New Upper Limb Prosthetic Resource for OTs

The fifth edition of  Introduction to Orthotics, by Brenda Coppard, PhD, and Helene Lohman, MA, OTD, OTR/L has just been published by Elsevier. Chapter 20 (co-authored by me; thank you to Shawn Swanson Johnson for recommending me to this project) features upper limb prosthetic technology with resources relevant to training, controls, and functional application.

Different by Design

Check out the Different by Design article in the inaugural edition of WNE! 

https://magazine.wne.edu/2018-winter/05-deb-latour.cfm

If you know me, I have nicknames for my different prostheses. For example, my body-powered prosthesis is "Wonder Woman"! Check out my prototype prosthesis... I covered the forearm and hand with ROCKTAPE. This covering is soft and gives a half-sleeve look.... hence the nickname "Tatoo".

TRS Topic- Debi Latour

TRS - Cutaneous Anchor with Debbie Latour

Is there equal reimbursement of prosthetic technology for individuals with congenital UL deficiency/difference vs. individuals with acquired loss?

And are all cases being treated equitably whether they are 'high-profile' and reported by the media vs the 'average' human being who lives life under the radar?

Well, these are loaded questions. -And deserve 'weigh-in' from my peers in the prosthetic industry as well as my clinical peers and my peers who are fellow consumers.

For starters, let's consider some factors that might heat up the discussion:

1. average life expectancy;

2. benefit of prosthesis use;

3. impact of overuse to the [alleged] intact upper limb;

4. benefit of the provision and use of diverse prosthetic technologies;

5. life span of these diverse prosthetic technologies;

6. cost of insurance (aren't we consumers of this as well?);

7. cost of advocacy;

8. should we even ponder the savings (profit?) accrued by the insurance 'providers'?;

9. are insurance companies truly 'providers' if they withhold reimbursement (how many prosthetic and rehabilitation companies have accounts receivable in excess of 120 days on previously approved devices and/or services? -or have gone out of business because of this?)?

10. are insurance companies truly 'providers' if they are not providing access to such technology?

Let's get this discussion going! I would love to receive your thoughts and will share my own as well.... Stay tuned!!!!

                                     (credit: Rhymes with Orange)

The fight continues: Amputee Coalition update!

The Amputee Coalition is happy to report that the public meeting last week about the recent Medicare proposal on lower limb prosthetics was a great success!
We are thankful to all of the individuals who spoke out against the recent proposal. Those in attendance and on the phone communicated effective, passionate, personal stories and experiences to express their opposition to the draft proposal and without the support of the many amputees and professionals who participated, we wouldn’t have had the impact that we did to show Medicare the depth and breadth of the opposition to their proposal.
After the Medicare Contractors (DME MACs) were forced to expand the meeting space to accommodate the huge number of people that registered, amputees and their families filled the meeting room. In addition, prosthetists, physicians, physical and occupational therapists, and others provided vital comments in opposition to the proposal to ensure their patients are able to receive access to appropriate prosthetic care.
Dan Berschinski, chairman of the board for the Amputee Coalition, presented our serious concerns with the proposal and encouraged the DME MACs to rescind the proposal and make significant changes in accordance with our formal comments.
It was inspiring to see so many members of the limb loss community come together to share their concerns and make sure amputees’ voices were heard. The comments made by the speakers at the hearing overwhelmingly centered on the issues that were identified by the Amputee Coalition shortly after the draft proposal was published:

• Proposed changes to patient functional levels:
  • Concern about eliminating potential in determining an amputee’s functional level
  • Concern that assistive devices like crutches, canes and wheelchairs would automatically limit an amputee’s functional status
  • Concern that amputees would be required to attain a “natural gait” in order to get a prosthetic device
• Proposed changes to the rehab process for new amputees:
  • Concern that the proposal would make new amputees rehab on out-of-date technology before being able to receive an appropriate prosthetic device
• Proposed changes that would limit foot and ankle options for patients
• Proposed changes that would eliminate elevated vacuum socket systems for all amputees
• Proposed changes that could make it more difficult to receive a custom fabricated liner

With more than 400 attendees on the teleconference, and a packed room, this was one of the largest attended public comment meetings in recent memory.  This is a testament to how seriously the limb loss community takes this issue and how powerful we are as a community.  We made the point that prosthetic devices are not a luxury and amputees must be able to receive the most appropriate device at the most appropriate time.
After the conclusion of the public hearing, a special meeting was organized by Sharon Lewis, senior disability policy advisor to the secretary of Health and Human Services (HHS) and Administration for Community Living (ACL). Susan Stout (president & CEO), and Jack Richmond (board chair-elect) represented the Amputee Coalition at the meeting. In addition, representatives from AOPA, the Academy, and the O&P Alliance attended to express concerns about the proposal with those at the meeting. From the government, those in attendance included Acting CMS (Centers for Medicare/Medicaid Services) Administrator Andy Slavitt, CMS Deputy Administrator Patrick Conway and Senior HHS Counselor Kevin Thurm. Acting Administrator Slavitt acknowledged that the concerns of the group had been heard loud and clear, and that our views would most assuredly be taken into consideration by CMS. He invited representatives of the groups in attendance to submit further comments about the proposal and provided a mechanism to deliver them directly to the medical director of CMS.
Even with the success of the meeting, it is still vital that everyone submits formal comments to the DME MACs about the concerns you have with this issue by the August 31 deadline. Use the Amputee Coalition’s prepared letter, or create your own and send it to: DAMC_Draft_LCD_Comments@anthem.com.