The Medicare O&P Improvements Act of 2017 (S.1191 and H.R. 2599) was introduced in May 2017. This bill, among other things, would separate O&P from DME, and allow orthotist’s and prosthetist’s notes to be part of the medical record for determining medical necessity. Visit www.AOPAvotes.org to request that your lawmakers co-sponsor the bill.
This bill would address these issues:
- Curbing overzealous audits
- Denying payments to unlicensed/unqualified providers
- Recognizing orthotists’ and prosthetists’ notes by stating that they “shall be considered part of the medical record”
- Separating orthotics and prosthetics from durable medical equipment
- Resolve the illegal delays for appealing denied claims to the Administrative Law Judge (ALJ), by adjustments to the recoupment policy
- Offering voluntary negotiation process to provide a prompt equitable settlement such as made available to hospitals
- Requiring CMS to separate appeals process data so O&P claim outcomes are tracked and reported separately from other DME claims
- Mandating CMS to adhere to the statutory definition of off the shelf orthotics eligible for competitive bidding as only being those needing “minimal self adjustment” by the patient, and no other person.
Please ask your member of congress to support these important bills. Sample letters are available at www.AOPAvotes.org
Advocating for our members and promoting the value of the O&P profession to legislators and policymakers is an important priority for AOPA. To do this, we address legislative and regulatory issues that affect all aspects of the industry, as well as patients. We also strive to keep our members informed about Washington’s legislative and regulatory activities through AOPAvotes and our twice-weekly SmartBrief updates.