In the April 20, 2017 AOPA in Advance: SmartBrief newsletter, AOPA announced that Performant Recovery, the contractor who serves as the national recovery audit contractor (RAC) for all Medicare DMEPOS, Hospice and Home Health services, had announced that it would begin performing an automated review on claims involving HCPCS code L5845 billed in conjunction with specific […]
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CMS Announces Initial Implementation of Prior Authorization Program-No Prosthetic Codes Included
December 20, 2016 at 11:28 am
On December 19, 2016, the Centers for Medicare and Medicaid Services (CMS) announced the initial implementation of the Medicare prior authorization program that was authorized through the final rule published on December 30, 2015. As expected, CMS has chosen a cautious approach in implementing its prior authorization program. The initial list of codes subject to […]
AOPA Announces Free Prior Authorization Webinar for Members
February 2, 2016 at 3:58 pm
CMS will be implementing Prior Authorization February 29, 2016 for certain DMEPOS items that included lower limb prosthesis. What does this mean for YOU? AOPA is pleased to present the beginning of our educational efforts related to Prior Authorization. Please join AOPA for an AOPA Member Exclusive introductory webinar on Prior Authorization, with 2 dates […]
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 […]
AOPA and O&P Alliance Meets with CMS Deputy Administrator Dr. Shantanu Agrawal
June 16, 2015 at 10:25 am
On June 3, the O&P Alliance, including AOPA’s President Charles Dankmeyer, and Executive Director Tom Fise, JD, met with the Deputy Administrator and Director of the Center for Program Integrity at CMS. The meeting included several topics: local coverage determination (LCD) recognition of O&P clinicians’ notes as part of the medical record; who can bill […]
AOPA & Congress Team up to Hold HHS to Task
May 21, 2015 at 9:12 am
Below is the text of an email AOPA Executive Director, Tom Fise, JD, sent to AOPA’s Board of Directors and allied organizations announcing the success of the sign-on letter that obtained the wide support of members of Congress responding to the full court press from AOPA members and the other O&P organizations. “I am pleased […]
2015 Medicare DMEPOS Fee Schedule Released
December 1, 2014 at 10:45 am
The Centers for Medicare and Medicaid Services (CMS) has released the 2015 Medicare DMEPOS fee schedule, effective for claims with a date of service on or after January 1, 2015. The net Medicare fee increase for O&P services for 2015 is 1.5%. This is based on a 2.1% increase in the consumer pricing index for […]
CMS Issues Final Rule on OTS Orthotics
November 4, 2014 at 8:25 am
CMS Reverses Fields, Scuttles Current Process for Redefining Orthotics, and for Limiting Scope of Practice for Certified Orthotic Fitters Late on Friday afternoon, October 31, CMS released the massive final rule covering end stage renal disease payments and a host of other topics, including its proposal to further amend the regulatory definition of “minimal self-adjustment,” […]
Two Leading Senators Write CMS to Support AOPA View, and Insist That CMS Observe Narrower View of “Minimal Self-Adjustment” in OTS Orthotics
October 20, 2014 at 11:14 am
Read the important letter to CMS Administrator Tavenner from Senators Chuck Grassley (R-IA) and Tom Harkin (D-IA). The letter speaks for itself, but its essence is to directly challenge CMS for exceeding the simple and straightforward statutory language “minimal self-adjustment” in defining off-the-shelf orthotics. These leading legislators, both of whom were in the Senate about a decade […]
OTS Regulations
September 2, 2014 at 9:55 am
OTS Orthoses – A New CMS Proposed Rule that could Limit your Patients’ Access to Care and Eliminate Orthotic Fitters CMS released a proposed rule on July 11 that addresses Off-the-shelf Orthoses and the definition of Minimal Self-Adjustment. In an effort to define the scope of individuals authorized to fit orthotic devices deemed by CMS […]