Sunday, August 30, 2015

Busy Week Update



On Wednesday, August 26th over 400 leaders in the O&P field and grass roots advocates from the Amputee Coalition converged at a public meeting in Linthicum MD to comment on the LCD proposals. For three solid hours testimony was provided to the committee members, urging the proposal be rescinded or significantly changed.  Dan Berschinski, Chairman of the Board for the Amputee Coalition, represented our organization.  His speech is provided at the bottom of this blog.

After the public hearing a closed door meeting was held among high level government officials and representatives from the Amputee Coalition and the O&P industry. Sue Stout, president & CEO and Jack Richmond, Board Member and Chair Elect, attended and spoke on behalf of the Amputee Coalition during this meeting. All in attendance agreed that the meeting was productive and that the concerns about the implementation of these proposals were heard and understood. 

Although strides have been made, we are urging all members of the Amputee Coalition community to continue to push against these proposals. Monday, August 31st is the hard deadline for submitting written comments. The Amputee Coalition has provided convenient and easy to use online forms to simplify contacting CMS and elected officials.  A patient/consumer letter can be found here and a supporter letter can be found here.  Both versions can be edited quickly to personalize and express your specific concerns.  It is imperative that the committee receive as many written comments as possible, so please take a few moments to make your voice heard on this issue. 

 Speech at Public DME Hearing, August 26, 2015
Good afternoon, my name is Dan Berschinski.  I am the chairman of the board for the Amputee Coalition which is the only national non-profit representing nearly 2 million Americans living with limb loss.  We work to ensure all amputees are able to reach their full potential through education, support, and advocacy.  I am also a military Veteran and an amputee.  While serving in Afghanistan as a young Army officer I lost both of my legs after being wounded in combat. I now walk with two prosthetic legs.
While I recognize that this policy impacts Medicare and doesn’t directly impact the Department of Defense or the Veterans Administration, I am here today to share the Amputee Coalition’s concerns.  I would also like to highlight the fact that Medicare’s policies are often picked up by other payers including private insurance and that Medicare’s policies could eventually set the tone for the VA as well, so there is certainly the potential that this proposal will go on to impact all Americans living with limb loss - not just Medicare beneficiaries.
We have several concerns with the primary concerns being - the new functional status definitions and requirements, the requirements for rehabilitation on a basic preparatory prosthesis, reduced access to appropriate prosthetic feet, and reduced access to appropriate socket technology and liner inserts.
First, the Amputee Coalition firmly believes that amputees should be provided with the most appropriate prosthetic device for their needs to be able to reach their full potential.  Under this proposal, there’s significant concern that the changes in the functional status definitions would limit that goal.  It’s disappointing to see that the proposal would not consider a patient’s future potential when determining their functional ability and would force patients into basic functional level classifications if they use an assistive device – like a cane for instance.  The Amputee Coalition believes that considering the patient’s potential abilities in assigning a functional level is important, and we stress that the use of assistive devices should not be used to limit an amputee’s functional status. If an amputee can walk at a K-3 or K-4 level while using a cane, why force that same amputee to be classified at a lower level? Because that is what these rules would require.
SECONDLY, the Amputee Coalition believes that the definitions and requirements for a preparatory prosthesis and a definitive prosthesis must be amended to better reflect current accepted practice in amputee care and rehabilitation.
Under this proposal, new amputees would be required to complete rehab on a preparatory prosthesis (a training leg if you will) with very basic components. The definitive prosthesis – that is the leg that the amputee will use for the rest of his or her life – would be completely different from the preparatory leg that the amputee had trained with. Those basic components of the preparatory leg are most likely not going to be part of a definitive prosthesis and shouldn’t be the type of components a new amputee should rehab on. Current practice is to provide a definitive device earlier in the rehabilitation process – so that the amputee can train with it - and although the socket may need to change as the residual limb matures, the overall device rarely changes.  With this in mind, the definitions and requirements for rehab completion under the proposal must be changed to allow amputees to rehab on the most appropriate device.
There is also significant concern that consolidating foot and ankle codes and limiting K2 level patients to fixed ankle feet would greatly impact patient care.  Every amputee is unique and so are their needs.  By consolidating feet and ankles into a single code, this proposal would likely result in amputees receiving a foot and ankle based on lower cost and not based on the most appropriate device for their needs.  The added stability and function that an appropriate foot and ankle can provide can’t be understated, and the determination of the most appropriate foot and ankle for each patient should continue to be made between the patient and their medical team.  Consolidating often leads to reduced options for patients, and this could significantly impact individual’s mobility and stability if they aren’t able to receive the appropriate foot and ankle.
Finally, the Amputee Coalition is concerned about the proposed changes to sockets and liners.  The socket is arguably the most important component of any prosthetic device.  In order for a prosthetic device to be effective for a patient, it must first and foremost fit properly and provide adequate comfort to be worn all day long.  With this in mind, it’s important to allow the patient’s medical team to determine the most appropriate socket and liner for their needs.  Suction suspension systems should continue to be available for all levels of patients and elevated vacuum systems should continue to be made available to patients if their medical team determines they are the most appropriate systems to meet their needs.  Additionally, it must be made clear that if a patient’s medical team determines a roll on custom fabricated liner or cushioned liner is best for the patient, they continue to be provided.
In conclusion, the Amputee Coalition recommends rescinding and making significant changes to the proposal to address these and other concerns outlined in our formal comments.  Again while I’ve been fortunate to receive the outstanding prosthetic care I have as a wounded warrior and veteran, I fully recognize that this proposal has the potential to impact many more lives than my own and I believe it’s important that these concerns be addressed appropriately so Americans living with limb loss are able to receive appropriate care.  Thank you.











