|
|
|
|
|
Search
05/18/2023
RESPONSES/COMMENTS
RE: Unequal Treatment of Ex-Patriot DPMs by ABPM
From: Jeff Carnett, DPM
There are many of us American trained DPMs working overseas who are not eligible to be board certified by either board as we did one or two-year residencies, but not three-year programs. So, how shocking to see that ABPM will certify those with bachelor degrees in podiatry from the UK, SA, Australia, Malta, and New Zealand who did not take the MCAT, have no basic medical sciences in their courses, and no residencies. These degrees are right from high school.
Doesn't that discredit anyone with the ABPM certification in the U.S.? So, we expatriate DPMs need to take a bachelor podiatry degree so we can get certified, but we can't get certified with a CPME-approved DPM degree and residency? I’m trying to understand how that helps the profession. While overseas, our work is often highly surgical, but alas that doesn't count.
Jeff Carnett, DPM. Auckland, New Zealand
Other messages in this thread:
07/17/2025
RESPONSES/COMMENTS (PODIATRIC EDUCATION)
From: John S. Steinberg, DPM
Ah the beauty and the challenge of open authorship forums such as PM News. Congratulations to Barry Block and his now 22,465 daily subscribers…BUT with this media comes responsibility and a duty for honesty.
We need to STOP publishing extremist statements and misinformation. We don’t want to hear it anymore. The notes of alarm that use terms such as ‘shrapnel, blast radius, and grenades’ seem determined to misrepresent the truth and create negativity about this great profession. I suggest that rather than seeking to frighten readers about podiatry for some unknown cause, we should instead put our efforts into productive...
Editor's note: Dr. Steinberg's extended-length letter can be read here.
Editor's comment: For the past 31 years (8,063 issues), PM News has been an open forum in which any podiatrist can comment or respond to another's comments. We publish all sides of issues including those we disagree with. This is how a free press operates. Dr. Steinberg, whom we hold in high esteem, apparently believes that PM News should not publish opinions that "create negativity." Censoring opinions is a slippery slope in which "the truth" is often perceived differently depending on who you are or what you believe in. We will continue to allow every podiatrist a respectful voice, and let the reader decide where the truth lies.
07/17/2025
RESPONSES/COMMENTS (MEDICARE FRAUD)
From: David Secord, DPM
I have a friend from college who is with the Federal Prosecutor’s office in Fort Smith, AR. About a decade ago, we were speaking about the length of time it takes for someone’s feet to be held to the fire after committing felonies. His response was enlightening. The DOJ has only a certain number of prosecutors and investigators upon which to rely for building and (potentially) litigating a case. He estimated that each case might entail $500,000 in costs (and that was a decade ago) and it is simply not possible for every, single instance to make it into the courtroom. There are not enough courts either.
The road you are forced to walk is to allow the potential defendant to build up a large enough number of offences that the Feds can approach and offer a plea agreement to plead guilty to a certain number of offences, pay a certain amount in fines and surrender of assets and agree to...
Editor's note: Dr. Secord's extended-length letter can be read here.
07/16/2025
RESPONSES/COMMENTS (PODIATRIC EDUCATION)
From: Lawrence Oloff, DPM
Rod, thank you for your continued devotion to podiatric medicine, but I do have some concerns about your statements. First off is your information about the number of [podiatry] schools. When you stated there are "25 or 30" (actually there are 11, and one of these schools is a public institution). While I agree with your premise on the number of schools, I think it is important to be accurate about what you state. Also, my understanding is that CPME only has the ability to decide whether or not a school meets their criteria. I do not believe it has the ability to tell a school to open or not. I would like to hear from a higher authority on whether my information is correct. If it is, then how do you influence a private entity from opening a school if we have no jurisdiction over that decision?
I always wondered whether all these posts are social media or whether they are accessible online by the public. Maybe someone can answer that. Your information you keep posting is interesting but its extensiveness and persistence sometimes feels like a diatribe against...
