Month: July 2017

This afternoon, the full House of Representatives acted by consent on suspension to adopt H.R. 3178, a bill to cut red tape and make some non-controversial changes to the Medicare program. Included in this bill was a single provision on O&P– the long-awaited provision to recognize the orthotist-prosthetist’s notes as part of the medical record in Medicare Medical Necessity Determinations. Here is the specific text as enacted by the House:

1 SEC. 103. ORTHOTIST’S AND PROSTHETIST’S CLINICAL NOTES AS PART OF THE PATIENT’S MEDICAL RECORD.

Section 1834(h) of the Social Security Act (42 U.S.C. 1395m(h)) is amended by adding at the end the following new paragraph:

”(5) DOCUMENTATION CREATED BY ORTHOTISTS AND PROSTHETISTS.- For purposes of determining the reasonableness and medical necessity of orthotics and prosthetics, documentation created by an orthotist or prosthetist shall be considered part of the individual’s medical record to support documentation created by eligible professionals described in section 1848(k)(3)(B).”

AOPA wants to recognize and thank Reps. Mike Bishop (R-MI and a Ways & Means member), Glenn Thompson (R-PA) who advanced the similar provision as part of the broader Medicare O&P Improvement Act, H.R. 2599, and Mike Thompson (D-CA and a Ways & Means Committee Member), and both House Ways & Means Committee Chairman Kevin Brady (R-TX) and Richard Neal (D-MA and the Ranking Minority Member of the Ways & Means Committee), for their strong support which resulted in this important action. Now it is on to the Senate, where S. 1191, the Grassley-Warner bill, supported by Senators Cassidy (R-LA) and Duckworth (D-IL) will hopefully move forward similarly to favorable action.

AOPA will keep you updated on any developments.

In conjunction with our continuing efforts to advance the provisions of H.R. 2599/ S.1191, the Medicare Orthotics & Prosthetics Improvement Act, we are pleased to advise you that the provision which would assure that the prosthetist/orthotist patient notes are included as part of the official Medicare medical record for purposes of medical necessity determinations has been picked up in a larger bill, H.R. 3178, which has been approved and recommended by vote of the House Ways and Means Committee on Thursday, July 13, to the entire House for favorable action.

Clearly, if the expected approval by the entire House ensues, a similar action by the entire Senate would be required before the measure would go to the President for signature. There has been strong interest in the Senate Finance Committee in enacting S.1191 in its entirety, hopefully later this year. Thursday’s action by the Ways and Means Committee, linked below, is very encouraging, and we both appreciate the strong support AOPA members and their patients have voiced for H.R. 2599/ S.1191; AOPA will keep you informed of additional steps toward enactment.

Click here for the overall approval synopsis.