balancing the costs and benefits of prosthetics . . . page 5 · balancing the costs and benefits of...

1

OPGA Member Magazine

Balancing the Costs and Benefits

of Prosthetics . . . page 5HIPAA Compliance: Will You Be Prepared

When the Office of Civil Rights Calls? . . . page 12

OPGA Announces New Partnership with Nymbl . . . page 18

Winter is here. Is Your Business Protected? . . . page 26

WINTER 2018

Good Day and Happy New Year! As we plow forward into 2018, it is without question setting up to be a very important and exciting year for the profession. Legislatively there are several important bills that need your voice of support, highlighted by the Medicare O&P Improvement Act, which includes three key provisions that would have an incredibly positive impact on the profession. Those three provisions are 1) Recognition of prosthetist and orthotist notes as part of the patient’s medical record and that these notes will help establish the medical necessity of prostheses and orthoses provided to Medicare beneficiaries, 2) Linking O&P provider qualifications with Medicare billing privileges (BIPA 427) and 3) Clarifying the scope of off-the-shelf orthotics. Now is not the time to watch from the sidelines. Please stay/get involved by contacting your congressional representatives and voice your support!

As OPGA moves forward into 2018, we are very excited to announce the new partnership we have formed with Nymbl

Systems. Nymbl brings a new and extremely user-friendly practice management software that is tailored to the specific needs of the independent O&P practice. This is a game changer and we encourage you to learn more about them. The press release and more information can be found on page 18 of this edition of The Connection.

The OPGA Community continues to grow and remains dedicated to the advancement of the independent provider. Please reach out to me or any of the OPGA staff, and let us know how we can help you achieve your goals and aspirations.

At your service,

NEWS from the President

2

Legislative Support Still Needed, New Year Brings New Partnership

OPGA President

31

3

Table of ContentsLetter from OPGA President Todd Eagen .................................................................................. 2O&P1 ................................................................................................................................................. 2PEL...................................................................................................................................................... 4

Balancing the Costs and Benefits of ProstheticsFrom PEL. ........................................................................................................................................... 5

HOMELINK ....................................................................................................................................... 6

Staples .............................................................................................................................................. 7Amplify Your Voice ......................................................................................................................... 8Amplify ............................................................................................................................................. 9Össur®................................................................................................................................................ 10-11HIPAA Compliance: Will You Be Prepared When the Office ofthe Office of Civil Rights calls YOU? ......................................................................................... 12 By Kelly Grahovac, The van Halem Group, LLC

The van Halem Group .................................................................................................................... 13Breg ................................................................................................................................................... 14-16OTS Marketing ................................................................................................................................ 17OPGA Announces New Partnership with Nymbl Systems ........................................................ 18Nymbl Systems ................................................................................................................................ 19

Upcoming OPGA Webinars .......................................................................................................... 19

Martin Bionics ................................................................................................................................... 20A Look at Basalt Braid ................................................................................................................... 21, 31From Coyote Design

Trulife ................................................................................................................................................ 22-23OCSI Inc.. ......................................................................................................................................... 24-25Winter is Here. Is Your Business Protected? From VGM Insurance Services ....................................................................................................... 26, 39

VGM Insurance Services ................................................................................................................ 27

DIA-FOOT® ..................................................................................................................................... 28Secure Tech Solutions ..................................................................................................................... 29Healthcare Cyber Security Must Complement HIPAA Compliance ....................................... 30-31FLO-TECH® ..........................................................................................................................................................................................................................................32Cypress Adaptive ........................................................................................................................... 33Drew Shoes ...................................................................................................................................... 34Coyote Design ................................................................................................................................. 35

Cintas................................................................................................................................................. 36

VGM Forbin ..................................................................................................................................... 37

VGM Apparel & Promotions ....................................................................................................... 38

Comfort Products ............................................................................................................................. 39

VGM Market Data ......................................................................................................................... 40

Össur®................................................................................................................................................ 41KNIT-Rite ........................................................................................................................................... 42

VGM Education ............................................................................................................................... 43

12

Kelly Grahovac, Senior Consultant, The van Halem Group

HIPAA Compliance: Will You Be Prepared When the Office of Civil Rights calls YOU?

