Announcement – Spinal Bracing RFP Re-opening AOPA, under the auspices of its Orthotics 2020 program, circulated a request for proposals early in 2018 relating to 5 subject areas for original orthotic papers, with the original deadline for receipt of applications by April 30, 2018. Proposals have been received in all five of those categories. This […]
On July 11, 2018, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule that proposes several changes to the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) competitive bidding program. In addition to the proposed changes to the competitive bidding program, the proposed rule also solicits comments regarding ways to improve […]
Last week AOPA reported that the report of the Inter Agency Workgroup that was formed to provide a consensus statement to inform Medicare coverage of lower limb prostheses had been published. As part of the consensus statement, the Inter Agency Workgroup recommended, and CMS concurred, that the draft LCD and Policy Article for Lower Limb […]
In 2016 the Center for Medicare & Medicaid Services (CMS) convened the Lower Limb Prostheses Interagency Workgroup in response to the comments received in regard to the 2015 Draft Local Coverage Determination (LCD) for Lower Limb Prostheses. The Workgroup’s purpose was to “develop a consensus statement that informs Medicare policy by reviewing the available clinical […]
AOPA and its lobbying team have been pressing CMS from all levels, most recently, including consultation with Trump Administration officials at the Office of Management and Budget, to formally implement the provisions of Section 50402 of the Bipartisan Budget Act of 2018 (Public Law 115-123) as it related to the prosthetist’s and orthotist’s clinical notes. […]
Recently, each of the four DME MAC contractors has published a revised version of the Dear Physician letter regarding artificial limbs. The revised version of the letter states that the Dear Physician letter is being retired due to pending guidance from the Centers for Medicare and Medicaid Services (CMS) on potential program changes that may […]
Earlier this week, AOPA provided a summary on the first report of results of Target, Probe, and Educate (TPE) audits by Noridian Healthcare Solutions, the Jurisdiction D DME MAC contractor. Since AOPA’s initial report which was limited to TPE results for “walking boot” orthoses, Noridian has published additional results for knee orthoses, spinal orthoses, and […]
Noridian Healthcare Solutions, who serves as the Jurisdiction A and Jurisdiction D Durable Medical Equipment Medicare Administrative Contractor, has released results for its initial audits under the Target, Probe, and Educate (TPE) program in Jurisdiction D. The published results are only for four HCPCS codes selected for the TPE program: L4360, L4361, L4386, and L4387, […]
As was stated in our notice last week, AOPA greatly applauds CMS for finally releasing the Proposed Regulation under BIPA 427. The proposal is far from perfect. That, coupled with: (a) the start of the new Trump Administration and the prospect that the Administration could easily view the Proposed regulations unfavorably as an effort to […]
In 2014, the American Hospital Association filed suit in the federal District Court seeking relief because HHS and the Office of Medicare Hearings and Appeals (OMHA) have for many years egregiously exceeded the statutory provision which assures a provider who must return money to Medicare as a result of an audit a final ALJ decision […]
