Government Affairs, Coding and Reimbursement C U R R E N T PEDORTHICS Volume 41, Issue 3 www.pedorthics.org Taking Steps for Pedorthists FTC Rules and You From the States – The Latest Update on Legislation Impacting Your Profession Pedorthic Footwear Association (PFA) 2025 M St., NW, Suite 800, Washington, DC 20036 C U R R E N T PEDORTHICS V o lu m e 4 1 , I ssu e 3 Strength in Numbers FEATURES Departments It’s a Red Flag! Federal Trade Commission Rules Applies to Pedorthists 4 From the President 15 You’ve Got Medicare Questions? We’ve Got Answers 34 Industry News 23 Strength in Numbers 27 From the States 30 For Your Information 9 Establishing PFA-Affiliated State Pedorthic Associations Critical 32 Association News 39 Pedorthic Industry Events 40 Pedorthic Marketplace 41 Product Reference Guide The Latest Update on Legislation Impacting Your Profession State Pedorthic Contact Information CURRENT PEDORTHICS • Volume 41, Issue 3 1 C U R R E N T PEDORTHICS Pedorthic Footwear Association Board of Directors Executive Committee President: Dane LaFontsee, C. Ped. Vice President: Kristi Hayes, C. Ped. Treasurer: Liz Chiles, C. Ped. Secretary: Jamie Dick, C. Ped., PT Immediate Past President: Randy Stevens, C. Ped. Directors Ryan Nichols, C. Ped., OST Stuart L. Pressman, C. Ped., CO Jay Zaffater, C. Ped., BOC Pedorthist Dean Mason, C. Ped., OST, BOCO Arthur Smuckler, C. Ped. Michael D. Veder, C. Ped., CO, BOCO Faith Ballard, C. Ped., CO Harlon Compton, C. Ped., CO Tamara A. Daulton, C. Ped. Pedorthic Educators Liaison: Vacant Vendor/Manufacturer Liaison: Stephen O’Hare Legal Counsel: Allan J. Weiner Headquarters Staff Executive Director Brian K. Lagana Membership Services Coordinator Caroline Stainback Director of Education Al Baggett Education Associate Lauren Kemp Director of Meetings and Conventions John Rubsamen Medical Advisors Raymond L. Fritz, DPM, C. Ped. Allan B. Grossman, DPM, FACFAS Craig Young, MD Exhibits and Sponsorship Coordinator Editorial Staff Gina Spear Jay Strother. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Publisher and Editor William Wargo. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Art Director Patrick Williams. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Design/Production Marlene Robbins Director of Marketing Marketing Coordinator Kevin Hurley Advertising & Services Government Relations Director Caroline Stainback. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Membership Tracey Aaron . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Current Pedorthics Marlene Robbins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PFA Symposium William H. Applegate Current Pedorthics (ISSN 1552-8111) is published bimonthly by the Pedorthic Footwear Association (PFA), 2025 M St., NW, Suite 800, Washington, DC 20036. Telephone: 202-367-1145 or 800673-8447, Fax: 202-367-2145, Web site: www.pedorthics.org, E-mail: info@pedorthics.org. Copyright© 2009, PFA. All rights reserved. No part of this publication may be reproduced in any manner without written permission. Letters to the Editor and other unsolicited material are assumed intended for publication and are subject to editing. Articles in CP do not necessarily reflect the opinion of PFA, its Board of Directors or its employees. CP’s use of trademarked names is done in an editorial fashion intended to benefit the trademark owner, with no intention of trademark infringement. Subscriptions are available for $45 per year in the United States ($65 outside USA). Back copies, if available, may be purchased for $5 U.S. If you have any questions regarding display advertising or classified ads, please e-mail Tracey Aaron at taaron@arlpub.com. Please send all product- and industry-related press releases to CPeditorial@pedorthics.org. 2 CURRENT PEDORTHICS • Volume 41, Issue 3 Marketing/Communications & Editorial Committee Chair: Kristi Hayes Faith Ballard Liz Chiles Jamie Dick Tammy Daulton Stuart Pressman Rob Sobel Pedorthist Preferences Our customer service reps told us we should change our pedorthic ad to tell practitioners about the products that they get requests for day after day. Some of these have been around for awhile and are proven winners. And some of them are new products that everyone seems excited about. But all of them are worth taking a look at if you haven’t tried them before. So call your friendly, knowledgeable PEL customer service rep today and order an old friend — or a new favorite. Waterhouse Leather Leather Hides Silipos® Achilles Heel Pad™ Darco Wound Care Shoe System UCO International Plaster Sculpting Tool Kit SoleTech® Advance™ Orthopedic Footwear Becker Orthopedic Tamarack Shearban® Sheets Anatomical Concepts PRAFO® Bauerfeind® GloboPed® Heel Relief Shoe Aetrex® PEL Focus Styles Keeping Pace Pediatric Brown Casual Shoe Acor Orthopedic Comfort Street Footwear with Tandem Closure Renia Colle de Cologne All Purpose Cement ® Experience the Power of One. One warehouse. One order. One shipment. One invoice. One