Why Eliminating Frustration is Fundamental to a Better ......Group offers both proactive and reactive RAC protection services to minimize the impact on your practice. We definitely

1

OPGA Member Magazine

Why Eliminating Frustration is Fundamentalto a Better Patient Experience page 6

FALL 2016

Understanding the Two-day Rule page 10

Where the Rubber Hits the Road page 20

Identifying Targeting Key Referral Sources page 22

2

SEVEN SOLUTIONS FOR CRITICAL ISSUES

Okay OPGA here are the issues What are you doing to help We are looking for solutions that we can implement in our practices not just lip service

HOW DO WE GET THE ldquoRIGHTrdquo REFERRALS AND HOW DO WE IDENTIFY THE ldquoRIGHTrdquo REFERRAL SOURCES

From Ryan Ball VGM Market Data (ryanballvgmcom)

How are OampP practices using Market Data Identify and rank upper and lower extremity amputation volume in your markets

If you are in the prosthetic business understanding which physicians and hospitals perform the most upper and lower extremity amputations is an integral piece of any targeted growth strategy VGM Market Data can help identify which of your markets have the greatest potential based on volumized rankings of key procedures and diagnoses

Laser-like focus on prosthetics orthotics bracing and other OampP No matter what your specialty VGM Market Data can identify and rank by volume which referral sources in your markets are referring for prosthetics orthotics or bracing After identifying and ranking key opportunities Market Data can also tell you which of your local competitors get the business and what market share you may potentially be missing out on

1

NEWS from the President

3

AUDIT ACTIVITY HAS SLOWED BUT THERE IS A NEW CONTRACT IN PLACE WITH A NATIONAL AUDITING FIRM

From Wayne van Halem The van Halem Group (waynevanHalemGroupcom)

The RACs are about to restart and unfortunately orthotics and prosthetics are on their target list However The van Halem Group offers both proactive and reactive RAC protection services to minimize the impact on your practice We definitely recommend our proactive services such as our affordable monthly compliance packages which include quarterly audits education and training compliance consults communications and more We also provide clinical pre-screen reviews for all services you provide These reviews performed prior to delivery provide feedback on what details may be missing and include recommendations for your referral sources so you can sleep better at night knowing you have what you need before you provide the items and bill for them We can also perform a one-time audit to identify any risk areas your practice may have and help develop a corrective action plan If you tend to be more reactive and are facing an audit or overpayment we provide comprehensive audit response and appeal prep services Our services have saved our clients over $30 million in overpayments and claim denials Dont be complacent be prepared for the RAC attack OPGA members receive significant discounts Call (404) 343-1815 email InfovanHalemGroupcom or visit wwwvanHalemGroupcom today to schedule a free consultation

CAN OPGA USE ITS GEOGRAPHIC FOOTPRINT TO HELP WITH CONTRACTING WITH PAYERS

From Tom Moody VGM HOMELINK (tommoodyvgmcom)

HOMELINKrsquos focus is to obtain contracts with payer sources and increase referrals for our membership More information regarding contracts and a listing can be found at httpwwwvgmhomelinkcomdealers-managed-care-contractsaspx Obtaining contracts with certain payers can be challenging One of the benefits of being part of HOMELINK is the ability to accept referrals for patients that you may not be

directly contracted with As a HOMELINK provider you are able to receive referrals from our patient care coordinators In addition if you receive a referral directly and are not in-network with that payer you can call HOMELINK If HOMELINK is contracted with the payer you are able to bill it through HOMELINK and still offer in-network benefits to the patient as long as you will accept the reimbursement rate that HOMELINK negotiates with you This rate is based on a contract that HOMELINK has with the payer

SOME OF OUR EXPENSES FOR EXAMPLE LIABILITY INSURANCE AND SURETY BONDS WE HAVE PURCHASED FROM THE SAME PEOPLE FOR YEARS DO YOU HAVE A WAY TO REDUCE THESE COSTS WITHOUT REDUCING COVERAGES MANY COVERAGE REQUIREMENTS ARE DICTATED BY HOSPITALS AND NETWORKS

