News

CMS Issues Final Rule on Medicare Prior Authorization for Certain DMEPOS Including Most Lower Limb Prostheses

December 30, 2015 at 2:32 pm

On December 29th, the Centers for Medicare and Medicaid Services (CMS) released the long anticipated final rule regarding Medicare prior authorization of certain DMEPOS, including most lower limb prostheses. The final rule, which will be published in the December 30, 2015 Federal Register, will be implemented 60 days after it publication. AOPA has reviewed the […]

Congress Close to a Deal on Funding of the Federal Government; Modest Potential Impact on O&P and Suspension of Medical Device Excise Tax for Non-O&P in Play

December 17, 2015 at 12:28 pm

On Wednesday, December 16th, President Obama signed a short term spending measure that will allow the Federal government to continue to operate until December 22, allowing Congress to finalize its long anticipated Omnibus appropriations and tax break extender legislation that will fund the Federal government for the remainder of the 2016 fiscal year. Two important […]

PDAC Announces Coding Verification Review for Ankle Gauntlets

December 9, 2015 at 9:05 am

The Pricing, Data Analysis and Coding contractor (PDAC) has announced that due to a change in the 2016 descriptor verbiage for L1902 and L1904, it will initiate a new coding verification for any ankle gauntlet style devices that contain joints that are currently listed on the PDAC site under L2999. Read the announcement. It is […]

2016 Medicare DMEPOS Fee Schedule Released

November 30, 2015 at 10:08 am

On November 23, 2015, the Centers for Medicare and Medicaid Services (CMS) released the 2016 Medicare DMEPOS fee schedule. As expected, Medicare fees for orthotic and prosthetic devices will be slightly lower in 2016 than they were in 2015. The annual update to the Medicare O&P fee schedule is based on a combination of the […]

RAC Contractors Have Been Authorized to Re-Start Audit Activity

November 17, 2015 at 10:13 am

It has been remarkably quiet on the Recovery Audit Contractor (RAC) front for the last 18 months or so. As a result of the original RAC contracts coming to an end and new RAC contract proposals being submitted and reviewed, the number of additional documentation requests (ADRs) has been reduced significantly. CMS advised its original […]

2016 HCPCS Codes Released

November 4, 2015 at 1:25 pm

The Centers for Medicare and Medicaid Services (CMS) has released the new HCPCS codes for 2016. There were no L-codes added or deleted for 2016. There were two minor verbiage changes for codes L1902 and L1904, which describe pre-fabricated and custom fabricated ankle gauntlet style devices respectively. Below is a breakdown of the code descriptor […]

Data, Hard Work, and Unified O&P/Amputee Community Response Yield PARTIAL WIN on Troublesome, Draft LCD for Lower Limb Prosthetics

November 2, 2015 at 3:53 pm

The White House just announced that CMS “will not finalize” the July 16, 2015 Draft LCD. That may be clarified further when comparable announcement text from both CMS and from the DME MACs are released and can be analyzed. The White House report appears to confirm the information that AOPA shared at the recent San […]

Obama White House Disappoints With Interim Response to “We the People” Petition on LCD

October 19, 2015 at 8:32 am

AOPA Reacts Over 100,000 people took President Obama at his word when they shared their names, email addresses and trust in/commitment to government, signing on in 17 days to surpass the 100,000 signatures required to prompt direct White House intervention and action on the draft lower prosthetic LCD. Others were skeptical, seeing the We the […]

Lower Limb LCD Policy Updates: What Has Happened after the Comment Period Closed and the August 26 Events

September 22, 2015 at 2:43 pm

AOPA updated you on all the events on the LCD Policy Proposal – the comments we submitted and helped members and patients submit, the rally at HHS, the meetings we had with CMS, the open DME MAC meeting, the PR campaign, etc. But what has happened since the closing of the comments on August 31st? […]

AOPA Submits Comments on LCD Draft Policy

August 31, 2015 at 9:35 am

AOPA submitted comments on the LCD Policy on Friday, August 28. Read the comments here. Researchers Referenced in CMS’ Bibliography in Support of LCD Submitted a Letter Objecting to their Use of their Work. Read their comments here. Today is the last day to submit comments on the policy. You can quickly submit a letter from www.AOPAvotes.org.