The National Association for the Advancement of Orthotics & Prosthetics (NAAOP) has released its latest webcast in which general counsel Peter Thomas, JD, comments on the federal budget proposals for fiscal year 2020, which will be released late due to the federal government shutdown. When the proposals are made public, NAAOP will report on their potential impact on access to O&P care, Thomas said.
In the interim, NAAOP will continue to work with the American Orthotic & Prosthetic Association and members of the O&P Alliance regarding off-the-shelf (OTS) orthotics and other priorities in the Medicare O&P Improvement Act, he said. Thomas said the 2018 provision recognizing the value of the O&P practitioners’ clinical notes as part of the patient’s medical record for determining medical necessity was a significant victory with many positive implications. “It was a real shot in the arm for the O&P field,” he said in the webcast.
Efforts were also expended to pass a provision redefining and limiting the scope of OTS orthotics subject to possible competitive bidding in the future, but this legislation was not completed before the 115th Congress adjourned. Late in the session, the Congressional Budget Office “surprised everyone” by claiming that the cost of the bill would have to be offset by a 35 percent reimbursement cut to over 50 orthotic codes, which was a non-starter, Thomas said. The bill was pulled from House floor consideration hours before it was scheduled for a vote.
As part of its legislative strategy for the 116th Congress, Thomas said NAAOP intends to reframe the O&P Medicare Improvement Act to focus on patient protection, streamline the bill, focus on those provisions that developed traction in the previous congress, and eliminate the most complex aspects of the 2018 version. NAAOP is also discussing new provisions that will recast the bill in a manner that it hopes will create positive attention from Congress and the current administration.
The legislation is important now that the Centers for Medicare & Medicaid Services has announced its intention to subject 24 knee and back orthoses to competitive bidding in the next round of that program, Thomas said. NAAOP and the O&P Alliance believes that 22 out of the 24 codes at issue are custom-fit orthoses, not OTS, and are pushing back hard against this proposal, he said.
The latest webcast is posted on the NAAOP website.