWS: Three New Developments Impact the O&P Community
http://www.naaop.org/vid.asp?name=webcast_february-2016-2.mp4

Three new developments impacting the orthotic and prosthetic profession occurred on February 9th that NAAOP would like you to know immediately:

1. Rehabilitation Research Bill Advances in Senate Committee: On February 9th, the Senate Health Education Labor and Pensions (HELP) Committee reported favorably on a bipartisan bill introduced by Senators Kirk (R-IL) and Bennet (D-CO) to advance rehabilitation research, including O&P research and development, at the National Institutes of Health (NIH). The bill would enhance coordination and improve the stature and visibility of this research at NIH’s 27 Institutes and Centers, particularly in the National Center for Medical Rehabilitation Research (NCMRR). NCMRR’s mission includes O&P research and development. This occurred in 1990 after extensive lobbying efforts by NAAOP to increase O&P research funding at NIH. This is the first major piece of legislation to address the NCMRR at NIH since that time and should spark additional attention at NIH in this area. The bill now goes to the full Senate for consideration. A companion House bill has already been introduced by Congressman Langevin (D-RI) and Congressman Harper (R-MS)

2. DC Appeals Court Ruling Offers Hope to Providers on ALJ Backlog: The D.C. Circuit Court of Appeals issued an important opinion in the American Hospital Association’s administrative law judge (ALJ) delay lawsuit. The D.C. Circuit reversed the district court’s decision and determined that the court has jurisdiction over this case because HHS has a clear duty to issue ALJ decisions in 90 days, and “escalation” to the next level of administrative review is not an adequate remedy for HHS’s failure to issue ALJ decisions in a timely manner. The court remanded the case to the district court for it to consider whether to compel HHS to comply with the deadline in light of the worsening ALJ backlog. The decision gives some hope to Medicare providers, including O&P practices, that the intolerable delay in ALJ appeals will begin to be resolved, but the court did not yet actually step in and solve the problem. A decision by the district court is expected late this year.

3. President’s Budget Proposes to Expand Competitive Bidding to ALL O&P Care: For the first time, the President’s budget for FY 2017, released yesterday, proposes to expand DMEPOS competitive bidding to include ALL PROSTHETICS AND ORTHOTICS, in addition to a number of other types of DMEPOS. The proposal is expected to save $38 billion over ten years. This is bad news in that NAAOP and the O&P Alliance organizations will have to mount a strong defense against this proposal, but it is important to put this development into perspective. Competitive bidding for anything more than off-the-shelf orthotics is currently illegal, so Congress would have to pass a law authorizing CMS to expand it to all O&P care. This is the last year of the current President’s budget. The budget represents a grab-bag of policies that the administration throws out to gather reaction, and to pad the savings they can achieve in order to pay for their other proposed priorities. In this calendar year, there is no chance this proposal will become law absent titanic developments in Congress, which are not expected. Congressional Republicans declared the budget “Dead on Arrival” and have shown no interest in this specific proposal. NAAOP will work with its Alliance partners to strongly oppose this proposal, but it is certainly not immanent.

Please visit our website at: www.naaop.org<http://www.naaop.org>

NAAOP
1501 M Street, NW
7th Floor
Washington, DC 20005-1700
e-mail: info@naaop.org<mailto:info@naaop.org>
(800) 622-6740
(202) 624-0064 Phone
(202) 785-1756 Fax
www.naaop.org<http://www.naaop.org>

2015 NC AAOP Meeting Agenda

  • Opening remarks: Clay Claiborne

* Treasurer’s report: Balance 5/1/2015 $ 60,905.65, 10/01/2015 $57,800

– Expenses include reimbursement for Stella Sieber to represent NCOPTA during the LCD public hearing, $500/month fee for Government Affairs director, Dues for organizational membership with NAAOP.

       – Nominations for Treasurer

       – Suggested Quarterly conference call

       – Google Group?

* LCD

– Attendance at LCD draft public hearing in Baltimore: Brittany Stressing- secretary, Don Dixon- president-elect, Ashlie White- director of government affairs, Stella Sieber and Daniel Sheret- patient representatives

 

– O&P Alliance LCD Response

 

– Senator Tillis, and Legislative Assistant Matt Flynn, plan to draft letters to the HHS, MAC contractors and VA.

 

* United Eliminates Coverage for Elevated Vacuum

– Excerpt from United Health Care August 2015 Policy Bulletin

 

Final Approval for Medicare Pre-Authorization

 

Insurance Fairness recruiting

 

* Medicaid Overhaul

 

 –House Bill 372

 

– NOVEMBER: Special Session on Medicaid Reform

 

– Breakdown 

WHAT YOU CAN DO ABOUT THE PROPOSED LCD POLICY

We are currently in the process of finalizing NCOPTA’s official response to the proposed LCD policy, which will be submitted to CMS tomorrow. Please know that we have been following this issue very closely. Our director of government affairs, Ashlie White has been part of NAAOP’s efforts to get ahead of this issue and to be prepared for what’s next.

