Amputee Coalition Guest Blog: The 2018 AOPA Policy Forum in Review

Written by Guest Blogger, Dan Ignaszewski – Director of Government Relations & Marketing, Amputee Coalition

PF2018-Button-300x300On March 78th 2018, AOPA held their annual Policy Forum in Washington, D.C. to educate legislators about issues affecting O&P professionals, businesses, and patients.  The Amputee Coalition has been a long time supporter of the AOPA Policy Forum, recognizing the importance of sharing the O&P industry story and improving patient’s access to care.

Earlier this year the ACA, AOPA, and the O&P Alliance were able to celebrate the passage of the provision of the Medicare O&P Improvement Act. With this provision, O&P clinician’s notes will now be recognized as part of the patient’s medical records in CMS determinations. This is a tremendous success for the profession and for patients, but much more still needs to be accomplished.

Key Legislative Issues Highlighted at the Forum

  • Ensuring Veterans maintain the ability to receive care from their chosen provider
  • Ensuring O&P care remains an Essential Health Benefit
  • Preventing the expansion of off-the-shelf orthoses and competitive bidding
  • Advancing regulations that underscore and identify qualified providers for O&P care (BIPA 427)
  • Raising awareness and concerns with the 2015 Draft LCD on lower limb prosthetics
  • Supporting a consistent fee structure for custom fabricated, direct milled inserts (K0903/A5513)

Day One Overview

On the first day of the Policy Forum, speakers helped prepare attendees for legislative visits.  Speakers walked attendees through what to expect in the meetings, how to plan their visits, the various talking points, and the importance of remaining involved in state and federal advocacy priorities.

It was emphasized during this session that these meetings were meant to facilitate larger conversations and that as professionals, YOU are the expert in the room.  Attendees were encouraged to share their stories and illustrate the impact O&P has on the continuum of care for the patient, helping them remain independent, mobile, and the able to integrate back into their communities.

Attendees also had the opportunity to support AOPA’s O&P Political Action Committee (PAC).  The O&P PAC allows the profession to support candidates that advocate and understand issues that impact O&P clinicians and the patients they serve.  This year, the ACA attended the PAC Luncheon and supported Representative Mike Bishop (R – Michigan). Representative Bishop is a key leader in Congress who ensured the language that recognized O&P clinician’s notes as medical records were included in legislation and passed into law.  Representative Bishop also attended the Policy Forum and spoke to attendees about the importance of participation, advocating for the profession, and educating legislators about issues that are important.  Following his presentation, he took questions from the audience and then concluded with a private reception for those who contributed to the O&P PAC.

Day Two Overview

On the second day, meetings with legislators and their staff went resoundingly well.  From those meetings, there were a lot of follow-up opportunities for AOPA and the Amputee Coalition, including getting patients to attend the Amputee Coalition’s Hill Day on April 16th and 17th.  The Amputee Coalition’s Hill Day, which follows the Policy Forum, provides an opportunity to reinstate the same message and issues impacting the patient community through meetings with the legislators.

Coming Full Circle

Over the years, significant wins for the O&P industry have developed with the support of these two important events.  This year, following AOPA’s Policy Forum, Medicare has already released a ruling in favor of supporting a consistent fee schedule for the custom fabricated, direct milled diabetic foot inserts.  These events raise awareness and provide an opportunity to advance these issues to the level where actions can be taken to address them.

Moving forward, AOPA and the Amputee Coalition are encouraging practitioners and patients to get involved in advocacy efforts.  The ACA is encouraging providers and paitents to attend the upcoming 2018 Amputee Coalition Hill Day and the 2019 AOPA Policy Forum.

There is still a lot to pursue, including enacting provisions of the Medicare O&P Improvements Act, finalizing the BIPA 427 regulation, and protecting access to O&P care through Essential Health Benefits and the Insurance Fairness for Amputees Act.  The ACA will fight to create more transparency and accountability within the LCD process and work to ensure ill informed LCD’s do not negatively impact patient care and healthcare access.

What Can You Do?