The beginning of a new year provides for so many things. It’s a fresh beginning, a clean slate, a new opportunity! And, what a great time to ensure your practice is compliant, especially where HIPAA rules and regulations are concerned. Understanding the HIPAA regulations isn’t easy. Lucky for you, The van Halem Group has a few ways to get you started in the right direction.

First, know where you need to be compliant. Generally, when you hear about HIPAA, the discussion is associated with a hospital or a medical group that had a breach or HIPAA violation. What most people don’t know is that HIPAA applies to organizations outside of hospitals and health networks. So, who exactly needs to be compliant when it comes to HIPAA? Health plans, health care providers, and business associates must all comply with HIPAA requirements. In fact, anyone who accesses or deals with protected health information (PHI) should be complying with HIPAA regulations.

Second, determine your risk. In 2003, the original HIPAA Privacy Rule was issued, and the requirement to have a HIPAA Risk Assessment was put in place. However, many entities have yet to comply. In fact, the Office of Civil Rights (OCR) has spent the last two years conducting HIPAA audits. The first thing they ask for? Your security and risk assessments from the past three years. Would you be able to comply with their request if the OCR audited you today? If that doesn’t frighten you, let’s consider the fines. In 2016, the OCR fined covered entities more than $23 million, and for 2017 that amount stands to be much higher, if not doubled.

A risk assessment intends to identify potential risks, vulnerabilities, availability, and integrity of PHI that an organization creates, maintains, receives, and transmits. Consider the following when conducting your risk assessment:

1. Identify where your PHI is stored, transmitted, and received.

2. Identify and document threats and vulnerabilities.

3. Assess your current security measures.

4. Determine the likelihood of a threat occurrence.

5. Determine the potential impact of a threat occurring.

6. Determine the level of risk.

7. Identify your security measures, and finalize documentation.

By identifying these potential risks, you can work to mitigate the potential for breaches of PHI and prevent fines for your organization. Developing this assessment is beneficial to help determine just how secure your practice is, as well as where improvements need to be made within your organization.

Third, implement training. Everyone on staff should receive regular and adequate HIPAA training that includes the proper handling of PHI, seeing and reporting suspicious activity and/or any possible violations, what constitutes a violation, and how to protect yourself and company from breaches, etc. After training has been provided, be sure to document what was covered and which employees participated.

If all of this seems like a daunting task, we can help! The van Halem Group offers HIPAAwise, a HIPAA compliance software that provides you with a security and risk assessment, employee training, complete policies and procedures, and much more.

We hope the New Year brings new opportunities for your organization when it comes to HIPAA compliance. To learn more about how HIPAAwise can help you reach your business goals, contact us today by visiting our website.

18

OPGA Announces New Partnershipwith Nymbl Systems

Orthotics Prosthetic Group of America (OPGA) is pleased to announce a new partnership with Nymbl Systems.

The arrangement provides OPGA’s 400-plus members with access to Nymbl’s practice management system at an exclusive discounted rate.

“We are very, very excited to begin this partnership with Nymbl Systems,” said Todd Eagen, president of OPGA. “Josh and his team have spent several years developing the Nymbl O&P practice management system, and we believe it is a game changer for the profession. They took the collective input from several of the leading O&P practices in the country and have created a comprehensive, cloud-based practice management system that is 100 percent HIPAA compliant and extremely user friendly. This system will improve practitioner workflow and reduce overall software costs.”

Founded by Josh Lau, Nymbl started in Lexington, Ky., when Lau, after receiving a degree in biology/premed from the University of Kentucky, met and became friends with a local CPO and nationally respected O&P practice owner. Lau was asked to analyze his friend’s business, where he immediately noticed that there was a huge gap in the technology being used in the prosthetic and orthotic community. After spending time better understanding the business operations and challenges, Lau created Nymbl and built the software on the principle of leveraging the latest technologies to

help practice owners maximize their time while delivering exceptional patient care and growing their practice.

“Being new to the profession has allowed me the opportunity to bring a unique perspective into the workflow and data management of the O&P practice,” said Lau. “Using my love for solving complex problems with technology, we have built a platform that requires little training and is intuitive and easy to use. We are fortunate enough to be working with OPGA and their members to help create the best solution for their business and the profession.”