less thing to worry about. Phone: 800-321-1264 Fax: 800-222-6176 E-mail: customerservice@pelsupply.com Web: www.pelsupply.com From The President Dear President LaFontsee: I don’t see a lot of new pedorthists entering the profession, and it seems like without that, our profession will contract and eventually die. It also does not seem that other organizations are doing anything to help advance pedorthics. My question is what can PFA do, and is PFA doing, to help turn the tide on this crisis hitting our profession? Dear Colleagues, I want to thank the sender of this tremendously timely and poignant question. Recently, I considered the factors over the years that have led us to where we are now, and the list is formidable. However, I believe that PFA’s responses to these challenges have been, to the best of the organization’s abilities, significant. A short, “sound bite” response just won’t do if the membership and the profession are to understand the situation and participate in the solutions that will ultimately benefit them. That the pedorthic profession is in crisis should be a surprise to no one, if you’ve kept track of current events: • The economy is taking a hit on everyone. • Pedorthists were hit with several unexpected and expensive Medicare requirements earlier this year; reimbursement levels continue to be low. • Student enrollment in pre-certification schools has declined, causing some of the schools to cancel classes and eliminate some pre-cert programs. • With fewer people going through the pre-cert program and into practice, and others leaving pedorthics, the profession isn’t growing. • The profession faces an identity crisis with lagging recognition of the value of pedorthic care among referral and potential referral sources. • The profession is segmented among “clinical”, “retail” and “other” pedorthists, with each segment having their own philosophies. 2006 was the watershed year for pedorthics with the merger between the American Board for Certification in Orthotics and Prosthetics (ABC) and the Board for Certification in Pedorthics (BCP). However, from a certain perspective, I see 2003 as a critical year as well with the passage of the Medicare Modernization Act (MMA) and the loss of the Therapeutic Shoes for Diabetes benefit’s (TSD’s) stand-alone status to the broader O & P benefit category. This was also the year that growth in pedorthics peaked, as measured by PFA’s membership and Symposium numbers and the number of individuals with pedorthic credentials. The following is what I believe to be a timeline of the critical factors leading pedorthics to where it is today. 4 CURRENT PEDORTHICS • Volume 41, Issue 3 1. Passage of H.R. 1 – the Medicare Modernization and Improvements Act of 2003 (MMA). Prior to passage of the MMA in 2003, Medicare’s Therapeutic Shoes for Persons with Diabetes benefit (TSD), which PFA helped to create in the late ‘80s and early ‘90s, was a standalone benefit with its own reimbursement schedule. When MMA re-categorized the benefit under the O & P category, subjecting the TSD to O & P fee schedules, it decreased reimbursement levels significantly across the board. During the past six years, PFA has drafted legislation introduced in the U.S. House of Representatives by our Congressional allies to turn the clock back on the impact of the MMA on the TSD. PFA has attempted to engage its membership in grassroots efforts to garner support for that legislation from respective members of Congress. Unfortunately member participation has been minimal and corrective legislation had not moved forward. 2. Merger in 2006 between the Board for Certification in Pedorthics (BCP) and the American Board for Certification in Orthotics and Prosthetics (ABC). BCP was created by PFA in 1972 as the pedorthic credentialing organization and the two organizations provided the pedorthic profession with a solid identity and strong voice. Even though the ABC-BCP merger allowed for two dedicated pedorthic seats on the 12 member ABC Board of Directors, it ultimately placed control of the pedorthic scope of practice, future requirements concerning pedorthic credentialing, and the general promotion and identity of the pedorthic credential in the hands of O & P with their solid majority on the ABC board. Pedorthists credentialed by ABC lost their ability to vote on changes to their professional standards that had existed with BCP. As you will recall, the summer before the merger occurred, PFA’s board communicated to the membership the pros and cons of an ABC-BCP merger, and included a survey to gauge the members’ views on a merger. Based the results of that survey, PFA’s board logically detailed its opposition to the merger. Despite its best efforts to represent members, PFA’s board received significant backlash for its stance from the membership and the profession. 3. Continued real reduction in Medicare reimbursement. For years, Medicare has continued to reduce in real terms the reimbursement for the