It’s important to stay involved with your state associations, AOPA, and the Amputee Coalition and stay engaged in legislative and regulatory issues.  Organization’s can’t do it alone and we need your help and support to continue to impact public policy on the local and national levels.

blog-author_10401456_ac407286a8437a2b8406dfefe6b02bf17405997eAbout the Author: Dan Ignaszewski is responsible for developing the positions of the Amputee Coalition on public policy issues; focusing on integrating public policy development with grassroots organizations. Dan works on federal and state issues, including the Amputee Coalition’s primary legislation, the “Insurance Fairness for Amputees Act,” funding for limb loss initiatives, research, veterans’ issues, and other issues affecting the limb loss community. Additionally, Dan works with the National Sponsor Program and the Amputee Coalition National Conference. He also markets memberships and publications for professionals. Dan has been with the Coalition since 2008.


FusiformCAST: Simplifying Orders for Custom Devices


FusiformCAST is a custom order portal where customers can maintain HIPAA compliant patient records, order custom devices through a supplier or distributor, and monitor the progress of a custom device from initial order to delivery.  Utilizing one portal for all custom devices reduces errors, improves turnaround time, and increases efficiency.

Fusiform provides visibility into custom orders processed through Cascade; finally allowing the customer to have direct communication with the fabricator on one easy-to-use portal.


Top 10 Reasons Why a Customer Would Use FusiformCAST

  1. Free portal for custom device management
  2. One-stop, HIPAA compliant portal for patient records
  3. 24/7 user-friendly access
  4. An Administrator account can be created to control who accesses the data with the use of security controls/permissions – perfect for centralized purchasing
    • One account can host multiple users with unique logins
  5. Fusiform Dashboard provides a snapshot of all patients/orders
    • Search functionality makes it easy to search for a patient record/order
  6. The order form cannot be submitted without completion of each section; making it error proof
    • All information is auto saved in portal
  7. Portal accepts all file types, no size restrictions
    • 3D annotations can be made on 3D scans
  8. Status markers indicate device progress
    • Real-time progress updates/notifications are sent to customer when devices incur status change
    • Instant messaging available for customer to communicate with Cascade/supplier directly without picking up the phone
  9. The Fusiform iPad App can be used without a wireless connection and will upload information once connected to internet
  10. It’s just another great way to consolidate all of your purchases through Cascade


High Level Overview of Order Process  Fusiform High Level Order Process - Page 1Where Can I Access the FusiformCAST Portal?

FusiformCAST can be accessed through either the online desktop portal or the IOS iPad Application.

What Devices are Currently Available through FusiformCAST?

Currently, you are able to process Cascade orders for the following custom items:

  • WillowWood® Alpha DESIGN® Liners
  • APEX® Custom Diabetic Inserts (CDI)

How Do I Learn More?

Trial the system on the Cascade-Fusiform Demo Account.  See below for details:

Fusiform Demo URL:

To learn more about the Cascade and Fusiform partnership, contact your Cascade Sales Territory Account Manager today!


2018 Medicare and Insurance Changes

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2018 marks a year of change as Medicare and private insurance companies implement new programs and coding updates.  This will impact the orthotic and prosthetic industry in several different ways.  Specifically, changes to Medicare codes will affect current billing practices and the practice’s bottom line, while notices of change posted from private insurers will affect patient’s coverage for orthotic and prosthetic services and devices.  It is important to understand these changes so adjustments can be made to internal processes, finances, and most importantly, the patient experience.

New Medicare Cards and Numbers

The Center for Medicare & Medicaid Services (CMS) has announced that 2018 will be anew card transitional year for its numbering and carding system. The new system will remove patient’s Social Security Numbers from their Medicare ID and patients will be assigned a new Medicare Beneficiary Identifier (MBI).  CMS will begin replacing patient’s cards in April 2018, with hopes the transition will be complete by April 2019. All current patient numbers (or HICNs), will be completely phased out by January 1, 2020.

Transitioning to Medicare’s new MBIs will be manageable if staff members and patients are educated and internal systems are adapted.  This new system does require practices to work with billing, clearinghouses, and any other integrated vendor systems to ensure their systems can handle both HICNs and MBIs during the transition.  CMS has a lot of useful information regarding the transition on their website, which can be accessed at

New Medicare Physician Fee Schedule

CMS has released the 2018 Medicare Physician Fee Schedule which includes updated payment levels for specific codes and changes to existing codes.  Additionally, some Orthotic and Prosthetic Management and Training codes have also been effected.  The Final Rule was published after public comment on November 15th, 2017 and additional information can be accessed by clicking here.  Be sure to be on the lookout for industry-specific summaries on how these changes will directly impact O&P practices.