Editor's note: Dr. Oloff's extended-length letter can be read here.
07/16/2025
RESPONSES/COMMENTS (PM ARTICLES)
From: Lawrence Rubin, DPM
A few weeks ago, I read a convincing article in Podiatry Management Magazine that portends podiatry's potential demise if there is continued low matriculation of students in our colleges. Then, a few days ago, I saw a LinkedIn post from APMA in which podiatrists attending a major convention were celebrating the fact that podiatry has never been more viable and successful than now and can look forward to a marvelous future.
While I have deep feelings wanting APMA and these podiatrists to be right, something tells me that we should not ignore our failure to attract students and the possible adverse consequences of this occurring.
Lawrence Rubin, DPM, Las Vegas, NV
07/16/2025
RESPONSES/COMMENTS (MEDICARE FRAUD)
RE: Inside the DOJ's Largest-ever Healthcare Takedown
From: Paul Kesselman, DPM
A recent Medical Economics article provides a detailed review of the Dept. of Justice's recent indictment of hundreds of conspirators who committed $14.6B (you read that right) in Medicare fraud. This not only threatens the Medicare Trust fund, but should be an affront to every honest medical practitioner and beneficiary.
I have asked the FBI and other law enforcement officers what took them so long when these types of investigations are presented at meetings. Again, we should all be asking law enforcement why there are not mathematical formulas in place which prevent runaway payment of new or established DME or other Medicare providers? Why are they not subject to pre-payment reviews for CPT and HCPCS codes which are often abused?
DME was not the only subject of concern; there were several providers who were indicted for abuse of allografts, others for genetic testing, and still others for hospice care.
Paul Kesselman, DPM, Oceanside, NY
07/16/2025
RESPONSES/COMMENTS (MEDICAL-LEGAL) - PART 2
From: Joseph Borreggine, DPM
Why is EBM Medical’s business model not implicated by Anti-Kickback Statutes or Stark Laws? The Anti-Kickback Statute [42 U.S.C. § 1320a-7b(b)] prohibits the knowing and willful payment of “remuneration” to induce or reward patient referrals or the generation of business involving any item or service payable by the Federal healthcare programs (e.g., drugs, supplies, or healthcare services for Medicare or Medicaid patients). Similarly, the Physician Self-Referral Law, commonly referred to as the Stark law [42 U.S.C. § 1395nn], prohibits physicians from referring patients to receive “designated health services” payable by Medicare or Medicaid from entities with which the physician or an immediate family member has a financial relationship, unless an exception applies.
In both instances, the application of the Anti-Kickback Statute and the Stark Law is predicated on a health service that is covered and reimbursed by a federal healthcare program. Because the products available through EBM Medical’s proprietary software platform are not covered by federal healthcare program and EBM Medical does not receive any payments from...
Editor's note: Dr. Borreggine's extended-length letter can be read here.
07/16/2025
RESPONSES/COMMENTS (MEDICAL-LEGAL) - PART 1
From: Kristin Happel
When our office takes any kind of cultures, biopsies, etc., we always have the patients sign a form (usually provided by the lab we are sending the specimen to), which clearly states we are sending the specimen, why we are doing so, and that the patient consents to this. Perhaps take a look at your office procedures, to make sure you are doing the same.
Kristin Happel, Medical Biller, Crystal Lake, IL
07/15/2025
RESPONSES/COMMENTS (PODIATRIC EDUCATION)
RE: Educational Fallout and Uncomfortable Truths
From: Rod Tomczak, DPM, MD, EdD
I’m writing this letter to ensure that the crisis in enrollment is not conveniently forgotten as a passing fancy which some members of the profession would like it to be. There are a few points that need to be brought to the forefront and hopefully burned into the collective cerebral cortex of the profession, especially the younger members. These facts need to be recalled repeatedly and contemplated extensively lest they do become the mere musings of a neo-OG. A lot of us really care about not only the profession and the younger members but also those yet to become members of the profession who will suffer from the shrapnel that will be blown far and wide when the pin is pulled on the Foundation for Podiatric Education (FPE) grenade.