Sunday, August 23, 2015

Medicare Updates

On Wednesday, August 19 the Amputee Coalition hosted a webinar focusing on the recent Medicare proposals. Dan Ignaszewski, our Director of Government Relations, presented the most up-to-date information concerning the proposal to over 200 registered attendees. The dynamic question and answer session was especially beneficial to clarify the information presented. 

If you missed the webinar, or would like to review the information presented, an archived copy can be found on our website through this link.  We are constantly updating our website with the most relevant information concerning not only this Medicare proposal but also anything pertaining to limb loss.  If answers to questions cannot be found on our website, we invite you to reach out to one of our Information Specialists at our Resource Center

In addition to raising grassroots awareness through our Facebook and Twitter #NotALuxury campaigns, the Amputee Coalition has been working closely with other organizations and groups to make sure that the needs of the community are fully represented.  Although the minimum 100,000 signatures have been secured on the We the People petition to rescind the Medicare proposal, we are encouraging everybody who has not yet signed to do so. Having a large representation will help the lobbying effort. 

We are the community to send a letter to CMS as well as their elected officials, voicing opposition to these proposals.  A convenient form is available on our website. Taking a few minutes to submit these letters is is another simple yet powerful way to help enable the amputee community.

This Wednesday CMS is hosting a public hearing concerning these proposals. Rest assured the Amputee Coalition will be in attendance and will be presenting the concerns of the community. Please continue to check our website, follow us on Facebook and Twitter, to stay abreast of the situation. 

Sunday, August 16, 2015

Keeping You Up to Date



The Amputee Coalition has been working furiously in our lobbying efforts concerning the recent Medicare proposals. We are constantly updating our website, and we encourage everybody to check back often to read the most up to date information.  We have recently added some letters in a convenient format to our website and are encouraging everybody to utilize these letters to contact CMS and your elected officials. Presenting a unified voice is imperative in this advocacy effort. 

Last week we hosted a vibrant Facebook chat with our Director of Government Relations who answered questions about the recent proposals. The chat is archived and can be assessed here.  It is important to note that the Amputee Coalition responded to as many questions as time provided, and those responses can be found in the comments under each question.

In addition to constantly updating our website with the latest information available and hosting a Facebook chat, the Amputee Coalition is hosting a Webinar on Wednesday, August 19 from 1:00-2:00 PM EST.  Register now for this opportunity here. The Webinar will be recorded and posted on our website at the conclusion, so everybody can benefit from the information provided. 

The Amputee Coalition has been leading the charge in rallying momentum and support for the online petition. Utilizing the hashtag #NotALuxury, amputees from around the world have been posting photos displaying their prosthetic use with a plea to sign the petition. The outpouring of grassroots support has been empowering, and we encourage you and everyone you know to visit our social media pages and participate in what has become the #NotALuxury movement.

The Amputee Coalition is also encouraging individuals to tweet their #NotALuxury photos and videos to @CMSGov, so get involved today!

There are a lot of rumors concerning the ramifications of the Medicare proposals. The Amputee Coalition remains dedicated to providing the most up to date and accurate information on our website. Visit often to stay informed. We are encouraging everybody to sign the petition, send your letters, and share your #NotALuxury videos and photos. 

Friday, August 7, 2015

Medicare Alert!


The Amputee Coalition has been working furiously since the detrimental Medicare Proposals were released on July 16th.  Please frequent our website to stay apprised with the most up-to-date information and ways to become involved.  We need the entire community to rally behind this effort.


We are imploring everybody to become involved and sign the petition!