Medicare Billing Code Changes

The 2018 HCPCS Codes were recently released by CMS and will have minimal impact on the O&P industry.  However, there were new codes issued, like L3761 for elbow orthoses and L7700 for a gasket or seal for use with a prosthetic socket insert.  These codes are applicable for all services provided after January 1, 2018.

Medicare’s Targeted Prove and Educate (TPE)

To cut down on improper claims, CMS utilizes Medicare Administrative Contractors (MACs), to review clinical documentation.  Through Targeted Prove and Educate (TPE), MACs focus on specific providers/suppliers and review 20-40 claims per provider, per item or service, per round, for up to three rounds of review.  After each round, providers are offered education based on the results of their reviews.  The more errors in the claim, the more rounds of review a claim is subject to.  Those who continue to have high error rates after three rounds may be referred to CMS for additional action.  Practices can counter this potential threat by being prepared, cleaning up claims processes. and conducting an internal audit with an industry advisor.  This effort will help identify ongoing issues so they can be resolved prior to an audit.

Private Insurer Notice of Change

As private insurers post their annual notice of changes in coverage, patients are seeing reduced or altered coverage.  It is critical that Practitioners advise patients (especially as they are selecting new coverage), to select a policy that includes them as a contracted provider.  Patients should also check benefit and coverage policies to make sure a particular device or their current devices are still covered.

What Should You Do

Unequivocally, the 2018 Medicare changes will impact clinics, staff, and patients.  The key to managing these changes is frequent communication. Verifying patient contact and insurance information regularly will help ensure that patients are aware of policy changes.  Kickstart the New Year by checking each patient’s information on file when they come in for an appointment.   Have them verify their address, get a copy of their insurance card, and advise them to check their Medicare address on file.  Refer to the CMS website often and subscribe to email updates.  Also, feel free to reach out to industry associations and advisors, such as Cascade and O&P Insight, to help guide you through a successful transition.

Together, we can build a better practice.

LesAbout the Author: Lesleigh Sisson, CFom, has been committed to serving the O&P community since 1992. Prior to starting O&P Insight, she served as the Director of Administration for a multi-practice company. During her experiences in administrative and clinical support roles, she recognized the need to assist dedicated professionals who want to provide excellent patient-centered care while achieving successful reimbursement. Lesleigh helps independent O&P practices to not only survive, but also thrive in today’s challenging and ever-changing healthcare environment.

Distribution Reimagined.


Happy Holidays!

2017 Holiday Banner Hours December 

Happy Holidays to you and yours from the Cascade Family!

This year, across the United States, many of our customers and community were affected by natural disasters.  As a company, we felt it was important to help restore and rebuild our industry.  On behalf of our valued customers, Cascade donated to the American Red Cross Disaster Relief Services.  The Red Cross Disaster Relief covers services for Hurricanes, Earthquakes, Tornados, Wildfires, and Superstorms.  Each disaster relief mission is different, but various resources are adapted the fit the needs which include (but aren’t limited to): Emergency Shelters, Emergency Supplies, Health/mental Health Contacts, Meals, Volunteer Workers, Emergency Response Vehicles.

This donation will help fund humanitarian programs across the nation and also support Cascade’s mission to improve the quality of life.  During this holiday season, we are grateful for your continued support and excited to see what’s in store for 2018.  Cheers to the New Year!

Cascade_RedCross-102Pictured: Cascade Director Team, Jeff Collins – President, and Kory Ley – American Red Cross Mission Partnerships Officer

Cascade Holiday Photo Dump

Christmas Pics.PNGCascade’s Annual Gift Exchange and Ugly Sweater Party
DSC01121.JPGCascade President, Jeff Collins, recognized at the Annual Holiday Party for his 15 years with Cascade

Stay Connected

Wishing everyone a safe and happy holiday! See you in 2018!




Cascade Welcomes Jayme Brendle and Russell Cannon to Sales Dream Team


In an effort to deliver more value, service, and support, Cascade is excited to announce the addition of Jayme Brendle and Russell Cannon to our National Sales Team.

Jayme Brendle – Mid-Atlantic Account Manager

Jayme Brendle will be managing accounts within the territory boundaries of Virginia, West Virginia, North Carolina, South Carolina, and Tennessee.  Jayme comes to Cascade with 10 years of experience in the O&P industry.  Jayme has a passion for helping people with mobility issues and is a Certified Orthotic Fitter and Athletic Trainer.