The shrapnel will not affect just a few. The blast radius will cover the whole profession, those in private practice, those getting ready for boards, no matter which boards, the students and the political mavens who worry more about…
Editor’s note: Dr. Tomczak’s extended-length letter can be read here.
07/15/2025
RESPONSES/COMMENTS (NON-CLINICAL)
RE: DPMs as Foot Experts?
From: Jay Grife, DPM, JD
As a former practicing podiatrist, I appreciate the comments extorting the population to accept podiatry as the leader in foot care and treatment. I also have noted from learned persons such as Dr. Tomczak whom I admire for his honesty and devotion, the devolution of podiatry. What I read as quoted below displays that podiatrists are omitted from a topic they see daily and likely treat more often than other healthcare providers. Lest we listen and react to Dr. Tomczak’s prescient explanation, I fear he might be right.
From Health: “Toenail fungus can begin as a minor cosmetic issue, but if left untreated, it may become painful and harder to treat. ‘The signs of toenail fungus are thickened nails that are hard to clip, might appear yellow or white, and can sometimes crumble,’ explains Jeffrey M. Cohen, MD, a board-certified dermatologist and Director of the Psoriasis Treatment Program at Yale School of Medicine.
After consulting with two dermatologists for their expert recommendations, we tested six toenail fungus treatments ourselves. A dermatologist from our Medical Expert Board also reviewed this article for medical and scientific accuracy.”
Jay Grife, DPM, JD, Jacksonville, FL
07/15/2025
RESPONSES/COMMENTS (MEDICAL-LEGAL)
From: Larry Kobak, DPM, JD
In answer to Dr. Grodman’s inquiry concerning office dispensing of compound prescriptions, it depends. If the dispensing physician is not an owner of the pharmacy, there is a medical necessity for the prescription, and his state allows a physician/podiatrist to dispense and charge for medication; then it should be legal. As usual, it is recommended that this arrangement be reviewed by competent legal representation prior to signing any agreement.
Larry Kobak, DPM, JD, Pine Brook, NJ
07/12/2025
RESPONSES/COMMENTS (OBITUARIES)
From: Elliot Udell, DPM
I am saddened, like so many of us, to hear of the passing of Dennis Shavelson. Dennis and I lectured at many seminars. What strikes me about him is how dedicated he was to the art of biomechanics. For many years, he owned his own lab and would run seminars at his lab. My last conversation with him was when he called me and let me know that he would coach me on biomechanics.
He also let me know that he no longer had his lab, but was solely interested in promoting all that he had learned about it to as many of his colleagues as possible. That was real dedication.
Elliot Udell, DPM, Hicksville, NY
07/12/2025
RESPONSES/COMMENTS (MEDICARE ADVANTAGE)
RE: DOJ Investigation of UHC Spreads To Former Physician Employees
From: Paul Kessleman, DPM
In yesterday's Wall Street Journal, an article appeared suggesting that the DOJ was speaking with former employees of UHC, including physicians, about allegations that UHC had pressured them to up-code diagnoses as part of a larger scheme. This was to increase CMS payments to UHC's Medicare Advantage Group.
The DOJ as part of a larger investigation along with CMS has announced they will be auditing every MCR Advantage Plan to ensure that these plans do not up-code their data mining in an attempt to inappropriately reap billions (you read it right) of dollars.
Paul Kessleman, DPM, Oceanside, NY
07/10/2025
RESPONSES/COMMENTS (OBITUARIES)
From: Daniel Chaskin, DPM, Paul Kesselman, DPM
I am saddened by Dr. Shavelson's death. He helped so many students learn about our fine podiatry profession.
