Watch Out for Fraud in Foot Orthoses!

The Good, the Bad and the Ugly: The Wild West we call the Orthotics Industry – Foot Orthoses and Fraud (The Ugly)

 “When you stretch the truth, watch out for the snapback.”

~Bill Copeland

In my role as an independent medical consultant for several large insurance companies, I see a range of questionable products and claims. Some are simple misunderstandings, most however, are one of two types of fraud.

The first fraud is purposeful deceit involving misrepresenting the product, pricing or procedure – what we call “creative invoicing”. The second fraud involves ignorance of the foot care industry and/or products.

Part II covered the single largest area where practitioners and patients knowingly (or not) misrepresent the facts – selling prefabricated inserts as custom-made foot orthoses. In other words, paying $500 for a $70 Dr. Scholl’s insert.

The second largest area where practitioners and patients misunderstand products is footwear.

Industry definitions

Custom-made Footwear – footwear that is manufactured from a 3-dimensional cast of the patient’s feet, and made of raw materials. Custom made footwear is specifically designed for each and every individual. It is usually needed when stock footwear will not fit due to deformity, or will not suit the client due to significant dysfunction. Custom-made shoes cost at least $1200/pair.

Orthopaedic Footwear – are not custom-made shoes. They do however have 11 features which defines them as “orthopaedic”.

1. removable sock liner / insert to accommodate prescribed orthotic devices.

2. a minimum of 5 mm (3/16) for women or 8 mm (5/16) for additional depth for men, in the shoe last.

3. manufactured with a variety of 3 or more widths, graded and sized to a recognized measuring / sizing standard and device.

4. adjustable closure (ie. Laces, Velcro) to secure hind-foot position inside the shoe.

5. a smooth protective inner lining

6. broad insole and last patterns that entirely accommodate the anatomy of a foot.

7. sufficient torsional stability through out the sole.

8. heel stability via a firm and / or extended heel counter.

9. an outer sole that is equal to, or exceeds the width of the upper.

10. an outer sole with sufficient toe spring roll to promote normal gait cycle.

11. a shoe that is conducive to permanent modification (s).

Orthotic Shoe – no such thing! An orthotic is one thing and a shoe is another. Putting an orthotic in a shoe does not make it an “orthotic shoe” nor custom-made nor orthopaedic.

 

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