Breaking News: DME MACs Issue Draft Policy Revision for Lower Limb Prostheses


The four DME MACs have just released a Draft Local Coverage Determination (LCD) and Policy Article that, when finalized, will govern Medicare coverage of Lower Limb Prostheses. The draft policy contains significant revisions from the existing Lower Limb Prosthesis medical policy and AOPA is working diligently to review the draft policy and provide a detailed analysis of the proposed policy revision to you as soon as possible.

Public comments regarding the Draft LCD and Policy Article will be accepted through August 31, 2015. AOPA will be providing detailed comments regarding the draft policy and encourage our members to do the same but we also welcome and encourage any feedback you would like to provide directly to AOPA that we can utilize in preparing our comments and making sure that they reflect all key concerns from our members. A comment portal has been established that will provide you with the opportunity to provide any comments and/or concerns that you may have regarding the draft Lower Limb Prosthesis policy. All comments will be reviewed and considered for inclusion in AOPA’s comments on this issue and may be submitted by clicking on https://aopa.wufoo.com/forms/comment-on-draft-policy-for-lower-limb-prostheses/.

This issue will clearly be a priority for your AOPA Executive Committee, Board of Directors, as well as the AOPA Coding and Reimbursement Committee which will meet on August 3. We expect that other O&P Alliance organizations and O&P patients will likely have substantial interests and concerns as well. A copy of the Draft LCD and Policy Article for Lower Limb Prostheses may be accessed at http://www.medicarenhic.com/viewdoc.aspx?id=3109.

AOPA considers this policy revision, some aspects of which appear to be incompatible with quality patient care, as a major priority and will be communicating with its members frequently over the next several weeks regarding the potential impact this policy revision may have on the provision of lower limb prostheses to Medicare beneficiaries. We will be back in touch with you on this soon.

Any questions regarding this notice can be directed to Joe McTernan at (571) 431-0811 or JMcTernan@AOPAnet.org.