Looking Out for Your Interests

“Policy and Your Practice” is designed to show you how different types of legislative policies—laws passed by Congress, Medicare regulations, tax laws and employee regulations, to just give a few examples—directly affect your practice. AOPA is committed to working on your behalf to give lawmakers the information they need to make legislation that is fair for you and your patients.

But policymaking can be so slow that it’s hard to see progress. With that in mind, we’ve compiled an overview of recent policy efforts. Here are some of the ways we have been working for you over the past year.

Increased lobbying efforts
AOPA recently retained lobbying firm Alston & Bird to help with lobbying efforts. With them, and in concert with the O&P Alliance, AOPA has met with a number of different congressional leaders to support O&P’s legislative agenda.

For instance, at the National Assembly, AOPA Executive Director Tom Fise and several contributors to AOPA’s PAC met with Congresswoman Shelley Berkley, D-Nev. As a member of the House Ways and Means Committee, as well as the Veterans Affairs Health Subcommittee, Berkley sponsors legislation important to O&P and is in a position to influence proposed bills and their funding. As a follow-up, Fise and others met with Berkley’s Washington staff to explore how the congresswoman could support O&P’s legislative agenda.
Senator Ken Salazar, D-Colo., is a member of the Senate Committee on Finance, which has jurisdiction over Medicare and Medicaid. In a recent visit, AOPA spelled out for his staff the role O&P professionals play in helping Medicare beneficiaries have full and active lives, and also addressed concerns about quality patient care and fraud and abuse issues in O&P.

Likewise, Executive Director Tom Fise briefed Senator Bill Nelson’s, D-Fl., staff recently. He spoke about the Florida fraud and abuse investigation undertaken by Medicare and the FBI, highlighting how enforcing Florida’s law prohibiting Medicare reimbursement to unlicensed providers could prevent abuse. Enforcing existing “qualified provider” statutes is one of AOPA’s key priorities as determined by its members.

Getting Medicare’s ear
AOPA’s government relations department consistently works to provide input to Medicare. In the past few months, there has been encouraging progress.

For instance, in response to AOPA’s request, CMS has decided to revise its policy on the coverage status of code L 5990 (addition to lower-extremity prosthesis, user-adjustable heel height).

Earlier this year, AOPA participated in the creation of some Medically Unnecessary Edits (MUEs) for CMS, ensuring that O&P practitioners’ claims for necessary procedures would not be automatically denied. CMS and its contractor reviewing the MUE list appreciated AOPA’s work enough that it asked for input on the next phase of proposed MUEs.

AOPA is continuing to provide input to official coding requests from CMS and others. For instance, SADMERC is working on revamping many L codes for CMS. Since prosthetic feet will be one of the first areas to be re-coded by SADMERC, it decided to address that subject first and brought together a number of foot manufacturers in order to generate a list of recommendations.

AOPA and the O&P Alliance are also working hard in hopes of refining Medicare’s reimbursement system to reflect the complexity of patient needs and the qualifications of the provider.

AOPA’s senior director of government affairs, Kathy Dodson, chaired a working group within the O&P Alliance, which updated definitions of categories such as “custom fabricated” and “off-the-shelf.” The group also revised the existing code categorization document, which assigns each O&P base L code to a category. The lobbying firm, Alston & Bird, now has this information in hopes that it will be able to be implemented as possible Medicare legislation is considered in the future.

Increasing O&P’s strength
Finally, AOPA is working for O&P by increasing the strength of its PAC and of Capitol Connection.

The O&P PAC is the only political action committee working to ensure O&P receives fair treatment on Capitol Hill. Capitol Connection is a fund that supports legislative and regulatory initiatives for better O&P care. At the recent National Assembly, fundraising efforts raised well over $30,000 for the two of them.

O&P needs your voice
Will you help? All of these efforts cannot survive without your input and your support. Visit www.AOPA
net.org and click on “Government Relations” to learn more, or contact Daniel Gurley at (571) 431-0876, ext. 212 or dgurley@AOPAnet.org.