From Dave Oleson VGM Insurance (daveolesonvgmcom)

We provide a free evaluation of your insurance coverages to avoid any gaps or duplicate coverages Our policy is designed specifically for the OampP facility so the coverages encompassed within our program meet or exceed the industry standards Our pricing has proven to save our members an average of 15 percent over current insurance plans and we continue to assess our underwriting guidelines to ensure superior coverage with competitive pricing This holds true with our surety bonds as well Providing low pricing with the necessary coverage to comply with Medicare

REGULATORY CHANGE IS HAPPENING SO FAST DO YOU HAVE SOMEONE WATCHING AND STAYING AHEAD WHEN POSSIBLE OF THE CHANGES

From Mark Higley VGM Regulatory (markhigleyvgmcom)

The OampP industry may be small but we play an integral role in the lives of millions of Americans CMS audits and restrictive reimbursement policies are challenging OampP businesses large and small forcing patients to do without

3

2

4

5

4

the products and services they need Wersquore here to help practices navigate the complexities of the legislative process and regulatory rules with two goals in mind first you have freedom to do business and second your voice is heard

(Mark Higley and the regulatory staff are experts at navigating government rules and programs related to OampP He is driven to educate and assist our members providing all necessary resources to help ensure your success)

WE UNDERSTAND WE NEED TO MEASURE OUTCOMES SO HERE ARE THE QUESTIONS HOW DO WE DO IT THAT IS MOST EFFECTIVE AND HOW DO WE COLLECT THE DATA WITHOUT COSTING TOO MUCH TIME AND MONEY

From Ron Turzy US Rehab (ronturzyvgmcom)

Because health care is trending to requiring outcomes and it is going to be tied to reimbursement by Medicare starting in 2017 with physicians A validated scientific outcomes tool is now available for measuring functional mobility This outcomes tool is authored by an internationally respected university (University of Pittsburgh) and administered through OPGA It streamlines the process of collecting functional mobility data at five touch points during year one by a patient self-reported survey The time invested by the practitioner for the initial intake and survey is minimal The outcomes tool is designed not only to measure outcomes but to indicate the need for intervention should outcome results decline Thus improving health and lowering costs by correcting identified functional concerns before they result in further complications

HOW CAN YOU HELP US GET THE WORD OUT IN WASHINGTON ON THE VALUE OF THE CARE WE PROVIDE RATHER THAN JUST THE COST

From Tom Powers and Collin Brecher VGM Government (tompowersvgmcom and collinbrechervgmcom)

The Government Relations team is actively tracking and advocating for key OampP legislation that protects practitioners

from burdensome regulation and enact quality policies OPGA and VGM Government Relations work closely with congressional offices as bills have been developed and make their way through the legislative process We also work to build these grassroots efforts that include numerous ways to get involved including in-district meetings location visits with elected officials support letters and much more

Seven critical issues and seven working solutions in place ready to be put into action to help every member of our community that needs them I am not so naive to think that each of these solutions is perfect or that every member will require each solution to be implemented in their business But I also know that having no plan for success is a plan for failure Together we will continue to change as conditions require

As a clinician I am proud of the work we do for the people who need our care As president of OPGA I am just as proud of the membership community we have created and the proactive steps we are taking to help insure your ongoing success

In your service always

6

Dennis Clark CPOPresident OPGA

7

5

Dennis Clark CPOPresident OPGA

15

Table of ContentsLetter from OPGA President Dennis Clark 2-4OampP1 2

Why Eliminating Frustrations is Fundamental to Better Patient Experiences 6From PEL

PEL 7

PEL Announces New Partnership with Amoena 8

Knit-Ritereg 9Understanding the Two-day Rule 10By Kelly Grahovac The van Halem Group LLC