Here’s what you can do right now:

REGISTER FOR THE NAAOP LCD UPDATE WEBINAR: COUNTDOWN TO PUBLIC COMMENT MEETING https://attendee.gotowebinar.com/register/2398145179968502017

REGISTER FOR THE PUBLIC COMMENT MEETING: Tomorrow, August 21, marks the deadline to register for the open comment meeting on the proposed LCD. If you are unable to attend the hearing in Baltimore, PLEASE register to attend the teleconference. Please make our presence felt and heard. http://apps.ngsmedicare.com/ADC/EventRegistration.aspx?Rid=1318&Iid=5739&Frm

Download  Talking Points for Response to LCD on Lower Limb Prostheses

If you missed the boat and have not sign the We The People petition, please do so here: https://petitions.whitehouse.gov/petition/rescind-medicare-proposal-restricting-access-prosthetic-limbs-and-returning-amputees-1970s-standards-care We achieved unprecedented response from the O&P community during this effort, which led by NAAOP (created by Dave McGill, president of NAAOP) along with support from the Amputee Coalition, AOPA, AAOP, ABC, BOC and NCOPE.

Ashlie White

OPAF Call for nominations

OPAF Seeking Nominations for Board of Directors

July 15, 2015 – Charlotte, North Carolina – The Orthotic & Prosthetic
Activities Foundation (*OPAF*), serving as the philanthropic arm of the US
Orthotic & Prosthetic Community has begun its annual search for individuals
who would like to participate within the O & P community through service on
the OPAF Board of Directors. Board members serve a three year term and are
required to attend at least one of the two face to face board meetings held
in conjunction with the AOPA and Academy national meetings.  Additionally,
directors are expected to be vitally involved in the ongoing work of OPAF &
First Clinics with adaptive recreation and to take an active role with all
of our fundraising efforts.

Nominees are needed at this time for at least one and up to three seats on
the Board of Directors, one of whom must be an ABC or BOC credentialed
practitioner within O & P.

More information and all nomination materials and instructions can be found
on the OPAF website at:

http://opafonline.org/about

Nominees should have an appropriate background, a history of 501(c)(3)
nonprofit committee/volunteer work (preferred, but not required) alongside
a familiarity with and dedication to fundraising, and a strong commitment
to the primary mission of the Fund:  to enable individuals, especially
those served by members of the orthotic and prosthetic community-to enjoy
the rewards of personal achievement, physical fitness and social
interaction.
Nomination materials are due into the OPAF office by September 1, 2015, and
terms will begin on December 1, 2015.
Please contact OPAF Executive Director, Robin Burton, or any OPAF Board
Member with questions or comments about the nomination process and serving
on the Board.  Please give thoughtful consideration to volunteering to
serve as an OPAF director to help with the ongoing OPAF mission of

*“Giving Wings to Dreams!”®.*

Updates from 5-1-15 Meeting

Below are items we discussed adding to the website during our Spring meeting last Friday, 05/01/15.

We have added a Mission section to the website, which has our purpose written out as well as a link to the complete bi-laws for the organization.

We discussed the language in the BlueCross BlueShield NC Medical Policy at length during the meeting. Attached is the full policy. Linda Collins and NCOPTA are currently drafting a letter to send to the medical director at BCBS to address this issue.

BCBS Medical Policy 

We will begin posting copies of Medical Policies and LCD language in a new section on the site. Please keep an eye out for that information.

 

 

 

2015 Spring Meeting Agenda

NCOPTA 2015 SPRING MEETING AGENDA 

May 1, 2015

Guest Speaker Linda Collins

8:00 – 8:30 Arrival, Coffee Provided

8:30 – noon Steps to Successful Outcomes by Linda Collins

– Understanding medical coverage policies

– Components of patient interviews

– Documentation requirements

– How to respond to audits and appeal denials

– Resources available

Noon – 1:00 Lunch

NCOPTA Board Meeting

1:00 – 2:30 Legislative Overview with Ashlie White

JUST ADDED: BCBS NC Medical Policy language concerns

– Recap AOPA Policy Forum and State Reps meeting

– State Medicaid proposed legislation

– Accountable Care Organizations and your referral sources

– Insurance Fairness legislation

2:30 – 2:40 Networking / restroom break

2:40 – 4:30 Policy Workshop

– Insurance Fairness legislation (Who will introduce)

– Addressing antiquated Lcodes and reimbursement

– Discussion on separating O&P from DME

Linda Collins is the Director of Market Access in Össur’s Reimbursement Department. In that role, she is responsible for helping identify and explore payer markets while also building relationships with those payers. Ms Collins has over 20 years experience in all phases of managed care including network development, sales, account management and claims/billing.

Ashlie White serves on the Executive Board of Directors for the National Association for the Advancement of Orthotics and Prosthetics (NAAOP). She is the Director of Government Affairs for the North Carolina Orthotics and Prosthetics Trade Association and serves on AOPA’s Mobility Saves Committee as well as the Alliance Steering Committee. She is also the Director of Project Development for Beacon Prosthetics and Orthotics.

