The Code of Professional Responsibility and Rules & Procedures

January 2020

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III. Responsibilities to the Patient

C3.1 — Confidential Information

All information relating to a patient’s identity, background, condition, treatment or management plan or any other information relating to the ABC Credential Holder/patient relationship is, and shall always remain, confidential and may not be communicated to any person or entity who is not providing direct medical care to the patient without the prior written consent of the patient or patient’s legal guardian.

All patient information derived in a work place from a working relationship relating to any patient shall be held and always remain confidential by all parties unless written permission to release the information is obtained from the patient or patient’s legal guardian. No patient documentation shall be removed, copied or transferred by any ABC Credential Holder. The confidentiality requirements set forth in this Code shall be strictly adhered to by all ABC Credential Holders unless: (i) required otherwise by law or valid court order or subpoena; (ii) it becomes necessary to disclose such information to protect the welfare of the patient or the community or (iii) confidential information must be disclosed to the Committee in connection with a valid complaint regarding a patient and an ABC Credential Holder in accordance with and pursuant to this Code. In such an event, any disclosure of confidential information shall be in accordance with applicable legal requirements.

C3.2 — Care

The ABC Credential Holder shall use all reasonable efforts to meet the patient’s orthotic, prosthetic and pedorthic needs. Upon accepting an individual for orthotic, prosthetic or pedorthic services (Services), the ABC Credential Holder shall assume the responsibility for performing the tasks associated with Patient Assessment, Formulation of the Treatment Plan, Implementation of the Treatment Plan, Follow-up Treatment Plan, Practice Management, and Promotion of Competency and Enhancement of Professional Practice, all within the scope of practice of the discipline(s) in which he/she/it are credentialed or privileged and as described in all ABC Practice Analyses, ABC Facility Accreditation Standards and the ABC Orthotic, Prosthetic and Pedorthic Scope of Practice (Scope of Practice), as they may be amended.

In the event the ABC Credential Holder seeks to terminate the professional relationship with a patient, the ABC Credential Holder shall provide advance written notification of such termination to the patient. The notification must include, at least, the effective date of the termination, the reason(s) for the termination and a statement that, upon the patient’s written request, the ABC Credential Holder shall deliver a copy of the patient’s records to the patient.

C3.3 — Records

Upon a patient’s written request, the ABC Credential Holder shall deliver a copy of the patient’s records to the patient and/or any subsequent designated care provider. The ABC Credential Holder may not charge the patient or subsequent designated care provider in excess of amounts permitted by Federal and/or state regulations.

C3.4 — Research

In the event that the ABC Credential Holder desires to engage in a research project or study, he/she/ it shall first ensure that: (i) all patients affiliated with such projects or studies consent in writing to participate in such projects or studies and to the use of the results of the project or study or; (ii) the data and information regarding the patient remains confidential; (iii) the dignity and well-being of the patient shall be primary concerns; (iv) the research is conducted in accordance with all federal, state and local law; (v) there is an absence of fraud; (vi) all data is fully disclosed; (vii) there is an appropriate acknowledgment of individuals making contribution to the research; and (viii) in the event that any acts in the conduct or presentation of research appears to be unethical and/or illegal, the ABC Credential Holder shall immediately report the unethical and/or illegal conduct to ABC and, if appropriate, the applicable law enforcement authority.

C3.5 — Trust and Honesty

The ABC Credential Holder shall be trustworthy and honest.

C3.6 — Fees and Compensation

The ABC Credential Holder shall provide Services and orthoses, prostheses or pedorthic devices based on the needs of the individual receiving the Services and not primarily for personal financial gain. The ABC Credential Holder shall not engage in false, misleading or deceptive actions in relation to the ultimate cost of the Services undertaken or furnished. The ABC Credential Holder shall not over-utilize or unnecessarily continue Services beyond the point of meaningful benefit for the patient or by providing services more frequently than necessary. The ABC Credential Holder shall not submit false or misleading information in requesting payment or reimbursement. The ABC Credential Holder may not: (i) deliver used devices or components when providing the Services; or (ii) utilize used components for the repair of an orthosis, prosthesis or pedorthic device, without the prior written consent of the patient. The ABC Credential Holder may not deliver used components when billing for a new orthosis, prosthesis or pedorthic device.

C3.7 — Practice Arrangements

The ABC Credential Holder shall not: (i) directly or indirectly request, receive or participate in dividing, transferring, assigning or rebating any funds derived from a referral of a patient to any other individual or entity, whether affiliated with the ABC Credential Holder or otherwise; or (ii) profit by means of a credit or other valuable consideration, such as, by way of example and without limitation, an unearned commission, discount or gratuity for providing Services except for the fees earned for Services performed for the patient.

