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CMS Delays Finalizing the LCD for Lower Limb Prostheses

The White House, through the We the People website, and the Centers for Medicare & Medicaid Services (CMS) announced that the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) will not finalize the Draft Local Coverage Determination (LCD) for Lower Limb Prostheses (DL33787) at this time. CMS said it is “committed to providing high quality care to all Medicare beneficiaries, including any beneficiary in need of a prosthesis. Both CMS and its contractors have heard your concerns about access to prostheses for Medicare beneficiaries.”

Additionally, after a preliminary review of the public comments, CMS said it is convening a multidisciplinary Lower Limb Prostheses Interagency Workgroup in 2016. The purpose of the workgroup will be to develop a consensus statement that informs Medicare policy by reviewing the available clinical evidence that defines best practices in the care of beneficiaries who require lower-limb prostheses. The workgroup will be composed of clinicians, researchers, policy specialists, and patient advocates from different federal agencies. The workgroup may also identify areas where evidence gaps exist related to the prescription of lower-limb prostheses and make recommendations concerning the study designs and outcome measures that best inform patient-oriented function, quality of life, and service satisfaction in this realm. CMS said it will ensure there is opportunity for public comment and engagement on the workgroup consensus statement and any related activities, and it “looks forward to working with the public to ensure appropriate access to prostheses.”

For further information, contact Susan Miller, MD, at 410.786.2118.