Introducing Cascade’s National Sales Manager, Debbie Hatch

Cascade is pleased to introduce our new National Sales Manager, Debbie Hatch.  Debbie has been a part of the Cascade team for over 11 years and was promoted from her previous position as North Atlantic Territory Account Manager.

Throughout her tenure with Cascade, Debbie has built strong relationships with her customers.  She is looking forward to growing these existing relationships and building new connections throughout the United States.  In her new role, Debbie will be working closely with Cascade’s supplier partners, customers, and internal teams with the goal of extending Cascade’s value-added services and solutions.

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Get to Know Debbie:

  • Debbie loves: Mexican food
  • Debbie has two pets: a cat named Lovey and a black lab named Bella
  • Her favorite sports are: tennis and baseball/softball
  • Debbie’s hobbies include: playing tennis, participating in Spartan races, spending time on the lake, and spending time with her nephews
  • She enjoys: traveling internationally and exploring new and unique places

Debbie’s Take on Her New Position

Debbie is proud to support the O&P industry and the individuals who help restore mobility and improve the quality of patient’s lives. Debbie is looking forward to expanding her reach and supporting the Cascade network of customers with the products, resources, and support they need to build a better practice. To connect with Debbie Hatch, please reach out to her directly at 530-748-5105 or by email at


(* Rare GIF depicting how excited the Marketing Department is for Debbie’s promotion)

Cascade Welcomes Pam Hale, CPO

Cascade is excited to introduce Pam Hale, CPO, our new Clinical Educator.  Pam has worked within the O&P industry for 25 Pam_Hale #2years, practicing as a Clinician, business owner, and clinical educator. Pam has a wide breadth of knowledge in both orthotics and prosthetics and is interested in incorporating progressive technologies into clinical O&P care.

In her new role, Pam will be working closely with our sales team, supplier partners, and customers, to provide product and fabrication related education. Pam loves working in an industry that is constantly evolving, it keeps her on her toes and allows her to continue to grow as an educator.

Fun Fact:

  • Pam graduated from UT Southwestern
  • She has an Australian Shepard named Kiyo
  • Pam is true mountain girl! When she isn’t working you will find her hiking, white water rafting, or skiing
  • She loves to travel
  • Pam is a foodie! She is open to trying anything she comes across in her travels
  • She enjoys hands-on learning and experiences

What Brings Pam to Cascade

Team history and product diversity! Pam feels that her past work experience with Cascade has given her great insight into the company’s overall culture and focus. She has also had the opportunity to build strong relationships with many Cascade team member prior to arrival. Never working for distributor before, Pam is excited to have a vast array of products available to her to teach about. We are so excited to have Pam as part of our Cascade team! With her hands-on experience, breadth of knowledge, and love of the industry, we will be able to provide you, our customer with the education need.


April = Limb Loss Awareness Month

Written by Guest Blogger, George Gondo – Project Director, Amputee Coalition


After working for the Amputee Coalition for over 10 years, I regularly find myself educating friends, family, and people I meet in my daily travels on the topic of limb loss. Many of these conversations begin in the same manner; rattling off facts. One that always comes to mind is “As a result of the conflicts in the Middle East, nearly 1,700 active duty military service members have lost a limb.”(1) Once engaged, the conversation moves towards the more prevalent causes of amputation, such as complications from diabetes and vascular disease. It is estimated that 82% of the 165,000–185,000 amputations performed annually in the U.S. are attributed to complications of diabetes and vascular disease. (2,3) With little exposure from the media, we are left with a lack of awareness and knowledge of limb loss across the general public, especially among individuals living with these conditions.

Limb Loss Awareness MonthLLAM-calendar-ribbon

To help raise awareness for the 2.1 million Americans that are living with limb loss, the Amputee Coalition has designated April as Limb Loss Awareness Month (LLAM). (4) The Amputee Coalition, along with limb loss support groups, hospitals, and the O&P community, have worked together to increase awareness of limb loss. By sharing stories and experiences of those who live with limb loss, as well as educating the public and policymakers, we hope to make an impact that will affect the current challenges and barriers patients face when accessing appropriate care and advocating for their rights.