The ABC Credential Holder shall refer all patients to the most appropriate service provider, taking into consideration the nature and extent of the problem, treatment resources and availability of healthcare benefit coverage, and the likelihood of receiving appropriate and beneficial care. If the ABC Credential Holder is involved in an arrangement with a referring source in which the referring source derives income from the ABC Credential Holder’s Services, the ABC Credential Holder must fully disclose all pertinent information to the patient including, without limitation, that the referring practitioner derives income from the provision of the Services. The ABC Credential Holder shall advise his/her employer of any employer or employee practice which is in contradiction with this Code.

C3.8 — Delay in Services

The ABC Credential Holder shall not accept any prescription or valid order when the ABC Credential Holder knows, or has reason to know that the orthosis, prosthesis or pedorthic device cannot be furnished within a reasonable period of time. In such instances, the ABC Credential Holder must discuss the situation with the patient and physician or other licensed healthcare prescriber in a timely manner. The ABC Credential Holder shall not unreasonably delay or allow for the unreasonable delay of the provision of Services.

C3.9 — Compliance with Laws and Regulations

The ABC Credential Holder shall provide Services in accordance with federal law and the laws and regulations of the jurisdiction(s) in which he/she/it provides Services.

C3.10 — Reporting

The ABC Credential Holder shall report to ABC any conduct about which the ABC Credential Holder is aware and that reasonably appears to violate this Code. This reporting requirement includes, without limitation, self-reporting, and the reporting about other ABC Credential Holders, in connection with a third party investigation and finding, regardless of whether the investigation has been completed. Each ABC Credential Holder must make such disclosure to ABC within 30 days of the date from when he/she/ it learns of a possible Code violation.

C3.11 — Delegation of Responsibility

The ABC Credential Holder shall not delegate any task requiring unique skills, knowledge or judgment to an unqualified person. The primary responsibility for orthotic, prosthetic and pedorthic care performed by supporting personnel rests with the delegating ABC Credential Holder. Adequate supervision, as defined in ABC’s Scope of Practice, is required to ensure patients receive the necessary and appropriate care.

C3.12 — Advertising and Public Communication

The ABC Credential Holder shall not provide any communication medium in exchange for professional publicity in a news item. When advertising, the ABC Credential Holder may publicize himself/herself/ itself through any commercial publicity or other form of public communication (including without limitation any newspaper, magazine, internet, telephone directory, radio, television, social media or other advertising) provided that the communication shall not: (i) contain a false, fraudulent, misleading, deceptive, unfair or sensational statement or claim; (ii) be misleading due to the omission of necessary material information; (iii) otherwise operate to deceive; (iv) be an unsolicited contact to an individual patient, in violation with any third party payer rules; or (v) promise remuneration of any kind, in exchange for providing Services, that would violate federal, state or local laws or regulations. Each advertisement shall be identified as an advertisement unless it is absolutely clear from the context that it is a paid advertisement.

C3.13 — Illegal Discrimination & Harassment

The ABC Credential Holder shall not decline to accept a patient on any basis that would constitute illegal discrimination under federal law. ABC Credential Holders shall not engage in any harassing behavior or illegal discrimination of any kind.

C3.14 — Sexual Relations with Patient Prohibited

Except in unique and justifiable circumstances, as determined by the Committee in its sole discretion, the ABC Credential Holder shall not have consensual or nonconsensual sexual relations with a current or former patient of the ABC Credential Holder unless: (i) a consensual sexual relationship existed between the ABC Credential Holder and the patient prior to the provision of any Services; or (ii) the ABC Credential Holder has not provided any Services to the patient for a six month period preceding the beginning of the sexual relationship; or (iii) the ABC Credential Holder has not provided any Services for a six month period after the termination of the sexual relationship. The ABC Credential Holder shall not engage in, require or demand sexual relations with a patient incident to or as a condition of providing any Services.

C3.15 — Sexual Relations with Key Third Parties Prohibited

Except in unique and justifiable circumstances, as determined by the Committee in its sole discretion, the ABC Credential Holder shall not have consensual or nonconsensual sexual relations with a Key Third Party when such relations are based on the use or exploitation of trust, knowledge, influence or emotions derived from a professional relationship. A Key Third Party is a person who is closely related to the patient and shall include, but not be limited to, spouses or partners, parents, siblings, children, guardians, caregivers. Each matter shall be evaluated on a case-by-case basis. Factors to be considered shall include: (i) the nature of the patient’s orthotic, prosthetic or pedorthic needs; (ii) the length of the professional relationship; (iii) the degree of the Key Third Party’s emotional dependence on the ABC Credential Holder; and (iv) the importance of the clinical encounter to the Key Third Party and the patient.

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