American Academy of Orthotists & Prosthetists

March 2009 • Vol. 5, No. 2

Advancing Orthotic and Prosthetic
Care Through Knowledge

Historic Agreement Reached on Education Requirements

This has been an exciting eight months for me. We have moved the American Academy of Orthotists and Prosthetists (the Academy) forward in many ways. In October, we embarked on the fifth year of our U.S. Department of Education grant. We closed out the Academy's fiscal year at the end of November 2008 in the black again and were able to make strides in building our reserve fund. We helped to raise funds for the new Orthotic and Prosthetic Education and Research Foundation (OPERF) and made a direct donation of $18,000 from the Academy to OPERF.

These are all important contributions, but by far the greatest pleasure I had and the work that I think will have a lasting impact for our profession was participating as a member of the O&P Alliance committee, negotiating alongside representatives from the American Board for Certification in Orthotics, Prosthetics & Pedorthics (ABC) and the National Association for the Advancement of Orthotics and Prosthetics (NAAOP), to reach agreement with the Board for Certification/Accreditation, International (BOC) on the minimum education required for treating Medicare beneficiaries who require the services of O&P professionals.

On Friday, December 16, 2008, I was pleased to report to the Academy membership that we had reached agreement with the BOC to raise the basic minimum education requirements to sit for the BOC exam to be equivalent to the current requirement for sitting for the ABC exam. The catalyst for this effort was the belief that it is crucial to speak to CMS with one voice as CMS develops the regulatory framework for the Benefits Improvement and Protection Act (BIPA), Section 427. Our historic joint agreement, printed below, was signed by the presidents of the Academy, AOPA, NAAOP, ABC, and BOC, who jointly recommend to CMS that there be specific minimum education and training requirements for those who serve Medicare beneficiaries and bill for the provision of custom orthotic and prosthetic care.

I believe that this historic agreement is in the best interests of all O&P patients and our profession. The Academy has long taken the position that to provide high-level O&P care, practitioners must have appropriate education and training.

Joint Statement of Agreement between BOC and the O&P Alliance Organizations

For the purposes of clarity and to ensure that all parties involved in these discussions (The National Association for the Advancement of Orthotics and Prosthetics-"NAAOP"; The American Board for Certification in Orthotics, Prosthetics and Pedorthics-'ABC"; The Board for Certification/Accreditation, Int'l -"BOC"; The American Academy of Orthotists and Prosthetists-'AAOP" and The American Orthotic and

Prosthetic Association-"AOPA") are in complete and total agreement that the absolute minimum education standard for acceptance to sit for the ABC and/or BOC certification exams is one of the following:

1. A bachelor's degree in orthotics and/or prosthetics as offered by current educational institutions accredited by CAAHEP; or

2. a bachelor's degree plus a certificate in orthotics and/or prosthetics as offered by current educational institutions accredited by CAAHEP; or

3. a foreign degree equivalent to a bachelor's degree in orthotics or prosthetics determined to be equivalent by the World Educational Service (WES); or, a foreign degree equivalent to a bachelor's degree determined to be equivalent by the World Education Service (WES), plus a certificate in orthotics and/or prosthetics as offered by educational institutions accredited by CAAHEP.

In addition, it is further agreed that the training requirement for acceptance to sit for the ABC certification exam is an NCOPE-accredited residency, and the training requirement for acceptance to sit for the BOC certification exams is, at minimum, twelve months of structured clinical affiliation (residency) under the direct supervision of a duly certified individual of the same discipline (orthotics or prosthetics).

It is further agreed that the parties to this Agreement will present the Centers for Medicare and Medicaid Services (CMS) with a joint written confirmation of this Agreement and encourage them to adopt such minimum education and training requirements into their regulatory framework for Section 427 of the Benefits Improvement and Protection Act (BIPA). Regardless of CMS's response, whether informally or in the form of a proposed or final rule of BIPA Section 427, the parties agree to work together for the purposes of achieving implementation of this Agreement as the long-term standard to be adopted by all public programs and private payers of orthotic and prosthetic care.

With respect to grandfathering, any individual seeking BOC Certification under the requirements existing as of December 31,2008, would have four years, until January 1,2013, to complete the requirements and apply for the BOC orthotist and/or prosthetist certification exam(s).

The parties to this Agreement also agree that each will make a good-faith effort to work together in the future to have states adopt O&P licensure laws that are consistent with the letter and spirit of this Agreement.