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Tag: Orthotics

Joe McTernan

Specialty Providers

Proposal increases access to ‘technological leap forward’ 

February 16, 2024Theresa Flaherty, Managing Editor

WASHINGTON – O&P stakeholders hailed a new proposal by CMS to expand coverage of microprocessor-controlled knees for certain K2 patients, something they say is long overdue.  Under the proposed changes, the agency will no longer limit the technology to patients classified as K3 and above.    “When this technology first came about in the in the 90s, it was really marketed and touted as kind of like the next technological leap forward for patients,” said Joe McTernan,...

American Orthotic & Prosthetic Assoc (AOPA), Joe McTernan, microprocessor-controlled knees, Orthotics, Prosthetics

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In brief: Senators push oxygen template, DME MACs publish supplies guidance

February 9, 2024HME News Staff

WASHINGTON – Sens. Bill Cassidy, R-La., and Maggie Hassan, D-N.H., urge CMS to adopt a standardized template instead of a medical record review to ensure access to supplemental oxygen for patients.   In a letter to CMS Administrator Chiquita Brooks-LaSure, the senators state:  “We ask that the Centers for Medicare & Medicaid Services (CMS) remove barriers for patient access to supplemental oxygen by establishing clear requirements for determining the medical necessity...

3D printing, Home medical supplies, Home Oxygen, National Home Infusion Association (NHIA), Orthotics, Template, VGM & Associates

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Also Noted

DME MACs issue 3D guidance

February 7, 2024HME News Staff

WASHINGTON – The DME MACs and the Pricing Data Analysis & Coding (PDAC) contractor have released long-awaited guidance on the use of 3D printing and digital scanning for custom fabricated orthoses. They state that 3D printing, or additive manufacturing, can be an acceptable alternative to traditional custom fabrication, if the method used meets the definition of custom fabricated in the DMEPOS Quality Standards, Appendix C. This reminder is consistent with the position of the American Orthotic...

3D printing, Orthotics

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OPGA, Össur open application period for grants 

January 22, 2024HME News Staff

WATERLOO, Iowa – The Orthotic Prosthetic Group of America (OPGA) and Össur have opened the application period for two grants available to U.S.-based O&P professionals. The two grants: The Russell Walker CP, LP Emerging Leader Grant, now in its third year, is designed to pay tribute to Russell (Rusty) Walker, a practitioner who was passionate about mentoring the next generation of O&P leaders; and the Todd Eagen Advocacy in Action Memorial Grant, now in its second year, is named after Todd...

Grant, Orthotic & Prosthetic Group of America (OPGA), Orthotics, Ossur, Prosthetics

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Noel Neil

Smart Talk

Reimbursement: Follow instructions closely for orthotics

January 16, 2024Noel Neil

Q. Why are my orthotics claims denying?   A. Prefabricated orthoses fall under two categories: OR02 custom fitted or OR03 off-the-shelf. There is no physical difference between the two. The differentiating factor is the adjustment needed at the time of fitting. For OTS, minimal self-adjustment by the beneficiary, caretaker or supplier is required but does not require the services of a certified orthotist. Custom fitted requires the expertise of a certified orthotist or an individual...

ACU-Serve, Noel Neil, Orthotics

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PCC launches Sole Marketing 

January 9, 2024HME News Staff

METUCHEN, N.J. – Podiatry Content Connection has launched Sole Marketing to provide podiatrists with communication, reminders and patient education to drive orthotic sales. "Many podiatrists lose orthotic sales to retail stores which offer the wrong solution for the patient,” said PCC National Director Randy Rosler. “Custom orthotics, designed and manufactured for the specific patient, deliver better results. Our Sole Marketing system connects the podiatrist with the patient...

Orthotics, Podiatry Content Connection, Sole Marketing

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Kelly Grahovac


Market changes likely to drive increase in audit activity 

December 1, 2023Liz Beaulieu, Editor

YARMOUTH, Maine – The end of Medicare’s competitive bidding program for knee and back braces on Dec. 31 could open the door to increased audit activity for orthotics in 2024, industry consultants predict.  “We’ve already seen the Supplemental Medical Review Contractor (SMRC) add braces back onto their project list and the Recovery Audit Contractor (RAC) still has them on their approved list,” said Kelly Grahovac, general manager of the van Halem Group. “But...

Andrea Stark, Audit, Braces, Continuous Glucose Monitor (CGM), Kelly Grahovac, Orthotics

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Business Development

LTA could be game changer for O&P

November 13, 2023John Andrews

The orthotics and prosthetics market received a positive boost from the passage of the Lymphedema Treatment Act (LTA) earlier this year and field specialists are optimistic it will benefit providers and patients.  Set to go into effect Jan. 1, 2024, the LTA allows for consistent Medicare coverage and reimbursement for compression garments and supplies for patients living with lymphedema. This new law could be a game changer for the industry, said Matthew Gruskin, COO for Owings Mills, Md.-based...

Board of Certification/Accreditation (BOC), Lymphedema Treatment Act, Orthotic & Prosthetic Group of America (OPGA), Orthotics, Prosthetics

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Foot Solutions opens new Florida location

September 14, 2023HME News Staff

ALPHARETTA, Ga. – Foot Solutions has announced the grand opening of its newest store in Delray Beach, Fla. "We are excited to bring Foot Solutions to Delray, and we look forward to serving our community with the highest standards of foot wellness care," said John Prothro, CEO at Foot Solutions, Inc. "Our dedicated team is passionate about helping our customers find solutions for their foot health concerns, and we can't wait to assist our Delray Beach neighbors in leading more comfortable...

Foot Solutions, Orthotics

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Man charged in telemedicine scheme

July 26, 2023HME News Staff

BOSTON – David Santana, owner of Conclave Media and Nationwide Health Advocates, will plead guilty to one count of conspiracy to commit health care fraud in connection with a $44 million telemedicine fraud scheme involving medically unnecessary durable medical equipment, including orthotics such as back and knee braces, and genetic tests. According to the charging documents, between January 2018 and August 2021, Santana, through his companies Conclave and Nationwide, entered into business...

Fraud, Health Care, Orthotics

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