The van Halem Group 11GAITRitereg 11Oumlssurreg Introduces Breakthrough Pro-Flex Footreg 12Oumlssurreg 13Oumlssurreg 14Drew Shoe 15Bregreg 16-17CINTASreg 18-19

PW Minor Where the Rubber Hits the Road 20 25 PW Minor 21

Identifying Targeting and Converting Key Referral Sources in 2017 22 34By Ryan Ball VGM Market Data

VGM Market Data 23 VGM Insurance Services 24Federal Court Urges HHS to Move Forward on Audit Backlog Situation 25 By Collin Brecher VGM Government Relations

Coyote Designreg 26Q School Coyote Designreg 27VGM Forbin 28

FLO-TECHreg 29Trulife 30-31COMFORT PRODUCTS Inc 32Brightree 33How Financing Can Carry OampP Providers Through Times of Change 34By Chad Hamann VGM Financial Services

VGM Financial Services 35

Liberating Technologies Inc 36-37M-Brace 38

OCSI 39

66

77

8

Providing products that meet breast cancer survivors needs

CLEVELAND OHIO ndash 2016 ndash PEL LLC the leading independent distributor of orthotic and prosthetic products announces an exciting partnership with Amoena the worldrsquos leading breast care brand Beginning in August PEL will distribute the Amoena product line through PELrsquos expansive OampP network of providers The line developed for women recovering from a mastectomy breast reconstruction or experiencing symmetry issues provides women with apparel they can trust making them feel more comfortable and confident

As the industry pioneer of silicone breast forms Amoena combines technology with supreme comfort offering an extensive product line of bras swimwear and symmetry products Serving women worldwide Amoena fully supports the needs of women following breast cancer surgery

According to the American Cancer Society in 2015 an estimated 231840 new cases of invasive breast cancer will be diagnosed among US women Of those women more than 70 percent had breast surgeries

ldquoThose women are the inspiration for and behind our productsrdquo said Ken Shaw presidentGM of Amoena USA Corporation ldquoPrior to partnering with PEL our products were available through select retailers hospital boutiques and department stores Now our products will be directly available to specialists and fitters throughout the OampP industryrdquo

Amoena has been dedicated to incorporating the latest technology into its products in order to answer the real-life needs of women who have had breast surgery The companyrsquos new product development program recognizes that these needs are ever-changing as surgery techniques evolve and as women demand more in terms of performance and choice

Amoenarsquos ongoing commitment to innovation has resulted in four decades of patented materials products and manufacturing methods ldquoTheir commitment is much like oursrdquo said Mike Sotak PEL CEO ldquoAs the industry grows and technology and products change wersquove adapted But our commitment to OampP practitioners providers

technicians and fitters has remained the same Wersquore here for them To help them change lives To give people their lives back Together with Amoena wersquoll do just thatrdquo

Since 1959 PEL has focused on helping practitioners provide the greatest possible care for their patients by being accessible to discuss the best potential products and solutions that can be delivered in a timely manner

About PEL LLC

PEL was founded in 1959 and is the leading distributor of orthotic and prosthetic components to the OampP industry Since its beginning PEL has focused on helping OampP practitioners technicians and fitters provide the greatest possible care for their patients by being accessible to discuss the best potential products and solutions As a worldwide distributor carrying over 300000 products from more than 250 companies PELrsquos friendly and highly trained staff is ready to help For more information visit wwwpelservicecom or call 1-800-321-1264

About Amoena

For more than 40 years Amoena has focused its efforts on supporting the mind body and spirit of women worldwide establishing itself as an industry leader with a robust product line of apparel bras swimwear and breast symmetry products that fully address the needs of any woman especially those affected by breast cancer The company is committed to designing collections that meet the most demanding standards for comfort support and fashion Other brands may offer more daring collections but none are more courageous than Amoena For more information visit wwwamoenaus

PEL Announces Partnership with Worlds Leading Breast Care Brand Amoena

9

10

Kelly Grahovac Senior Consultant The van Halem Group

Understanding theTwo-day Rule

Recently questions have arisen regarding the appropriate way to bill for orthotics and prosthetics for a patient who is in an inpatient stay Specifically how can the OampP practice receive payment from the DME MAC for the items provided to the beneficiary for use in the home following discharge from an inpatient stay