Daniel Chaskin, DPM
I am quite saddened to hear about the passing of Dennis Shavelson both as a friend from yesteryear and a mentor. Back in the late seventies and early 1980s, as everyone knows, there were way more graduates of podiatry school than there were residency programs. Dennis opened his office to a surgical/biomechanical preceptorship through NYCPM. This enabled many students who did not match but nevertheless were in the top of their class to receive post-graduate training of one- or two-years duration. His program prepared many who eventually either went on to match in residency programs, or prepared them to thrive in private or institutional practice. Due to his diligent teaching and the caseloads preceptors handled, most of his students were taught the skills needed to eventually log sufficient cases, enabling them to receive surgical or orthopedic board certification.
In 1981, he had two practices in the South Bronx which catered primarily to the...
Editor's note: Dr. Kesselman's extended-length letter can be read here
07/07/2025
RESPONSES/COMMENTS (MEDICARE)
RE: Upcoming Medicare Issues
From: Paul Kesselman, DPM
1) Prior Authorization. On Jan 1, 2026 Medicare is implementing a pilot prior authorization program in several states for several procedures including cellular tissue products.
2) Common Electronic Data Interchange. For those submitting DME claims electronically, the time to revalidate your CEDI trading partner number starts on July 1 and runs through December. It takes only a few minutes. If you need assistance with this, your EHR should be able to assist you.
3) Re-validation. Medicare is contemplating changing the DME enrollment re-validation from triennial to annual. There were no updates on the fee, so one can assume for now that the fee would still be paid on a triennial basis, while the revalidation would be annual. I have been told that this will only affect those who require facility accreditation (DPMs do not). Facility accreditation fees are also going up.
Paul Kesselman, DPM, Oceanside, NY
07/07/2025
RESPONSES/COMMENTS (CLASS ACTION LAWSUITS)
RE: BCBS Class Action Settlement
From: Howard Dinowitz, DPM
I recently received this email. Is it real? “We recently sent you a message regarding MCAG, a class action settlement expert we’ve partnered with to assist our eligible clients with recovering settlements from a class action lawsuit that was filed against BCBS for engaging in anti-competitive practices leading to reduced reimbursements for healthcare providers.
We selected MCAG, the leader in third-party claim filing, to help eligible organizations submit a claim by July 29th, 2025 to receive cash from the $2.8 billion settlement. MCAG has helped clients recover more than $330 million across 50 settlements.”
Howard Dinowitz, DPM, Brooklyn, NY
Editor’s Note: To file a claim for the Blue Cross Blue Shield (BCBS) settlement, providers should visit https://www.bcbsprovidersettlement.com/ the official settlement website. The deadline for providers settlement is July 29, 2025.
07/04/2025
RESPONSES/COMMENTS (STUDENT RECRUITMENT)- PART 1A
From: Kathleen Neuhoff, DPM
Podiatry camp sounds like a good option to me. In my other career (veterinary medicine), many of the schools have had them for years. They are generally targeted to 12-13 year-olds because in the veterinary side; research has shown that most students have made the decision to go into veterinary medicine by age 13. I do not know what this number would be in podiatry since most students do not know who we are! But if the APMA advertising campaign is successful, offering camps would be a great follow-up.
Kathleen Neuhoff, DPM, South Bend, IN
07/04/2025
RESPONSES/COMMENTS (STUDENT RECRUITMENT) - PART 1B
From: Arden Smith, DPM
As I am getting older, I tend to try not to tax my aging brain too much and try to keep things as simple as possible. My own experience from years of dealing with “kids”, tells me that our recruitment program should deal with four basic related points; and then go on from there as needed:
-You are a DOCTOR, a noble and honored profession.
-You get to help people and do good.
-You have an opportunity to earn an extremely good living while you are helping people and doing good, at the same time [that's a gift that very few people have].
-Our profession is conducive to a good family life as well as a very good and rewarding lifestyle.
Simple. Once we have their attention, we can go from there.