Fun Facts About Jayme

  • Graduated from Ohio Northern University
  • Owns a dog named Titus
  • Enjoys outdoor activities such as kayaking, basketball, and 5k marathons
  • Loves spending time with her family
  • Likes to travel to new places, some of her favorites are the Caribbean Islands, Europe, Alaska, and Hawaii

What is Jayme Looking Forward To

As part of the Cascade team, Jayme is looking forward to providing the O&P industry with expanded product offerings and business solutions through the distribution business model.

Russell Cannon – Northeast Account Manager

Russell Cannon will be managing accounts throughout  Maine, Vermont, New Hampshire, Massachusetts, Rhode Island, Connecticut, and New York.  Russell has over 25 years of experience in the O&P industry, starting his career as a Technician and eventually transitioning into Sales.

*Please note: Debbie Hatch will remain an active member of the Sales Team in the North Atlantic Territory which includes: Pennsylvania, New Jersey, Washington D.C., Maryland, and Delaware.

 Fun Facts About Russell

  • Graduated from the University of New Hampshire
  • Married with two kids (14-year-old son and a 30-year-old daughter) and a proud grandfather of two!
  • Owns two cats – Sully and Luna
  • Enjoys hiking with his family
  • Loves to travel and is focusing on touring European countries

What Brings Russell to Cascade

Over the course of his career in the industry, Russell collaboratively partnered with Cascade and discovered his goals aligned perfectly with the mission and vision at Cascade.  Now that Russell is part of the team, he can’t wait to visit accounts and help them become more efficient, profitable, and successful.

Cascade is very excited to welcome Jayme and Russell to our expanding Sales Team. We look forward to the addition of these team members to the Cascade Family and hope they can become part of your too!  To check out the rest of the Cascade Sales Team and the respective territories, please click here.

Breast Cancer Awareness Month

2017 Breast Cancer Awareness_October

In honor of Breast Cancer Awareness Month, we sat down with James Toland, Senior Research and Development Engineer at Trulife, to find out a little more about the breast care industry and the new mastectomy product line from Trulife; ReCover. 

Breast Cancer Stats

Did you know that one in eight women in the United States will be diagnosed with breast cancer in her lifetime?  While progress has been made in the treatment of breast cancer, it still remains the most common cancer among women and claims thousands of lives each year in the United States.  Each year it is estimated that over 252,710 women in the United States will be diagnosed with breast cancer and more than 40,500 will die.

Conversely, death rates from breast cancer have been declining since the early 1990’s, due to better screening and early detection, increased awareness, and continually improving treatment options.  Currently, there are over 3.3 million breast cancer survivors alive in the United States.

Information on Breast Care Awareness Month

October is recognized throughout the world as Breast Cancer Awareness Month.  Charities globally aim to increase awareness and funding for cancer research through various activities, programs, and group events like sponsored runs.

Trulife sponsors competitions and promotional giveaways for customers throughout the month of October to help raise awareness.  Literature, graphics, and social networks are key networking channels used in the recognition of breast cancer awareness month.  Be sure to follow @trulifebreastcare1 for the latest updates on product, programs, and promotions!

Advancements in Breast Surgery and Product Design

Since Trulife developed the world’s first breast prosthesis in 1958, they have been dedicated to ongoing research on new materials, manufacturing techniques, and innovative product design.

Alongside this, continual advancements in breast surgery has allowed Trulife to develop products specifically for post surgical application, various stages of healing, and everyday wear.  Trulife utilizes medical journals, articles, and direct relationships with breast surgeons to stay current with the latest surgical techniques and market needs.

The ReCover Line

Discover ReCover! The ReCover collection was designed specifically for post reconstructive surgery care, offering the user options during the various stages of reconstructive surgery.  Following a surgery, there may be a recovery waiting period ranging from three months to a year, depending on the patient.  The ReCover collection is available as an enhancer, overlay, or shell and completely customizable based on the patient’s need.

The ReCover line is produced with medical grade soft silicone to provide adjustable fullness and projection.  Each option provides a gentle and comfortable fit, helping the patient feel more natural and complete during the multiple stages of reconstruction.

For more information on the complete Trulife Breast Care Product Line, please click here or ask your account manager today!

Stay tuned this month as Trulife and Cascade recognize and support Breast Cancer Awareness.  Together, we hope to deliver a wide range of solutions to fit the varied needs of breast care patients.