Medicare policy states that the location the beneficiary uses the equipment (place of service) determines who will receive reimbursement for the items with very few exceptions One exception to this policy is what we often refer to as the ldquotwo-day rule According to the CMS Claims Processing Manual (IOM 100-04 Ch 20 Section 11032)

ldquoIn some cases it would be appropriate for a supplier to deliver a medically necessary item of durable medical equipment (DME) a prosthetic or an orthotic - but not supplies - to a beneficiary who is an inpatient in a facility that does not qualify as the beneficiarys homehellippre-discharge delivery of items intended for use upon discharge are considered provided on the date of dischargerdquo

In order to qualify for this exception and to bill the DME MAC for the equipment the provider must deliver the completed OampP device to the beneficiary during a Part A hospital inpatient rehab or skilled nursing facility (SNF) stay within 48 hours of the patientrsquos anticipated discharge As long as the device is not intended for use during the remainder of the patientrsquos inpatient stay and the patient is being discharged to a location that qualifies as his or her home the provider may bill the DME MAC directly for the device Understand that the you are delivering the device in order to provide basic instruction on how to use and care for the device following discharge

When billing the DME MAC for the device be sure that the date of service is the date of discharge In some instances obtaining a copy of the discharge summary is a good practice to avoid inpatient denials and unnecessary appeals Your proof of delivery should appropriately document that you delivered the device during the inpatient stay within two days and in anticipation of discharge You will also need to bill the place of service as HOME (12) or other qualifying place of service code which indicates where the device will be used

A word of caution when delivering items to the hospital or SNF If the OampP device is needed as part of the patientrsquos recovery or rehabilitation in the facility it must be paid for by the facility regardless of when it was delivered OampP providers must be especially aware of this requirement as many inpatient facilities try to use the two-day rule to avoid having to pay for medically necessary items provided to patients who are under their care

As we see the RACs transition from four to one it is imperative that you are mindful of the beneficiaryrsquos discharge date and location following discharge Billing the DME MAC during an inpatient stay is a common automated review that the RACs deploy to recoup money back to the Medicare Trust Fund It is anticipated that once the new national RAC contract has been awarded automated reviews will lead the transition as they do not require human interaction to complete

It is also very important to remember that submitting a claim for reimbursement under Medicare Part B that is either intended to be reimbursed by another entity or is included in payments being made under Medicare Part A is a serious compliance concern Double billing could occur as a result and this could lead to more serious issues up to and including false claim violations and civil monetary penalties of $11000 or three times the amount of falsely claimed charges

In the event you receive a RAC audit letter related to inpatient stays or worse The van Halem Group can help Our reactive services include clinical summaries with recommendations audit response and if the claim is denied appeal submission and tracking is part of the package Our proactive services include pre-screen reviews of your patient files performed by our clinical staff to include recommendations and education (when needed) Contact us for more information on how we can help you

1111

GAITRitereg The Global Leader in Portable Gait Analysis

In 1992 CIR Systems Inc changed the world of GAIT Analysis with the introduction of the GAITRitereg ldquoTruly Portablerdquo Walkway Systems for TemporalSpatial analysis The acknowledged ldquoGOLD STANDARDrdquo is used in many disciplines as well as in support of numerous FDA trials Its user base now covers the globe

GAITRiteregrsquos product line has developed to meet the needs of the ever-growing user base For clinical practices where time-efficient simple-to-use assessment tools are essential GAITRitereg BASIC is the product of choice providing true outcome measures in simple to produce reports at an affordable price that fits any budget

GAITRitereg BASIC is offered in two economically priced lengths 10rsquo amp 12rsquo ideal for most clinical settings with software that includes targeted clinical features with standard reports for most conditions as well as a customizable report generator for patients with multiple conditions

