Month: April 2017

On April 27, AOPA met with several key members of the HHS Leadership team to discuss issues important to O&P. In attendance were HHS and CMS officials John Brooks, J.D., Counselor to HHS Secretary on Medicare, Policy Advisor Amanda Street and several AOPA key leaders, including AOPA President Michael Oros, CPO, FAAOP; AOPA Executive Director Tom Fise, JD; AOPA President-Elect James Weber, MBA; Scott Schneider; AOPA lobbyists Michael Park and Stephanie Kennan; and Peter Thomas, JD, counsel to the O&P Alliance. The meeting provided an opportunity for AOPA to brief key health-care administrators on the full range of issues facing orthotics, prosthetics, and pedorthics providers and their patients.

The agenda focused on top concerns as well as activities and solutions that AOPA believes can help achieve better outcomes for patients and deliver economic benefits for Medicare. Foremost among the roughly 10 topics on the agenda were the following:

1. Recognizing the prosthetist’s/orthotist’s notes as a legitimate part of the medical record;
2. Enacting the Medicare O&P Improvement Act;
3. Finalizing long-awaited proposed regulations on qualified providers under Section 427 of the Benefit Improvement and Protection Act; and
4. Dropping the July 2015 proposed revisions to the prosthetic lower-extremity Local Coverage of Determination (LCD).

The April meeting served as a productive first step in communicating the positions of AOPA members to the new administration. Future meetings and communications will build on this initial meeting and set the stage for relations over the next four years. Read the agenda and briefing. AOPA will keep members informed of any developments.

In December 2016 the Academy, on behalf of the O&P Alliance, sought your assistance in responding to a request from the Agency for Healthcare Research and Quality (AHRQ) Call for Comments on key questions related to Lower Limb Prosthesis. The Academy, in conjunction with the O&P Alliance, submitted a detailed formal response to that request.*

Based on feedback from the December 20, 2016 request the key questions (and study eligibility criteria) were revised to improve clarity, focus the topics more closely with the sponsor’s needs, and to evaluate measures and outcomes of interest to stakeholders.

We have now been contacted by the Effective Health Care (EHC) Program at (AHRQ) to submit comments on the development of an evidence review on Error Rate Reduction Regarding Lower Limb Prosthesis based on these revised key questions.

The protocol for the evidence review on Error Rate Reduction Regarding Lower Limb Prosthesis has been posted and a submission portal for the voluntary submission of scientific information packets is active.

The Academy and AOPA encourage the submission of protocol improvements as well as the scientific information packets that are being requested. Your submission will help communicate the important points that need to be included in the evidence review.

Your participation as researchers in the O&P profession is valued and is an integral part of our efforts. While both the Academy and AOPA are committed to providing detailed, formal responses, the contributions of individual practitioners and researchers is important to offer a complete view of the issues at hand.

The turn-around time for submissions is tight. The deadline for submission is April 28, 2017 at 11:59 pm EDT.

*If you would like to read the AOPA response click here.

On March 30, AOPA submitted comments on two recently announced Connecticut Medicaid policies.  The proposed changes include the elimination of some L-Codes from the Connecticut Medicaid fee schedule due to lack of utilization, as well as a 10% reduction in the fee schedule for several custom fitted or custom fabricated orthosis HCPCS codes.

One proposed reimbursement change that is of particular concern is a 40% reduction in Connecticut Medicaid reimbursement for cranial remolding orthoses described by HCPCS code S1040.  The notice from Connecticut Medicaid states that the 40% reduction is to “ensure consistency with reimbursement rates of other states and to contain costs.”  In addition to the proposed 40% reduction in reimbursement for cranial remolding orthoses, there are also proposed changes to the prior authorization process for cranial remolding orthoses that may lead to unnecessary and inappropriate delays in the provision of quality care.

AOPA submitted comments on the March 30^th deadline and provided a letter that 73 AOPA members in Connecticut plus supplier members submitted through the AOPAVotes website. Read AOPA’s comments.

If you have any questions, please contact Joe McTernan at jmcternan@AOPAnet.org or 571/431-0811.