STUDY: HIGHER STANDARD OF CARE FOR PATIENTS WITH LIMB LOSS OR SPINAL INJURIES SAVES MEDICARE MONEY IN MOST CASES Even Though Devices Are Often Costly, Long-Term Bill for Taxpayers Ends Up Lower Or Only Slightly Higher; Win, Win: Findings Indicate Patients Also Benefit from Higher Quality of Life and Increased Independence. Click here to […]
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Prior Authorization
Prior Authorization: O&P Was A Serious Player Although CMS may have thrown us a curve when they published their proposal to require 89 lower limb prosthetic codes be subject to prior authorization on May 28, 2014, it became clear that in its proposed form, the rule would do more harm than good. AOPA’s Board authorized […]
AOPA Statement on Combating Fraud, Waste, and Abuse in the Medicare Program
April 30th, 2014 — The American Orthotic and Prosthetic Association (AOPA) is pleased to provide this statement, which was delivered to the House Ways & Means Subcommittee today, concerning Medicare fraud and the delivery of care to Medicare beneficiaries who have suffered a loss of a limb or impaired use of a limb or the spine. […]
Next Medicare Open Door Forum to Discuss the CMS Proposed Physician Documentation Template Scheduled for June 13, 2013
The Centers for Medicare and Medicaid Services has announced that the second of several Open Door Forums to discuss the proposed physician documentation template for O&P services will be held on Thursday, June 13, 2013 from 4pm-5pm EDT. AOPA encourages all of its members to participate on this call and provide feedback to CMS regarding […]
CMS Publishes Draft Clinical Template Designed to Assist Physicians to Properly Document Medical Need for Lower Limb Prostheses
The Centers for Medicare and Medicaid Services (CMS) has published a draft document on its website that, in its words, “will assist physicians with documenting the physician notes that substantiate the need for a Lower Limb Prostheses.” AOPA believes that the draft template, in its proposed form, actually represents imposition by CMS of a serious […]
American Orthotic & Prosthetic Association Files Lawsuit Against Medicare Arising from Unfair Medicare RAC/Pre-payment Audits, Where No Fraud Exists, and Challenges Unlawful Changes to Medicare Standard for Care of Medicare Amputees
Alexandria, VA – May 13, 2014 Today, the American Orthotic and Prosthetic Association (AOPA) filed suit against HHS/Medicare in the Federal District Court for the District of Columbia, seeking relief from the unfair and unauthorized actions of the Center for Medicare and Medicaid Services, primarily via actions of its RAC auditors and DME MACs relating […]
CMS Reverses Its Position on Replacement of a Prosthesis Without a New Prescription
On April 24, 2013, CMS announced that Medlearn Matters Article SE1213 had been revised to remove a statement that indicated that a prosthesis could be replaced without a new order from a physician as long as there was no upgrade from the previously ordered prosthesis. This statement was originally added to Medlearn Matters Article SE1213 […]
AOPA Letter to Tavenner and Sebelius Further Challenges “Dear Physician” Letter
AOPA’s counsel on CMS matters, Tom Mills of the law firm Winston and Strawn, has issued a second letter to HHS Secretary Sebelius and CMS Acting Administrator Tavenner again seeking withdrawal of the “Dear Physician Letter” which unleashed the horrendous increase in RAC and other audits as well as burdensome prepayment reviews. All of these […]
Reminder: PECOS Edits for Referring/Ordering Physicians Scheduled for Implementation on May 1, 2013
The Centers for Medicare and Medicaid Services (CMS) has announced that it will implement Phase 2 of the PECOS referring/ordering physician edits for claims submitted on or after May 1, 2013. What this means is that claims for services ordered by a physician or other eligible provider who does not have an active enrollment […]
Policy Forum Makes Big Impact on Raising Congressional Concerns over RAC Audits
AOPA Executive Director, Tom Fise, brought the Board of Directors up to date in a recent email on how AOPA members attending the Policy Forum took the lead in urging their legislators in the House of Representatives to sign-on to the letter Rep. Tammy Duckworth and Rep Brett Guthrie will send to HHS Secretary Sebelius. […]