Angry about the Medicare Proposals? PLEASE HELP US WITH THIS PROJECT.

It’s pretty simple: record a 10-15 second video of yourself doing an everyday activity; attach that video to a tweet.

Pick a basic activity that you do every day (e.g., carrying your child, walking your dog, buying groceries, etc.).

End the clip by saying, “[insert activity] is not a luxury.” So, for example, if you shot video of you walking the dog, you’d walk towards the camera with your faithful hound and then stop and say, “Walking my dog is not a luxury.”

Start the tweet with “@CMSGov”. That’s the Twitter handle for Medicare. We want Medicare to see each and every amputee’s video.  (Feel free to tag us (@AmputeeUSA) so that we can retweet your message!)

After that, type “[insert activity] is ‪#‎NotALuxury‬.” So again, using the previous example, the tweet would read, “Walking my dog is #NotALuxury.”

Finish by linking to the petition asking Medicare to rescind this proposed policy: http://wh.gov/iIIoi
By putting the face of people with limb loss on this movement, we can greatly increase the public’s awareness of the issue and help us get to the 100,000 signature mark by August 30.

We need every amputee to help us get there! Please take a few minutes out of your day and put YOUR face on this important
initiative.

Monday, July 13, 2015

Congratulations Scholarship Recipients


The Amputee Coalition is honored to be the steward for the Scott Decker, M.D. Memorial Scholarship which was established by his friends and colleagues after his passing in 1989.  After a thorough vetting process, four applicants have been chosen to receive the $1,000 scholarship to further their education.  “The Amputee Coalition is very pleased to have so many qualified applicants for the Scott Decker, MD, Scholarship that we were able to award four different individuals. Each of these young people has learned to live successfully with limb loss and each has clear goals for their future,” said Susan Stout, president & CEO of the Amputee Coalition. “Once again, we sincerely thank Dr. Decker’s family for the opportunities this scholarship will present to the recipients.”





Austin Brown will attend Washington State University and will study engineering. He’s an accomplished golfer who started playing the game at age four.“Dr. Decker did a lot of good for people during his life and his family continues to do so,” said Austin. “I hope that I can have a similar positive impact on others. I extend a sincere thanks to the Amputee Coalition and Dr. Decker’s family and friends for their generosity. I am truly honored to be recognized by the selection committee. I am sure that there were many deserving applicants, so it feels really good to have them believe in me and appreciate the hard work I have put in, academically and otherwise.”



Tyson Higel currently attends Northwest Missouri State University and is studying Therapeutic Recreation. Having just completed his freshman year with an impressive 4.0 GPA, he also boasts being a member of the  USA Volleyball’s A2 Sitting Volleyball team. Aptly balancing academics and sports, he aspires to play in the 2020 Paralympics. “I am honored that I have been selected as a recipient of the 2015 Scott Decker, M.D., Memorial Scholarship,” said Tyson. “This helps with the financial stress not only of having to pay for my undergraduate studies, but also for my future graduate studies. This scholarship allows me to continue my education path to becoming a certified orthotist/prosthetist, and for that I am grateful. I will continue to strive for excellence to make amputees, the Amputee Coalition and anyone who has a dream proud. Thank you. “



Brickelle Bro is heading to Stanford University this fall to study psychology and the mental impact of limb loss. She is also a member of the US Paralympic swim team who is also dreaming of Paralympic gold.  “I have always felt it was my responsibility as an amputee to speak with groups about limb loss and physical differences,” said Bro. “As I leave home for Stanford, I greatly appreciate this scholarship. The support of organizations like the Amputee Coalition will help me to attend college, but more importantly, show that talking about limb loss, supporting those who experience it, and working to prevent it are worthy activities. Limb loss is not a reason to settle for less from life. With the support of the Amputee Coalition, every person affected by limb loss can work hard to reach their full potential.”



Amy Frank, who lost her leg last year, is attending Texas A&M to pursue a degree in geophysics. Still adjusting to life as an amputee, she is determined to live life to the fullest and refuses to give up.  “This past year has been a great struggle but I am ready to move on and start my college life with the support of the Amputee Coalition. I would like to take this opportunity to thank the Coalition for their generosity. I feel very fortunate to have been chosen as a recipient of this award. This scholarship has been a wonderful blessing! I could not be more excited to now officially be a Fighting Texas Aggie! Gig ‘Em!”



The Amputee Coalition is proud of the 2015-2016 recipients of the Scott Decker, M.D. Memorial Scholarship.  Each recipient was chosen because they demonstrate the academic standards, drive, and determination that were the hallmarks through Dr. Decker's illustrious career.  We look forward to watching each continue to grow and strive to reach their goals.