Spring Meeting Announced for MAY 1, 2015

Spring Meeting May 1, 2015

We are excited to announce the 2015 Spring Meeting to be held on May 1, 2015 at the Courtyard Raleigh-Durham Airport, located at 2001 Hospitality Court, Morrisville, NC. A discounted room-rate of $99 per night is available for those traveling to the meeting from further areas of the State. Please call 919-467-9444 and tell them that you are attending the NCOPTA Spring meeting to receive the discounted rate.

Our guest speaker will be Linda Collins, Director of Market Access for Ossur’s reimbursement department. Several sessions will be offered during the meeting including, Steps to Successful Outcomes, which will review the following:

Understanding medical coverage policies

Components of patient interviews

Documentation requirements

How to respond to audits and appeal denials

Overview of resources available

The event will begin at 8:30 am and will end at 4:30 pm. Coffee will be provided throughout the day and lunch will be provided at noon. After lunch we will review the current legislative environment surrounding O&P and discuss/workshop our plans for legislative action over the next two years. A full agenda will be announced closer to the meeting date.

We have received approval for 7 CEUs from ABC and BOC for attendance to this event.

Practitioners and administrative staff, who work at NCOPTA member facilities are invited to attend the meeting for FREE. Non-members will be charged $75 per attendee. Please follow the links below to register and pay.

REGISTRATION

RENEW MEMBERSHIP OR JOIN NCOPTA

PAY FOR NON-MEMBER REGISTRATION->   

AOPA Leadership Conference

A note from Ashlie White, Director of Government Affairs,

This past weekend I had the opportunity to speak at the AOPA leadership conference. I was honored to be asked to speak to such a distinguished group of O&P professionals. The meeting was an intense 2 days of enlightening presentation and thought-provoking conversation. I thought it would be appropriate to share some of the knowledge and insight I obtained at this conference with our membership here. Please be on the lookout for an email/mail announcement of the spring meeting and feel free to share your thoughts in the comments section below.

Leadership Conference Major Theme: Our Identity!

For so long we have described ourselves a providers of orthotics and prosthetics. When asked what do we do we answer, “I make artificial limbs.” The truth is that we are not manufacturers of a device, nor are we simply providers of devices. We provide prosthetic and orthotic care, which is a healthcare service. This is how we need to describe ourselves, as healthcare professionals.

The shrinking margins and decreases in reimbursement are directly related to the way the payers view what we do. Payers do not see Orthotist and Prosthetist as professionals providing healthcare services, but rather as vendors supplying a device. This is where the conversation needs to begin. Our efforts need to be focussed on distinguishing ourselves from DME. The physicians certainly don’t want us to send our patients back to them to perform the healthcare part of what we now do. Our services are valued in the healthcare community and it’s time that the payers, independent and public, acknowledge this fact. It is also time that we acknowledge who we are and stop discrediting ourselves by marketing the devices we have in stock rather than the services we provide to the patient.

This concept of identity was a major theme at the conference this past weekend. We saw leaders from all areas of the O&P profession speak about the changing healthcare environment and our place within the healthcare world. Working together is going to be vital to our success in the future.

Other topics presented:

  • Consolidation in every community
  • Increased RAC audits expected in 2015
  • The increasing importance of data collection and outcomes studies (Mobility Saves)
  • Understand where we fall in the ACO paradigm
  • Fee-for-service is dying, fee-for-value is the future
  • Creating strong patient advocate groups
  • Understanding and adapting to healthcare trends and knowing our place (ex. stroke, diabetes)

Issues brought up by other NCOPTA members on the table for the Spring meeting:

  • VA issues (contracting, etc)
  • Licensure is dead, or at least frozen, what other approach can we take to distinguish ourselves as professionals within a healthcare environment where everyone else is licensed?
  • Medicaid changes and potential capitation (2016)
  • Insurance Fairness legislation

Please feel free to comment below and start a conversation. An announcement for the Spring meeting will be emailed/mailed within the next couple of weeks. Thank you for taking the time to read this email and I look forward to seeing everyone at the Spring meeting.

-Ashlie White

Membership and Dues

There are many issues before us in North Carolina that will affect the way you do business. It is imperative that we address these issues together and present a strong, united front. Our success and/or failure to protect the interest of O&P in North Carolina is effected by your decision to participate or not. Please consider joining now!

There is a first time fee of $1,000 to join NCOPTA. Each year following the $300 dues must be paid to maintain your membership in the Trade Association.

NOTE: The $1,000 first time fee is currently being waived for joining members. We are also waiving past dues for a limited time as we continue to rebuild our community. To join or renew the rate is currently $300. Thank you, NCOPTA Board. 

To pay with a credit card:

 

Please send checks to

ATTN: Rose Carter

NCOPTA Treasurer

3224 Lake Woodard Dr.

Raleigh, NC 27604

If you have any questions please contact us.