Arden Smith DPM, Retired, Great Neck, NY
07/04/2025
RESPONSES/COMMENTS (PM ARTICLES)
From: Joseph Borreggine, DPM
The recent article on the Stark Law is very important and informative for all medical providers to read and ultimately understand with respect to the day-to-day operations of running a medical practice, working cooperation as a medical referral source, as well as being an employee in a more than two person (group) medical practice. This law is meant to not only protect the Medicare system from fraud and abuse which can be deemed direct or indirect but also provide government regulation and guidelines preventing physicians from being paid inappropriately whether in a small group or larger corporate practice setting.
I commented on this subject a while ago in this publication and did not get one response; either because 1) every reader was either fully knowledgeable of what I was talking about or 2) was completely ignorant of my comments with respect to payment for “designated health services” (DHS) in a group...
Editor's note: Dr. Borreggine's extended-length letter can be read here.
07/03/2025
RESPONSES/COMMENTS (PM ARTICLES)
From: Paul Kesselman, DPM and Larry Kobak DPM, JD
In the June/July 2025 issue of Podiatry Management, the Legal Corner provides an excellent synopsis of Stark Law and how it can find its way into everyday podiatric practice. There is one point (Number 5), however, which requires clarification. Regarding DME, it states, "If you own a durable medical equipment company and refer a patient to that company," this could potentially be a Stark violation.
Providing DME to your own patients in your podiatry practice is an allowed exclusion under Stark, just as taking x-rays of your own patients is an exception under Stark. Further clarifying is that you and the doctor must perform the service. You cannot have someone in your office dispensing the DME, in particular if the DME is a designated health service, as AFOs, for example, are. Furthermore, if your employees are assisting in providing any designated health service (DHS), they must be performing this under your direct supervision, while you, the doctor, actually are in the office. There are certain DME (e.g. surgical dressings) which are not DHS, and all the Stark rules may or may not apply.
Furthermore, if you do own a legally identifiable DME company with a separate tax ID from your practice and you refer your patients there, that may be problematic. Under these circumstances, it is highly suggested that you consult with a healthcare attorney to ensure you are in compliance with all Federal Stark and Anti-kickback regulations. There are also other regulations, including state licensing requirements, facility accreditation, and surety bonding that likely will apply here, which again like Stark, DO NOT APPLY to physicians providing DME to their own patients as part of a treatment plan and within their scope of practice.
Paul Kesselman, DPM, Oceanside NY, Larry Kobak, DPM, JD, NY, NY
07/03/2025
RESPONSES/COMMENTS (STUDENT RECRUITMENT) - PART 1B
From: Richard Boone, Esq
Dr. Tomczak’s idea for a podiatry camp may not be as weird as some folks are thinking. In my day (several years ago), dozens of young women were channeled into nursing through Candy Striper programs at local hospitals. And I’ve lost count of the number of podiatrists who told me that they became interested in in podiatry as the result of caring for the feet of a beloved relative.
Like everything else in life, you have to get to folks when they’re young and impressionable. My suggestion would be summer intern programs for high school students.
Richard Boone, Esq, Falls Church, VA
07/03/2025
RESPONSES/COMMENTS (STUDENT RECRUITMENT) - PART 1A
From: Gary S Smith, DPM
I agree that the podiatry camps are a great idea. I really think it would help with recruiting. Since most medical schools enroll a huge number of students on SSI disability, they have all created "alternative pathways of learning." Many of the SSI students have no study skills, a poor education, or an anxiety or social disability that precludes them from traditional studies. These new "pathways" allow them to mostly avoid the classroom. They study in groups and various other ways. Some never take tests as we know them. Grading is often subjective.
Most schools no longer have anatomy lab because of the large number of students that can not deal with it. You can Google any school and read about their particular alternative pathway. Maybe these alternative pathways could be marketed more?