The GAITRite BASIC system is even more portable than the CLASSIC walkway based on the lighter smaller and narrower profile making it easily transportable between locations and requiring less floor space when laid out

All systems come with warranty including customer support

For information contact salesgaitritecom or call 888-482-2362

GAITRitereg BASIC Ideal for Clinical Practice

12

By Oumlssur

Oumlssur Introduces Breakthrough Pro-Flexreg Foot

Designed to reduce amputeesrsquo joint pain and injury risk

Global prosthetics innovator Oumlssur has launched Pro-Flexreg a new foot designed to help reduce joint pain among amputees who engage in low-to-moderate impact activities

Pro-Flexrsquos design is intended to address many of the well-documented co-morbidities often found in people with lower limb loss including compromised gait dynamics which may increase the load on remaining joints and contribute to higher-than-average rates of knee osteoarthritis (OA) Individuals with lower limb amputation are documented to have as much as 17 times greater risk of OA than in the general population Increased load also may cause diabetic or dysvascular amputees to experience foot ulcers which if left unaddressed may lead to subsequent re-operations

ldquoAs a company Oumlssur is dedicated to providing technology that enables people to pursue a life without limitationsrdquo said Jon Sigurdsson Oumlssurrsquos president and chief executive officer ldquoWersquore proud to introduce Pro-Flex as one of our Dynamic Solutions that provides not only exceptional functionality for the userrsquos affected side but focuses on supporting individualsrsquo sound side over the longer termrdquo

Unique Anatomical Design Enhances Physically Correct Gait

Pro-Flexrsquos unique three-blade design features levers and pivots plus a foot blade with a full effective toe lever and a more anatomical split toe These innovative technologies help generate exceptional mechanical power and afluid natural progression from heel strike to toe-off Pro-Flex is compatible with Oumlssurrsquos Unity sleeveless vacuum system allowing excellent suspension and volume control with no added build height and only minimal added weight

Visit the Pro-Flex product page for more details

FOLLOW OPGA ONLINE

ADVANCING THE PROFESSION

1313

14

Pitt MSO continued from page 17

15

1616

1717

18

19

20

Where the Rubber Hits the Road

Drew Gallacher CPed

At PW Minor we know what OampP professionals need when it comes to a shoe supplier one that fits the requirements of their patients and referring physicians alike We respect the fact that you fit shoes on the very people who truly require the best possible footwear so as to address a multitude of orthopedic problems and pathologies

The new owner of PW Minor Pete Zeliff purchased the company two years ago just as it was floundering from years of neglect In fact the company was merely days away from permanent closure with the loss of 80 good jobs in Batavia NY After a few months of assessment and reflection on where the company was he formulated a plan that would rescue the company and more importantly set course towards a new future Pete identified five key areas that had to be addressed

Inventory Availability

With inventories depleted and backorders at an all-time high we realized that this was not a practical arrangement for you the practitioners who need shoes quickly to fill the RXs that you encounter on a daily basis However like most shoe companies these days the vast majority of P W Minor shoes were at that time manufactured in China and there was a five-month lead time to replenish our shelves Understanding that this was a reality of the supply chain from Asia Pete embarked on a two-track solution one short term purchasing a large quantity of inventory from Asia a multimillion dollar investment to see us through a two year period and a second long-term track the modernization of our plant in Batavia so that we could achieve the goal of 100 percent manufacturing in the USA and truly gain control of our own success through in-house inventory management

Quality

As suppliers to the segment of the shoe industry that deals with the most difficult footwear cases we know that you need quality products We have embarked on a quality control program in Batavia that ensures the finest craftsmanship goes into every pair we proudly make in our USA plant

Beginning with the selection of leather from USA tanneries in the midwest all the way through the manufacturing process to the production of our own arch supports we target the highest quality possible each step of the way

