CMS Withdraws BIPA 427 Proposed Rule


On October 3, 2017, the Centers for Medicare and Medicaid Services announced that it has withdrawn the proposed rule that represented the first step in creating regulations that would implement the qualified provider provisions for prostheses and custom fabricated orthoses legislated in section 427 of the Benefits Improvement and Protection Act of 2000 (BIPA).  The notice of withdrawal will be officially published in the October 4, 2017 Federal Register.

According to the notice published by CMS the proposed rule is being withdrawn due to “the cost and time burdens that the proposed rule would create for many providers and suppliers, particularly the cost and burden for those providers and suppliers that are small businesses, and the complexity of the issues raised in the detailed public comments.”  CMS indicated that they received over 5,000 public comments regarding the proposed rule.

AOPA is disappointed that CMS decided to withdraw the proposed rule that would finally create regulations to implement a law that was passed more than 17 years ago.  The withdrawal of the proposed rule once again exposes the Medicare population to no regulation regarding what qualifications are required to provide custom orthotic and prosthetic services.  While the proposed rule was far from perfect, as AOPA expressed in its public comments that were submitted to CMS, AOPA believed that issues that were of significant concern to several provider groups, who viewed the proposed rule as a threat to their ability to continue to provide services within their scope of practice, could have been addressed through changes to the final rule rather than through the complete withdrawal of the proposed rule.

The combination of the recent administration change, including the new administration’s philosophy to reduce overall regulatory burden on businesses, the significant opposition from several high profile provider groups, and the restrictive language that would significantly limit certain providers from continuing to provided custom orthoses and prostheses appear to have led directly to the demise and subsequent withdrawal of the proposed rule.

AOPA will continue to make every effort to ensure that all recipients of O&P care receive that care from folks who have been properly educated and trained in the fabrication, fit, and delivery of orthotic and prosthetic devices.

View the CMS notice.