Gary S Smith, DPM, Kane, PA
07/02/2025
RESPONSES/COMMENTS (STUDENT RECRUITMENT)
RE: Podiatry Camp, Not Your Band Camp
From: Rod Tomczak, DPM, MD, EdD
When I mentioned podiatry camp in my last posting, I was serious about the concept. I’ve had a few phone calls from people in the profession who don’t want to write to PM News but would like to offer comments. So let’s devote a posting to the idea of podiatry camp, the why, the what I think it should be, and what it shouldn’t be.
First of all, I want to extend my kudos to practitioners who want to see the profession return to full classrooms if we are going to keep podiatry schools open and grant DPM degrees and retain the soul of our profession. But, if I’m a 21 year old kid, I don’t want to listen to some semi-polished well intentioned lunch lecturer who starts the presentation with, “You know, I have a couple grandkids your age.” I don’t know if as a visitor going to an office of a podiatrist who has socks older than I am is the best way to be impressed about...
Editor's note: Dr. Tomczak's extended-length letter can be read here.
07/02/2025
RESPONSES/COMMENTS (MEDICARE FRAUD ALERTS)
RE: Alert: Medicare Fraud Scheme Involving Phishing Fax Requests
From: Paul Kesselman, DPM
I received this notice today:
CMS has identified a fraud scheme targeting Medicare providers and suppliers. Scammers are impersonating CMS and sending phishing fax requests for medical records and documentation, falsely claiming to be part of a Medicare audit. Important: CMS doesn’t initiate audits by requesting medical records via fax. Protect your information. If you receive a suspicious request, don’t respond. If you think you got a fraudulent or questionable request, work with your Medical Review Contractor to confirm if it’s real.
DO NOT RESPOND TO ANY FAXES OR EMAILS WHICH REQUEST THIS INFO. Medicare typically does not request this sort of information by fax or email. The entities sending these faxes/emails are attempting to steal patient PHI and then use it to bill for services and DME which were not provided. Don't be part of perpetuating fraud and protect yourself, your patients and the Medicare Trust Fund.
Paul Kesselman, DPM, Oceanside, NY
07/01/2025
RESPONSES/COMMENTS (STUDENT RECRUITMENT) PART 1A
From: Bret M. Ribotsky, DPM
I believe Dr. Richie’s response focuses on personal criticisms rather than addressing the substantive issues raised. It is concerning that someone who built their career by modifying an existing brace design, trademarking it under his own name, and commercializing it within the profession would question another’s business practices. My position has consistently been that physicians’ time and expertise deserve appropriate compensation.
Dr. Richie appears to misunderstand the distinction between not-for-profit institutions and public entities that operate without profit margins. Not-for-profit organizations can generate revenue; the key difference is how surplus funds are utilized (bonuses, salaries, retreats and paying guest faculty) rather than distributed. Rather than engaging in personal attacks, I was attempting to offer constructive solutions to address identified problems within our field. I believe our professional discourse would benefit from focusing on the merits of proposed solutions rather than personal criticisms.
Should Dr. Richie wish to evaluate our respective contributions to this profession’s advancement without profit motive, I welcome that discussion. I have dedicated over twenty years to serving on multiple professional boards and lectures to teach others how to benefit and earn a good living ethically. As anyone involved in public speaking and education can attest, clinical practice typically offers greater financial returns than teaching and professional service. I encourage Dr. Richie to engage with the substantive issues at hand in future discussions.
Bret M. Ribotsky, DPM, Fort Lauderdale, FL
07/01/2025
RESPONSES/COMMENTS (STUDENT RECRUITMENT) - PART 1B
From: Ivar E. Roth, DPM, MPH
Dr. Richie’s reply in my opinion is spot on. I am in my last third of life and I feel very compelled to give back to this wonderful profession. Recently, I have been interested in student recruitment and I have made it known to the local component society that I am ready to be part of a concerted effort to help. I encourage all who are in a similar part of their lifecycle to make the effort to get involved and give back.
Ivar E. Roth, DPM, MPH, Newport Beach, CA
Editor's note: This topic is now closed.
|
| |
|
|
|