Innovation

Pete realized that to become truly 100 percent ldquomade in the USArdquo we would need to change and improve our production processes dramatically and that to be competitive modernization computerization and even robotics would be the order of the day So he has invested in Automatic leather grading and cutting machines computerized sewing machines state-of-the-art lasting machines robotic sanding and roughing tools and a direct attach soling machine These key pieces of tooling allow us to produce many more units per shift today than we could using the seventy-year-old equipment we had been utilizing until very recently This has allowed us to drop costs and compete in pricing with the products we were importing from China and because we have to make so many pairs in house the added bonus is that we have not lost any of our work force through the automation process The only change is our workforce now employs a different skillset to operate the new machinery much to employeersquos satisfaction

Appropriate Last Design

At PW Minor wersquore very familiar with the feet you have to work with and for that reason we remain committed to last selections that will assist you in fitting your patients accurately and safely We will continue to offer a wide selection of shapes and sizes including Xtra Depthreg DX2 (double depth) Summit Super Depthreg and our new womenrsquos ldquoCloudrdquo last which features extra ball girth to accommodate bunion and bunionette deformities In compliance with the A5500 code we also remain committed to offering a large range of sizes and a minimum of three widths on all of our shoe styles This selection of last shapes and sizewidth combinations gives you the practitioner the best possible choice in fitting your patientrsquos needs

Value

We recognize your patients need and deserve the highest quality footwear but at the same time we understand the constraints of reimbursement policies through both government and private health care systems Making shoes in the USA and remaining competitive has been a challenge but we believe that we have

PW MINOR continued on page 25

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22

In todayrsquos world of providing custom orthotics and prosthetics with audits endless documentation requirements and declining reimbursement independent OampP providers must leverage business from more physicians if we are to remain relevant and thrive in difficult times As we enter the 2017 strategic planning season a greater focus on finding new business and maximizing the potential value in current markets is a necessity but how do you get there By creating and executing a strategic growth plan making goals engaging your team and defining success

How to Create a Strategic Growth Plan

In order to properly create and execute a strategic growth plan you must first have a keen understanding of your market and be able to answer the following questions

Who are the largest potential referral sources in your market and how much of their business do you receive

How many total referrals for your productservices are generated in your area

Who are the largest referral sources for your main competitors

If you are entering a new product or geographic area how do you plan to target your sales and marketing efforts to establish yourself in the marketplace quickly

Helpful hint The answers to all of these questions can be found in data

Step 1 Dig into the Data

The first step in executing your strategic growth plan is utilizing data to identify qualify and target key referral sources

Many independent OampPrsquos donrsquot use the data they already have at their fingertips within their EMR system Ranking physicians by volume of referrals you receive year-over-year volume comparisons strategic engagement plans for referral sources whose volume decreases over time All of these metrics are right there in your EMR system but it takes planning and analysis to turn that data into actionable intelligence for your sales team

There is also market intelligence data available to help you better understand the competitive landscape in your markets Your EMR can only tell you information about your business but that is only one piece of the puzzle To succeed you must understand the competitive referral dynamics of key physicians

in your market to separate you from your competition Once you are able to identify the highest value referral sources in your markets you will be able to create tangible goals and drive the day-to-day operations of your salesmarketing team

After identifying and qualifying key referral source opportunities with your sales team assign key prospects to relevant sales territories create tiers of prospects based on potential value and targeted contact plans for each tier Incentives can also be developed for executing the contact plans and growing business with key identified prospects Properly done this process helps ensure that your team is focused on the accounts that have the greatest potential value for your business

Step 2 Create Tiered Contact Plans

If you want to convert physician prescribing behavior you must create tiered contact plans Breaking your prospects into defined groups based on potential value can help ensure you focus appropriate resources for each tier based on their potential value to your practice Contact plan strategies prioritize visits touches personnel and marketing to ensure your top prospects are the main focus The best contact plans include multiple communication mediums and provide targeted relevant information based on your market intelligence of the prospect

