Amplitude / blog / amputee to amputee / NAAOP Responds to White House Reply to We the People Petition on the Proposed LCD for Lower Limb Prostheses

NAAOP Responds to White House Reply to We the People Petition on the Proposed LCD for Lower Limb Prostheses

On October 16, the White House issued its initial response to the We the People petition requesting that the president rescind the draft Medicare Local Coverage Determination (LCD) for Lower Limb Prostheses. The following is the response from the National Association for the Advancement of Orthotics and Prosthetics (NAAOP) to the White House’s reply to the petition:

While not a substantive reply to the petition’s request, the White House acknowledged that it will provide an update in the future. The White House’s initial response mentions that the U.S. Department of Health and Human Services (HHS) “has met with stakeholders on this important issue, and both CMS [the Centers for Medicare and Medicaid Services] and its contractors understand the questions that have been raised about access to the right prosthetic care-including related technologies-for Medicare beneficiaries.” It also stated that “CMS wants to make clear that they’re committed to providing high-quality care to all Medicare beneficiaries.”

Peter W. Thomas, JD, NAAOP general counsel, noted that, “While we would have preferred a final answer instructing the DME MACs [Durable Medical Equipment Medicare Administrative Contractors] to rescind the draft LCD, we are encouraged that the White House recognized the need to publicly respond and provide this initial update. NAAOP will continue to work with CMS and the White House and press the issue by educating legislators and government officials to achieve the outcome both Medicare beneficiaries with limb loss and privately insured amputees in the United States deserve.”

David McGill, JD, NAAOP president, added, “After attracting over 100,000 signatures in 17 days, witnessing the prosthetic and orthotic community submit thousands of public comments, and participating in both an amputee protest and a high-level meeting with CMS and HHS officials, we cannot hide our disappointment that the draft LCD has not yet been rescinded. But we take CMS at its word that they understand the concerns we have raised and look forward to working with them to achieve a good outcome for patients, their families, and the providers who serve them. NAAOP will recommit itself to advocacy work on this vital issue.”

Rescission of the draft LCD is critical because it lacks virtually any clinical or medical evidence to support its proposals while other payers look to it for guidance. United Healthcare has already discontinued coverage of vacuum socket technology by referencing the draft Medicare policy. “NAAOP believes strongly that the public must be offered another opportunity to comment on the final LCD when it is announced. The draft LCD was so fundamentally flawed that the next iteration must be considered a draft subject to public comment,” stated McGill.

NAAOP had previously announced that it had surpassed the 100,000 signature mark on its We the People White House petition on July 17. The petition, which calls for the Obama administration to “rescind the Medicare proposal restricting access to prosthetic limbs and returning amputees to 1970s standards of care,” was supposed to have received a formal response from the White House by October 16.

Numerous organizations endorsed and promoted the petition, including the Amputee Coalition; the American Orthotic & Prosthetic Association (AOPA); the American Academy of Orthotists and Prosthetists (the Academy); the American Board for Certification in Orthotics, Prosthetics and Pedorthics (ABC); the Board of Certification/Accreditation (BOC); the National Commission on Orthotic and Prosthetic Education (NCOPE); prosthetic clinics and business; as well as multiple organizations representing rehabilitation hospitals, physician organizations, and disability groups through a coalition known as the Independence Through Enhancement of Medicare and Medicaid (ITEM) Coalition.

For future updates on this and other O&P issues, link to NAAOP’s Twitter feed and Facebook page, or visit