Nymbl’s functionality allows practitioners to access patient records, submit insurance claims, schedule appointments, and purchase supplies, all from the convenience of any mobile device. For more information, visit https://www.nymblsystems.com or www.OPGA.com

About OPGA

Representing more than 1,200 independent O&P facilities nationwide, OPGA provides a comprehensive array of innovative business services that improve productivity, proficiency and profits for both members and suppliers in the network. These services include managed care access, high value referral targeting data, comprehensive practice management software, cyber security solutions, regulatory and compliance programs, competitive rates on liability and property insurance, website development and hosting, and other educational and marketing needs.

Media Contact: Andy Schmitz, Director of Business Development, OPGA, [email protected], 888-556-7607.

FOLLOW OPGA ONLINE!

ADVANCING THE PROFESSION!

19

Thursday, Feb. 8, 10 a.m. CST

Nymbl: New practice management software

Presented by Chad Feinberg and Josh Lau, founder of Nymbl

Tuesday, Feb. 13, 10 a.m. CST

Cybersecurity: Don’t risk it all when it comes to Patient Data

Presented By Carol Albaugh

Tuesday, Feb. 20, 10 a.m. CST

Össur Upper Extremity – Touch Bionics – i-limb

Presented by Nathan Wagner, CPO, LPO, OTR/L

You can register for the webinars on our website at www.opga.com under the Services tab and Education or by contacting OPGA.

Upcoming OPGA WebinarsCheck out www.opga.com for up-to-date listing of webinars!

Free and approved for 1.5 ABC CEUs

2020 Continued on page 39

21

For centuries, the O&P industry utilized wood, metal, and leather in manufacturing prosthetics and orthotics. 1970 is considered to be the beginning of the modern age of prosthetics/orthotics. The introduction of plastics was the main driver of changing how devices are fabricated. 1950 can be considered the start of resin composites being used in orthotics/prosthetics.

Dale Perkins, CPO and co-founder of Coyote Design, was first introduced to exotic composites in early 1980. One of his patients who was a recent amputee and an outdoor enthusiast, Tom Whittaker, brought him some Kevlar he was using in kayak construction. One of his life goals prior to his amputation was to climb Mt. Everest, and this dream only intensified after the amputation. Dale fabricated several sockets for him, incorporating Kevlar, but these proved unsuccessful due to the polyester resin he was using at the time.

"Polyester resins would not saturate Kevlar, so we were basically just gluing the fabric together, not creating a durable composite," said Dale.

Dale started to use carbon cloth sourced from kit aircraft manufacturers with similar failures to Kevlar because polyester resin did not saturate carbon fiber. As carbon fiber started to be manufactured in knitted tubes (e.g., golf club shafts), it found its way into prosthetic socket manufacturing. Improved resin, both epoxy and acrylic-modified epoxy, improved performance of carbon prosthetic sockets, but due to brittleness of the carbon, there was still a high rate of cracking failure. By 1989 Dale created carbon fiber prosthetics for Tom’s first Mount Everest attempted ascent and his two other Everest climbs. Tom was the first amputee to successfully climb Mount Everest in 1998. Tom's book, "Higher Purpose," describes his life and Mount Everest climbs.

In the 1990s, Dale’s son, Matt Perkins, now CEO of Coyote Design, was a technician working in his father’s lab. As with all

lab techs working with carbon fiber, he suited up in hazmat gear and used expensive dust collecting systems to help diminish the health risks and lesson the itch.

"As you well know, despite best efforts, there is still the never-ending itch,” said Matt.

Years went by and Matt and Dale were trying to create a more flexible socket for their patients when they heard about an alternative to carbon fiber: basalt braid, formed from volcanic rock.

Dale recalls, “A large number of our patients wanted their copoly test sockets back; they said it was more comfortable because of the extra flex. By eliminating carbon fiber and fiberglass and using basalt and nylon stockinette, we were able to develop a basalt composite socket that had the flex characteristics of the copoly. Not only did we create a more flexible socket that patients preferred, we dramatically reduced socket failures, such as cracking, compared to carbon fiber/fiberglass sockets. The basalt/nylon stockinette sockets are much less toxic than carbon fiber/fiberglass. Eliminating the carbon and fiberglass has made a safer lab environment as well.”

