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CMS and VA Announce Partnership to Strengthen Prevention of Waste, Fraud, and Abuse Efforts

On January 23, 2018, the Centers for Medicare and Medicaid Services (CMS) and the US Department of Veterans Affairs (VA) announced a new partnership in which they will share data, data analytics and best practices in an effort to improve both agencies efforts to combat waste, fraud, and abuse in their respective healthcare delivery systems. […]

OIG Work Plan Targets OTS Spinal and OTS Knee Orthoses

As part of its update to its 2018 work plan, the Department of Health and Human Services Office of Inspector General (OIG) announced that, based on abnormally high utilization and unusually high improper payment rates, two off the shelf (OTS) HCPCS codes that describe lumbar sacral orthoses (L0648 and L0650) and one OTS knee orthosis […]

CMS Issues Temporary “K” Code to Describe Direct Milled, Custom Fabricated Diabetic Inserts

On January 11, 2018, as part of its quarterly HCPCS update, the Centers for Medicare and Medicaid Services (CMS) issued a new HCPCS code to describe direct milled, custom fabricated diabetic inserts.  The new code is effective April 1, 2018 reads as follows: K0903–For Diabetics Only, Multiple Density Insert, Made By Direct Carving With CAM […]

CMS Finalizes Revised DMEPOS Quality Standards

On January 9, 2018, CMS published its final changes to the DMEPOS Quality Standards, specifically the standards that address the definition of the term “molded to patient model” as it relates to the provision of custom fabricated diabetic inserts. CMS made only one small change to the definitions it included in its November 2, 2017 […]

CMS Releases the 2018 Medicare DMEPOS Fee Schedule

The Centers for Medicare and Medicaid Services (CMS) has released the 2018 Medicare DMEPOS fee schedule which will be effective for Medicare claims with a date of service on or after January 1, 2018.  The 2018 Medicare fee schedule for orthotic and prosthetic services will be increased by 1.1% over 2017 rates. The 1.1% increase […]

AOPA Submits Comments and Publishes Ad on Proposed Rule That Would Limit a Veteran’s Right to Choose Their Orthotic and Prosthetic Provider

The October 16, 2017 Federal Register included a proposed rule published by the Department of Veterans Affairs (VA) that intends to “reorganize and update the current regulations related to prosthetic and rehabilitative items, primarily to clarify eligibility for prosthetic and other rehabilitative items and services, and to define the types of items and services available to eligible […]

AOPA Submits Comments on CMS Proposed Change to the DMEPOS Quality Standards

On December 11, 2017, AOPA submitted formal comments on CMS’ proposed change to the DMEPOS Quality Standards that would expand the definition of the term “molded to patient model” to include custom fabricated diabetic inserts that are fabricated using a virtual or digital model of the patient’s foot and a direct milling process.  Earlier this […]

AOPA Submits Comments on the CMS Proposed Rule That Would Provide States with Additional Flexibility in Defining Essential Health Benefits

On November 2, 2017, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule in the Federal Register entitled “Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2019.”  Among the provisions in the proposed rule is a section that would provide individual states with increased flexibility in […]

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