First and foremost, we extend our thoughts and prayers to our colleagues and others in Louisiana and all the other states who are struggling through the aftermath of hurricane Ida. There is a long road to recovery for them and I am sure they can all use our support. Ida caps off a few weeks of headlines that have not been very uplifting. But I want to tell you about a positive story whose outcome you can influence!
We have come a long way, in fits and starts, since the 2002 Negotiated Rulemaking fiasco. Here we are, nearly 20 years later with an opportunity to codify the intent of BIPA 2000 section 427 and more.
There are two bills before Congress, S 2556 and HR 1990 both called the Medicare O&P Improvement Act. The language in both bills is identical and both have bipartisan support. The bills are the results of years of coordinated work by the O&P Alliance, supported by AOPA, the Academy, NAAOP, NCOPE, ABC, and BOC. What makes this special is that we have identical bills in both houses at the same time, both with bipartisan support. But the work has just begun. This is where your action is crucial. There are 4 key goals that will be codified in this Act, should it pass:
- The legislation would differentiate in statute the clinical, service-oriented nature in which O&P care is provided from durable medical equipment (DME). DME is totally different than O&P care and should be treated separately in statute and regulations. O&P clinical care would no longer be viewed through a DME lens, permitting more appropriate regulation.
- Revises the interpretation of “off-the-shelf” (OTS) orthotics for purposes of competitive bidding by clarifying that the Centers for Medicare and Medicaid Services may only competitively bid orthoses that require “minimal self-adjustment” by patients themselves, restoring congressional intent and ensuring that patients in need of custom fit orthoses will continue to have the clinical care necessary to achieve proper orthotic fit and function.
- This bill would exempt certified and/or licensed orthotists and prosthetists from the requirement to have a competitive bidding contract in order to provide OTS orthoses to their patients, much like the law treats therapists and physicians. These orthoses would be subject to the competitive bidding rate so this provision would increase patient convenience without increasing Medicare outlays.
- The bill would reduce waste, fraud, and abuse by prohibiting “drop shipping” of all prosthetic limbs and orthotic braces that are not truly OTS (i.e., subject to minimal self–adjustment by the patient). This would save Medicare outlays and ensure the provision of clinical O&P care.
What you need to do: express your support for these bills! There are over 5,000 people directly involved in the provision of O&P care in the United States, yet fewer than 1,000 have used AOPA’s legislative tools to show support for these bills.
Please ask everyone in your practice, and especially ask your patients, to indicate their support for this by using the tools to write to your representatives in Congress. AOPA makes this SO EASY. It will take you less than 5 minutes to do it and can have a profound impact on our profession and O&P patient care. Use the link below to simply enter your information on the AOPA votes platform, personalize the letter as you see fit – it’s important to tell YOUR story – and click send.
In addition to asking your Senators to sponsor the Medicare O&P Patient-Centered Care Act, please also take a few minutes to reach out to your Representative following the same steps and ask them to support H.R. 1990 if they aren’t already.
As you use the AOPA votes platform to send letters to your Senators and Representatives, be sure to use the automated Twitter campaign. Every Member of Congress has a Twitter account making it a great way to ask for their support.
Doing these three things will take just a few minutes and will go a long way in securing passage of this legislation. If Members of Congress do not hear from you, they will not know how important this legislation is to your businesses and more importantly, your patients.