Dale found his patients preferred the little extra flex the basalt braid gave to their prosthetics and orthotics. For orthotics, they found that the less brittle nature of the basalt almost eliminated the breakdown, which leads to the cracking and splintering that can occur with carbon fiber. They found it holds its shape and rarely fails if made correctly.

The Frenchman Paul Dhé was the first with the idea to extrude fibers from basalt; he was granted a U.S. patent in 1923.

Around 1960, both the U.S. and the Soviet Union began to investigate basalt fiber applications, particularly for military applications. In 1970 U.S. glass companies imposed research strategies that favored glass fiber instead of basalt fiber, while in Eastern Europe research was nationalized by the Soviet Union’s defense ministry, and they continued to develop basalt composites. After the breakup of the Soviet Union in 1991, the results of Soviet research were declassified and made available for civilian applications.

So, what’s the difference? Carbon fiber is more rigid, slightly lighter, and more brittle. Basalt braid is tougher, less brittle, and saturates more thoroughly. Both composite braids create very strong, light-weight products.

A Look at Basalt Braid

From Coyote Design

Continued on page 31

Dale Perkins

26

Winter has officially settled in. And while the season normally batters northern tier states with frigid temperatures and snow, as we’ve seen this year so far, southern states are not always immune from winter’s wrath. In other words, winter weather can cause headaches for O&P business owners and managers no matter where they’re located as they try to keep their facilities, customers, and employees as safe as possible. Here are our best tips to manage winter risk.

The Physics – and Cost – of Frozen PipesWinter temperatures can reach low enough to wreak havoc on a building’s fire sprinkler system, leaving the facility susceptible to fire and the damage it can cause.

In any type of fire sprinkler system, you’re dealing with water. When water freezes, it expands within the pipe by 10 percent, which can cause hairline fractures in the pipe. These cracks will go undetected until the next warm up when the ice melts and water begins exiting the pipe, potentially causing major damage to the property. A broken, one-inch pipe can lose up to 60 gallons of water per minute. The average cost of a burst pipe is at least $30,000 per episode. And, that doesn’t take into account what would happen should a fire break out while the sprinkler system is down.

Prevention TipsThe best defense against a frozen sprinkler system is a good offense—that is, ongoing maintenance, testing, and inspection of the system.

• All structures on your company’s property that are pro-tected by fire sprinklers should be physically inspected BEFORE cold weather hits. There should be no areas with insufficient heat, and precautions should be in place to make sure the sprinkler system is not exposed to freezing temperatures.

• Set all thermostats to 55 degrees or higher at all times.• Do not let ice and snow to accumulate on roofs, windows,

and around foundations of your building’s structures.• Your employees should watch for and report any possible

cold weather problems.• The sprinkler system should be inspected annually by a

licensed contractor. The contractor should demonstrate to all of your employees how all valves operate. You should then assign to an appropriate employee the responsibility of shutting down the system in the event of a burst pipe.

• Check on your building’s fire protection systems more fre-quently than normal during cold weather.

Snow and IceWhile accumulations of snow or ice can damage property, the greater risk they pose are to your customers and employees, causing slips, trips, falls, and back injuries. Removing snow and ice as soon as possible from parking lots, walkways, porches, patios, steps, and entry ways should be a priority during winter.

If your business has its own snow removal equipment, it should be inspected long before the first snow fall. This includes shovels, snow blowers/snow throwers, snow plows, snow rakes and salt spreaders.

If you outsource snow removal, make sure the company you hire is reputable, experienced, and can show proof of liability insurance. Be specific about what you want cleared: just the parking lot, or do you want all areas where people can walk cleared as well?

Regardless of who handles your snow removal, here are a few suggestions of what you can do BEFORE the expected snow fall:

• Place tall stakes along the driveway, walkways, and around the parking lot. These stakes show you or your snow removal company where to shovel, plow, or put down ice melt. You may know where the edges of these areas are, but your snow removal company may not.

• Clear your parking lot of all vehicles that don’t need to be there.

• Make sure you have an adequate supply of sand or ice melt on hand, especially for walkways, steps, porches, and patios.

Your Real Winter EnemyIce – whether from melted snow or rain – can be the real enemy in winter. No matter where your business is located in the U.S., you’ve no doubt faced a winter ice storm at some point.

