On March 2, 2005, Jeff Yakovich, CO, FAAOP, President-Elect for the American Board for Certification, presented public comments to Medicare's Program Advisory Oversight Committee. Mr. Yakovich's comments focused on the need for quality standards in the accreditation of providers.
As Prepared:
Good afternoon.
Thank you for the opportunity to speak today. I was encouraged to hear several of you speak positively this week about the affect accreditation can have on the quality of patient care under competitive bidding. I am here this afternoon to present public comment on behalf of The American Board for Certification in Orthotics & Prosthetics, for which I serve as the President-Elect of the Board of Directors. I intend to establish why we believe ABC accreditation for suppliers of custom fit orthoses and prostheses should be implemented as a requirement for participating with CMS.
As a certified practitioner and an amputee, a great deal of my life revolves around prosthetic and orthotic care. I have been very fortunate to receive proper prosthetic care, which has enabled me to live a full and productive life. Unfortunately, many Medicare beneficiaries are not so privileged. But with the right prosthetic and orthotic supplier standards, this can change.
This oversight committee will be monitoring the competitive bidding process as it is implemented to help ensure that Medicare funds are not un-necessarily spent and that the quality of patient care does not suffer as a result of the bid process. Your recommendations will affect the future productivity of millions of disabled Americans, including diabetic patients, victims of traumatic accidents, and our wounded soldiers returning from abroad.
Establishing standards for suppliers of custom fit orthoses and prostheses has a serious impact on the quality of life of these disabled patients. The post-operative health of an amputee is based on the patient’s ability to get back on their feet; and proper care is one way a patient can return to a productive life.
Setting appropriate standards is crucial to ensuring that proper care is provided to our patients. The accreditation standard of the American Board for Certification is already a nationwide standard for orthotic and prosthetic care providers. Doctors, insurance companies, and practitioners recognize that care for an amputee is not simply providing DME- but much more. Our unique patients require unique standards- and ABC accreditation is the realization of these needs.
ABC accreditation is based on the JACHO model; incorporating on-site surveys, standards for patient care, safety, and quality assessment and improvement. Our accreditation standards can help reduce fraud and abuse by ensuring that prosthetic and orthotic suppliers are stable businesses, operated by people not on the OIG exclusion list.
I’d like to briefly state a few facts about ABC accreditation:
1. The ABC accreditation program began in 1948, and now accredits nearly half of the nation’s O&P facilities.
2. This number continues to grow. Hanger Orthopedic group, which operates approximately 25% of all U.S. O&P patient care centers, has adopted ABC accreditation as a requirement for each of its 632 facilities. With this decision, over 300 additional sites of care will seek ABC accreditation, further increasing the number of available accredited suppliers.
3. ABC accreditation is the prosthetic and orthotic supplier standard most used by private insurance companies. Groups such as Blue Cross Blue Shield, Linkia Managed Care, and United Healthcare all require patients to receive care from ABC accredited suppliers.
4. ABC accreditation is affordable, with annual fees per supplier of less than $1,000. Affordability is essential for a profession in which 75% of the suppliers are small businesses. It is important to note here that if more expensive accreditation standards are implemented, hundreds of O&P suppliers would be affected, possibly upsetting the balance of supply and demand.
As a patient and provider, I know that proper patient care is no accident. It takes educated and experienced professionals practicing at a safe patient care center.
That’s what ABC accreditation accomplishes. These time-tested, strict standards will give Medicare beneficiaries the best chance to return to a productive life. I urge the committee to push for the adoption of ABC accreditation as the standard for suppliers of prostheses and orthoses.
In conclusion, we recommend that orthotic and prosthetic care be supplied only by ABC accredited facilities. Existing L-Codes distinguish custom orthoses from Durable Medical Equipment and I urge the committee to ensure that custom orthoses and prostheses are provided only in a safe, patient-care based environment. Setting ABC accreditation as a standard is the way to accomplish this. We look forward to this committee’s support of quality O&P patient care.