Step 3 Measure Your Contact Plans

Measurement is also important to any strategic plan Evaluate your contact plan to ensure you are effective in the marketplace You can do this by tracking the volume attributable to physicians identified in your targeting plan What are you getting from them on a monthly average over the past 12 months After three months of targeted engagement review volume attributable to each targeted physician and see whether yoursquove moved the needle This exercise should also be done for physicians who you are not currently working with did you find new business These tracking mechanisms help you set and deliver on compensation plans for your sales team that are data-driven and attainable Create incentives based on your strategic goals a new order from a new physician is worth more than increased orders from a current physician a new prosthetic referral is worth more than a new brace referral etc

Whether you use your own internal data or acquire market intelligence data from a third party data is here to stay and is a necessary tool to reach your goals in 2017

Identifying Targeting and ConvertingKey Referral Sources in 2017

By Ryan Ball Director VGM Market Data

Key Referral Sources continued on page 34

232323

By Ryan Ball Director VGM Market Data

23

2424

25

As Medicarersquos backlog of appeals continues to increase and the hearing delays remain at a staggering average of 935 days the DC federal court handed down a decision on September 19 to ramp up the pressure on the US Department of Health and Human Services (HHS) to solve the issue The court hearing was prompted by a lawsuit filed by the American Hospital Association (AHA) in which HHS had requested that the court put this litigation on hold until September 30 2017

The DC Circuit Court of Appeals denied HHSrsquo request as the presiding judge declared ldquoThe best medicine can sometimes be hard to swallowrdquo There was a great deal of compelling evidence within the ruling to justify urgent reform action as appeal delays average 935 days Yet another staggering number cited in the ruling was ldquoBetween fiscal years 2010 and 2014 the number of appeals filed at step three grew 936 percent - from 41733 to 423534rdquo

As these audits are overwhelmingly overturned practitioners are facing the struggle of cash flow being withheld from their business by the federal government This creates a problem for patients and providers alike as noted in the ruling ldquoBecause of the consequent financial burden some providers are lsquoforcedhellipto reduce costs eliminate jobs forgo services and substantially scale backrsquo all of which affects the quality and quantity of patient carerdquo

The AHA had filed this lawsuit in 2014 against HHS in an effort to mandate ALJ appeals to be decided within 90 days After the suit was dismissed in December of 2014 the case was appealed to the DC Circuit Court of Appeals which was ruled predominantly in favor of AHA HHS had been requesting a delay in further proceedings until Sept 30 2017 in hopes that the agenciesrsquo internal efforts and legislation in Congress would reduce backlogs without any judicial intervention into the issue The Court disagreed with HHSrsquo proposed delay as ldquothe Secretaryrsquos proposed solutions are unlikely to turn the tiderdquo

Although this was not a complete slam dunk as AHA suggested the court simply order HHS to resolve each of the pending appeals by the statutorily prescribed deadlines was ldquowishful thinkingrdquo by the presiding judge this will create a lot of pressure for HHS to find a better solution to the backlog than the efforts that have been largely ineffective thus far While there are no additional concrete solutions that HHS has laid out to solve this ongoing problem this ruling is a great win for the health care industry as providers are facing a constant barrage of audit troubles

Federal Court Orders HHS to MoveForward on Audit Backlog Solution

By Collin Brecher VGM Government Relations

achieved just that Can you buy cheaper shoes Of course but our goal has been to produce high quality shoes at affordable prices through automation We have achieved the same price points as we did for the import shoes we got from China and at the same time have managed to reduce the cost of our traditional made-in-the-USA boots and shoes by up to 30 percent We donrsquot know of another company providing an A5500-approved work boot or shoe that is made in the USA for less than $100 We hope that you see the value and will give our products a try

Our new approach to the market will cover three distinct segments of the market

Abrams Boots Our work boot collection offering both soft toe and safety toe styles which will both be coded A5500

Orthopedic Our core shoes designed for medical needs in the styles that you are familiar with

The Airloft Collection A cross-over orthopediccomfort collection geared toward less critical medical conditions but still coded A5500 for therapeutic use

