Month: May 2020

We hope this note finds you and your loved ones safe and well. We are reaching out today with an announcement about the 2020 National Assembly. Due to the ongoing COVID-19 pandemic, the American Orthotic and Prosthetic Association (AOPA) has decided that the in-person 2020 National Assembly that was scheduled to take place September 9-12 at Mandalay Bay Resort & Casino in Las Vegas has will instead be delivered virtually on the same dates.

This was not an easy decision, but ultimately the health and safety of our attendees, exhibitors, speakers, and staff were our top priority.

AOPA is very excited about the opportunities that a Virtual National Assembly offers, rest assured that it will be full of the same great content and networking opportunities that were planned had we been face-to-face. AOPA intends to channel the energy expended thus far by the Planning Committee into a remote learning and engaging event with continuing education credits for the highest level of O&P clinical, business, and technical education. AOPA stands committed to serving its members and the extended O&P community by providing access to quality education while saving costs – dollars on travel, lodging, and entertainment.  

In the coming weeks, we will be reaching out with specific communication to exhibitors, speakers, and attendees to share relevant information.

Thank you for your support during these unprecedented times. As we prepare for the first-ever Virtual National Assembly, we hope you and your loved ones remain safe and well. We look forward to seeing you online in September.

If you have questions please contact Tina Carlson at tcarlson@aopanet.org

The COVID-19 pandemic has led to an increasing reliance on telehealth and other virtual forms of patient interaction. However, under the current billing structure, orthotists and prosthetists are unable to submit claims for certain Medicare services despite being considered essential providers. Key members of Congress are currently circulating a letter to be sent to Secretary of Health and Human Services Alex Azar and Administrator of the Centers for Medicare and Medicaid Services Seema Verma urging them to reconsider this policy during the COVID-19 Public Health Emergency (PHE). We urge you to write your legislators and ask them to sign on to this letter.

During the pandemic, orthotists and prosthetists have relied on telehealth as a valuable mechanism for providing care to patients to address issues such as skin breakdowns, ensuring safe use of the prosthesis and/or orthosis, and assisting beneficiaries with adjustments to their wearing schedules. While our profession is able to provide a wide range of direct clinical care via telehealth there is currently no reimbursement for non-repair services provided to these patients after 90 days from the date of delivery. The congressional letter seeks a temporary solution to this issue.  

We’d love to have your legislators join this letter – please visit our AOPA Votes page to get started. The process will take just a few minutes but can make a big difference. Thank you for your advocacy efforts!

Questions? Contact AOPA’s Director of Government Affairs Justin Beland at jbeland@AOPAnet.org.  

AOPA staff recently participated in educational webinars presented by the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) and on DME MAC provider advisory councils during which they  confirmed that physicians, including MDs and DOs that are certifying the medical need for diabetic shoes may utilize telehealth to fulfill face-to-face encounter requirements during the COVID-19 Public Health Emergency (PHE). 

On April 6, 2020 the Centers for Medicare and Medicaid Services (CMS) released an Interim Final Rule with Comment Period (IFC) that indicated for claims with dates of service on or after March 1, 2020, policy based “requirements for face-to-face or in-person encounter for evaluations, assessments, certifications or other implied face-to-face services would not apply during the COVID-19 PHE.”

Additional guidance was provided on the IFC by the DME MACs on May 7, 2020 in a joint educational article.  The DME MAC article indicated that while the IFC provided significant relief from policy-based face-to-face visit requirements, a subsequent CMS IFC that was issued on May 8, 2020 reiterated the statutory requirement to establish and document the medical necessity for Medicare covered services.  The DME MAC article indicated that Medicare approved, physician-based telehealth visits, including those that meet the relaxed telehealth rules in effect during the COVID-19 PHE, will be considered compliant for purposes of establishing and documenting the medical necessity of Medicare covered services.  Telehealth based physician encounters will also meet any face-to-face visit requirements that are incorporated into existing Medicare policies. 

The DME MAC joint article indicated that the IFC based waiver of face-to-face encounter requirements only applies to policy-based requirements and therefore does not apply to face-to-face encounter requirements that are memorialized elsewhere, specifically those that are part of the DMEPOS Quality Standards or Social Security Act.  This led to significant questions, especially related to Medicare coverage of therapeutic shoes which require in-person visits with the certifying physician and the supplier of the shoes.  While the IFC allows certifying physicians to use telehealth encounters to certify the medical necessity of diabetic shoes, suppliers of diabetic shoes, including orthotists, prosthetists, and pedorthists will still be required to perform an in-person evaluation at the time of shoe selection and an in-person fitting of the shoes at delivery as these are addressed in Appendix C of the DMEPOS Quality Standards.

Access the DME MAC guidance article on the CMS IFC.

Questions regarding this issue may be directed to Joe McTernan at jmcternan@AOPAnet.org or Devon Bernard at dbernard@AOPAnet.org.

For more on telehealth join AOPA next Tuesday, May 19 from 3:30 to 4:45pm ET as we will hold our second Townhall, Operating During the Pandemic: Telehealth and Continuum of Care.