On August 6, the Senate introduced the Medicare O&P Patient-Centered Care Act (S. 4503). This bipartisan legislation would improve access to, and quality of, orthotic and prosthetic care while simultaneously combatting fraud and abuse. The Senate bill is identical to the one introduced in the House late last year (H.R. 5262). The American Orthotic and Prosthetic Association (AOPA) thanks YOU for all your efforts to get this vital legislation introduced in both the House and Senate!
A high priority for AOPA, this bill would:
- Restore congressional intent by revising the overly expansive regulatory interpretation of the meaning of “off-the-shelf” (OTS) orthotics to clarify that competitive bidding may only apply to orthoses that require minimal self-adjustment by patients themselves, not the patient’s caregiver or a supplier.
- Distinguish the clinical, service-oriented nature in which O&P is provided from the commodity-based nature of the durable medical equipment (DME) benefit. Orthotics and prosthetics care include a patient care component that is decidedly more in-depth and personal than simply supplying DME. Most orthotic and prosthetic devices are custom fabricated or custom fit and require the expertise of an orthotist or prosthetist who receive Master of Science degrees and residence training before becoming certified practitioners.
- Reduce the likelihood of waste, fraud, and abuse in the Medicare program by prohibiting the practice of “drop shipping” (shipping an orthoses or prostheses to a beneficiary without first receiving direct patient care from a trained, certified or licensed health care practitioner) of orthotic braces that are not truly “off-the-shelf” (i.e., subject to minimal self-adjustment by the patient him- or herself).
Visit AOPAvotes to request that your lawmakers co-sponsor the bill.
Advocating for our members and promoting the value of the O&P profession to legislators and policymakers is an important priority for AOPA. To do this, we address legislative and regulatory issues that affect all aspects of the industry, as well as patients. We also strive to keep our members informed about Washington’s legislative and regulatory activities through AOPAvotes and our twice-weekly SmartBrief updates.