Ice can cause a great deal of bodily harm. Slips, trips, or falls can result in sprained ankles, broken bones, head injuries, or worse. What’s particularly hazardous is ice you can’t see – hidden under a layer of snow, making it extremely slick. Extra caution should always be taken when shoveling snow should there be ice underneath.

Winter is Here.Is Your Business Protected?

By Bill Wilson, VGM Insurance

Continued on page 39

31

Here’s an example of best use of each material in different terms; If you want a racing bicycle, the stiffness of carbon fiber is a must. If you are looking at snow boards, skis, and tennis rackets, the up and comer is basalt braid. That little bit of extra flex helps absorb the impact and deflect the energy but is still rigid enough to give the desired results.

Matt and Dale named this product Coyote Composite to fit in with the rest of their company line. What is Coyote Composite? It is about 99 percent basalt braid heated and formed into a thread and woven into a sleeve, fabric, or rope. The other approximately 1 percent is called sizing. Sizing is a resin that holds it all together. All fiber braids have some type of sizing.

Anna Larsen, CPO, at Coyote Prosthetics and Orthotics, stated, “My patients have noticed it is more comfortable because of the added flex in the socket.”

Anna said she doesn’t see catastrophic failures as much with patients using prosthetics and orthotics made with Coyote Composite. She likes the added flex it gives to her patients and that it is better for the environment, better for her health, and that it is less itchy.

Technicians who have used Coyote Composite found they didn’t suffer from the itchiness associated with grinding carbon fiber, and repairing AFO breakdown has almost became a thing

of the past. Russ Bartlett, Jr., CPOA, central fabrication lab manager at Coyote Design, has worked with the basalt braid for years and said, “Coyote Composite makes every bit as good a socket as carbon fiber. If I wasn’t told what it was when I started using it, I wouldn’t have known any different.”

Coyote Design’s other central fabrication manager, Bradley Davis, CPA, CTP, said he liked that it has very little itch and no smell when grinding when compared to carbon fiber.

Brad says, “It makes excellent sockets, and I wouldn’t go back to carbon for working with or wearing.”

Brad is a congenital below knee amputee and has worn prosthetics all his life. He started wearing a prosthetic made of Coyote Composite three years ago and loves it. He enjoys the added flex it gives him.

Basalt fiber is all natural and is finding its way into a number of industries because of its strength, low cost, fire resistance, non-conductivity, insulation, and absorption properties. It is being used to insulate pipes and wires from heat and replace rebar in concrete structures due to its strength and the fact that it doesn’t corrode, breakdown, or rust over time. It has also become an asbestos alternative because it is non-toxic, non-carcinogenic, and inert.

Due to its variety of uses and the fact that there is an abundance of this renewable resource, basalt braid is considered to be "the green industrial material of the 21st century."

COYOTE DESIGN Continued from page 23

39

Your customers will, rightfully so, assume your parking lots, walkways, steps, and porches will be free of ice when they arrive at your facility. Your company could be held liable should an accident occur that harms someone. Your employees should take whatever steps are necessary to clear snow and ice from all areas where people will be walking.

Employee Exposure and SafetyAs they do so, your employees should be instructed on how to best clear the snow and ice safely. They are as susceptible to injury as your customers. A worker’s comp claim is only a slip, trip, fall, or twisted back away when employees are clearing snow and ice. Your employees should be instructed on the proper use of snow blowers and snow throwers as well as the proper technique for shoveling snow. Older employees are especially susceptible to heart attacks when shoveling snow, especially a heavy snow.

ConclusionWinter weather is often unpredictable at best, and with it comes particular risks for your O&P business, regardless of location. By being proactive and diligent, you can take certain steps to mitigate those risks to your property, your customers, and employees. As a business owner or manager, understanding the exposures your business has allows you to have an educated discussion with your insurance agent or broker who can provide you with the most competitive rates in your area.

For more information about VGM Insurance and our comprehensive coverages, or to speak with one of our insurance experts, call 800-362-3363 or email [email protected].

WINTER IS HERE Continued from page 26

41

LIFE WITHOUT LIMITATIONS

1111 W. San Marnan Dr.PO Box 1467

Waterloo, IA 50704800-214-6742www.opga.com

www.pointhca.com

A Division of VGM Group, Inc.

balancing the costs and benefits of prosthetics . . . page 5 · balancing the costs and benefits of...

Documents