Whats to Come

As you can tell we are very excited at all the changes that have been in the works over the last two years finally coming to fruition We have a new management team Kristine McCarthy our VP of Product Development and Brian Benedict our director of sales and marketing who have both been working furiously to deliver all these new products and services Just recently Brian launched our new website wwwpwminorcom and has implemented a social media and digital marketing campaign along with a new catalog which will hit your facilities in a week or two We truly intend this to be just the beginning of a PW Minor revival that will prove to you the practitioners we rely on that we will prove to be a top-shelf supplier for your orthopedic footwear needs

PW MINOR continued from page 20

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2727

2828

2929

303030

3131

32

3333

34

How Financing Can Carry OampP Providers Through Times of Change

By Chad Hamann VGM Financial Services

The most important investment an OampP provider can make in equipment may be time spent investigating how to pay for it Cash flow issues arise within an OampP business as a result of both growth and challenges in the market Establishing a line of credit with an equipment finance company before cash flow is weak can help maintain consistent cash flow and avoid any shortfalls while being able to purchase the needed equipment

With planning those managing an OampP business can establish a lease line of credit then use it to get the most out of the financial flexibility it provides For example by locking in a fixed monthly payment over time cash and bank lines can be preserved for other operating or short-term needs

Pay over time or up front

Consider equipment as if it were an employee Rather than pay an employees salary up front each year payments are spread over time OampP providers can do the same with equipment purchases Structuring an equipment lease to match the reimbursement period allows the equipment to work for the business ndash and generate revenue ndash as payments are made

However before making any finance decisions OampP providers should determine if equipment qualifies for a lease and generates sufficient revenue on a monthly basis If it is a cash-and-carry type of product it may be better suited for purchasing with cash on hand or bank lines

Lease vs purchase

Whether the plan is to grow the business or avoid running into cash flow problems cash saved by leasing equipment can help carry the business through tough times

Financing flexibility is endless and an important asset to the ever-changing OampP industry Equipment finance companies that specialize in the OampP industry understand the unique economic

environment and the demands placed on equipment Unlike traditional lenders equipment finance companies often package equipment software installation training maintenance and other services into a single lease

Cash flow during growth

OampP providers can also experience cash flow issues during times of growth including landing a new contract or being the lowest responsible bidder in the competitive bidding process A cash flow shortage could prohibit a business owner from pursuing these and other growth opportunities such as

bull Opening a new locationbull Offering niche productsbull Expanding via acquisitions

These opportunities require additional capital to purchase the necessary equipment to service a contract or its patient base This is another reason to have a lease line of credit established in advance with an equipment finance company Whether an OampP provider is experiencing growth or a challenge ndash eg competitive bidding Medicare audits deductible season payment delays ndash taking the time to explore equipment finance options will help maintain flexibility during periods of change

What you need to know

VGM Financial Services provides business-to-business equipment financing solutions to orthotics and prosthetics providers and manufacturers with industry-specific programs that increase sales and market share

Contact Chad Hamann national account manager at 800-532-4656 or chamannvgmfscom The perspective offered by Chad Hamann is based on his expertise and is not necessarily the view of VGM Financial Services This article does not constitute tax or accounting advise

Engaging key referral sources and increasing your brand awareness is more important than ever Valuable physicians canrsquot send you business if they donrsquot know who you are and the benefit of working with you to manage the care of their prosthetic patients At OPGA we hold the strong belief that when an independent orthotist or prosthetist enters the care continuum of a patient their health outcomes increase and the overall cost

to treat that patient decreases significantly We have a great story to tell and now we have the ability to target the physicians we need to grow our practices and help more patients

Key Referral Sources continued from page 22

Ryan Ball is the director of VGM Market Data providing data targeting services to independent orthotic and prosthetic providers

35

By Chad Hamann VGM Financial Services

3636

3737

37

3838

39

1111 W San Marnan DrPO Box 1467

Waterloo IA 50704800-214-6742

wwwopgacomwwwpointhcacom

A Division of VGM Group Inc