 James Toland, Senior R&D Engineer at Trulife

2017 AOPA World Congress Snap Shot


The 2017 AOPA World Congress was a whirlwind of excitement, generating a contagious buzz throughout the educational sessions and exhibit hall.  With over 2,500 people registered (from 41 different countries), the show hit record attendance.

Hosted in Las Vegas, Nevada, the show offered a broad range of product showcases, extraordinary special events, presentations on innovative technology, and an abundance of continued education courses covering topics like Osseointegration, Exoskeletons, Gait Salvage, and the latest in clinical research.

Unique to the show was AOPA’s 100 Year Anniversary, tagged by the team as a celebration of a century envisioning the next. Attendees had the opportunity to Walk-through Time  with AOPA in a special showcase located in the Exhibit Hall.  Historical perspectives, artifacts, and photos were on display, inviting attendees to learn about the origin and growth of the O&P Industry.

– See below for a Cascade Recap of the 2017 AOPA World Congress Highlights –

Vegas Spirit Contest


The Welcome Reception kicked off in true Vegas style, with a performance by the Las Vegas production of La Reva – the Dream. The “Cascade Pack” was a sight to be seen in 1920’s flapper dresses and traditional paper boy drabs. Along with full costumes, a lot of time and effort was put into perfecting a 1920’s Vegas booth design and decor. The biggest complement to the effort was the 1st Place Vegas Spirit Award in the Medium Size Booth category.  Thank you to all those that voted for the Cascade booth.  Congrats to those who received awards in additional categories.

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Spirit Awards

Large Size Booth: College Park Industries                                                                       Medium Size Booth: Cascade Orthopedic Supply, Inc.                                                          Small Size Booth: LimbTex Ltd.

Win with Cascade Contest                                           Scratcher

Attendees had the chance to stop by the Cascade booth and pick up a “Win with Cascade” scratcher! Along with a fun assortment of prizes, customers had the opportunity to win a Grand Prize Trip to Cascade and a tour of the local Chico area!   The lucky Grand Prize Winner was Bio Tech Limb and Brace of Birmingham, Alabama.  Cascade is excited to host Bio Tech in lovely Chico, California.  Thank you to everyone who participated…it goes to show that everyone is a winner with Cascade!dsij

Award Winning AOPA Members

Ralph R. “Ronney” Snell Legislative Advocacy Award Recipients

The Ralph R. “Ronney” Snell, CPO, FAAOP, Legislative Advocacy Award recognizes individuals who have made valuable contributions toward advancing the legislative and regulatory goals of the O&P field by motivating members of Congress and other decision makers to take action on behalf of O&P. – AOPA

Arron Holms – founder of Wiggle Your Toes, a non-profit organization that assists individuals who have suffered limb loss, by offering consultation, planning and referrals.

As an amputee, Arron has been a longtime advocate and participant in the AOPA Policy Forum. He has participated in the fight against the draft Lower Limb LCD in 2015 and has testified at a Congressional briefing on his own experiences.

Adrianne Haslet, a Boston Marathon bombing victim, below the knee amputee, and an outspoken advocate.

Adrianne has worked hard for the advancement of O&P advocacy agency by testifying before Congress on the behalf of AOPA, as well as a plethora of additional briefings. Hopefully, you had a chance to hear her speak and meet her adorable dog Fred Astaire.

Edwin & Kathryn Arbogast Award, and Otto & Lucille Becker Award Recipients

The Edwin and Kathryn Arbogast Award and Otto and Lucille Becker Award were founded in 2012 and made possible by a special endowment by Becker Orthopedic and WillowWood. These awards are granted to scientific papers submitted for the Poster Presentation at the AOPA National Assembly. – AOPA

Elizabeth Bell, University of Maryland-College Park, presented her poster on the topic of “A Mixed-Methods Examination of Limitations to Physical Activity as Reported by Individuals with Lower Extremity Amputations”. Elizabeth is the proud recipient of the Edwin and Kathryn Arbogast Award.

Kierra Falbo, Northwestern University, presented her poster on the topic of “Characteristics of Delphi Processes in Orthotics and Prosthetics Research”. Kierra is the proud recipient of the Otto and Lucille Becker Award.

We are so grateful for our customers who continue to support Cascade.  The future looks bright and we are glad you are part of it!

We will see you in Vancouver, BC next year for the 2018 AOPA National Assembly!

AOPA 2018