Limb Loss Awareness Month Outreach and Events

In order to meet our ambitious goals, the Amputee Coalition conducts a number of outreach activities to help spread the word through both social media and community involvement throughout the United States. During the month of April, various organizations coordinate events in their communities such as Amputee Awareness Day in Cedar Crest, PA or the Ohio Amputee Celebration in Columbus, OH.  These events help to strengthen the limb loss community at the local level, as well as raise awareness for limb loss.  To see a full listing of events, and find one in your area, check out the Amputee Coalition’s event calendar!

llam-amputees-megaphoneOthers have used the month of April to organize local fundraisers to support various limb loss programs, like the Amputee Coalition’s Paddy Rossbach Youth Camp and the Bridge to Ability Scholarship. With so many affected by lower extremity limb loss, many of these organization put on “Walk, Run or Roll” event to help patients regain mobility. Some examples of these events, are ABC & AOPA Limb Loss Awareness Charity Walk on Saturday, April 20th and the Adventist Healthcare Rehabilitation’s 3rd Annual Amputee Awareness 5K on Saturday, April 28th.

In addition to local events, the Amputee Coalition has created several virtual events that anyone can participate in on social media. By using the following hashtags: #WOW, #AmputeeCoalition, #LLAM, #AmplifyYourself, you too can join in supporting LLAM.

Events include:

  • Wear Orange on Wednesdays (#WOW) – Post a picture of yourself on social media wearing orange every Wednesday during the Month of April with #WOW
  • Support Group Appreciation Day April 14th – Celebrate your local support group by giving them a shout-out on social media with the hashtag #LLAM
  • Certified Peer Visitor Appreciation Day April 21st – Give a nod to all the wonderful people who are trained and certified to provide peer support to others who have just experienced an amputation. Post a picture of any amazing CPV and use the #LLAM to give them some much-needed recognition and appreciation
  • Show Your Mettle April 28th – Limb Loss Awareness Month’s signature social media event! Show Your Mettle day is the limb loss community’s opportunity to flood social media channels with pictures of people with limb loss showing their metal (e.g., prosthesis) or mettle (e.g., how awesome they are)

Raising More than Awareness: Amplify and Advocacy

The overall goal of Limb Loss Awareness Month is to raise awareness of limb loss and the limb loss community for legislators and policymakers. Through education and awareness, they will have a better understanding of how to create policies that will help improve the lives of those affected. We encourage all members of the limb loss community to utilize the Amputee Coalition’s Amplify tool to share their stories.  It is critical patients contact members of Congress and medical insurance companies in order to share how their policies effect them.

Our advocacy efforts will reach their peak with the Coalition’s Hill Days in Washington D.C. on April 16th and 17th. This event will bring limb loss advocates from around the country together to learn more about the issues facing their community. They will receive training to help them effectively educate policymakers regarding these issues, as well as visit with their Congressional representatives and their staff.  To attend Hill Days, or for more information, visit the Amputee Coalition’s website.

Tools and Resources to Promote Limb Loss Awareness Month

As O&P providers, you can help spread the word about Limb Loss Awareness Month and the specific activities taking place in April. The Amputee Coalition has created a handy toolkit of resources to help you get the word out there! The “toolkit” contains the following resources:

  • An infographic with current statistics about limb loss in the United States
  • Posters and graphics you can use on your website, social media profiles, and office
  • Information about the Coalition’s Amplify Yourself campaign

The time is now. Let’s raise the voice of the limb loss community and be heard!

new-piktochart_29372557 About the Author: George Gondo, MA; has worked for the Amputee Coalition since 2007.  During his time with the company, he has held numerous roles and responsibilities, including program development and evaluation. George currently serves as the Project Director for the Amputee Coalition’s National Limb Loss Resource, managing the Coalition’s cooperative agreement with the Administration for Community Living.  Community Living collaborates with researchers to generate evidence to improve access to appropriate post-amputation care and continues to enforce limb loss within the research community.

Fischer H. A guide to US military casualty statistics: operation freedom’s sentinel, operation inherent resolve, operation new dawn, operation Iraqi freedom, and operation enduring freedom. Congressional Research Service2015;7:5700.
(NIS) HNIS. Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS). In: Quality AfHRa, editor. Rockville, MD2014.
Adams PF. Health and Vital Statistics. 1999.
Ziegler-Graham K, MacKenzie EJ, Ephraim PL, Travison TG, Brookmeyer R. Estimating the prevalence of limb loss in the United States: 2005 to 2050. Arch Phys Med Rehabil2008 Mar;89(3):422-9.

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!