The members of the O&P Alliance, along with the Amputee Coalition, released a joint statement about the November 2 White House response to the We the People petition to rescind the Draft Local Coverage Determination (LCD) for Lower Limb Prostheses. The statement was signed by all members of the Alliance-the American Academy of Orthotists and Prosthetists (the Academy); the American Board for Certification in Orthotics, Prosthetics and Pedorthics (ABC); the American Orthotic & Prosthetic Association (AOPA); the National Association for the Advancement of Orthotics and Prosthetics (NAAOP), and the Board for Certification/Accreditation (BOC)-as well as the Amputee Coalition.
The statement from the six national organizations, who established the SaveProsthetics.org website and spearheaded the We the People petition, included the questions and concerns that they hope to work with the Centers for Medicare & Medicaid Services (CMS) to “resolve expeditiously,” including:
- Will the Medicare contractors formally rescind the draft LCD and remove both the draft LCD and the draft policy article from their websites as the We the People petition requested, so that private insurers like United Healthcare will not continue to adopt draft CMS coverage policies for prosthetic care as if they represent evidence-based, final policy?
- Will the draft LCD and related draft policy article be removed from CMS’ Medicare coverage database accessible through the CMS website to signal to patients and providers that it is being completely reworked?
- How will the voices of patient advocates, external clinicians, rehabilitation physicians, and therapists be heard if, as the CMS release suggests, the workgroup consists only of federal government representatives?
- Will the “consensus statement” developed by the workgroup be used to merely tweak the draft LCD or will CMS and its contractors use it to review the existing prosthetic limb LCD in effect for years that has provided effective coverage for those with limb loss?
“We are grateful that the petition/CMS response confirms that the draft LCD will not be implemented at this time,” said the statement. “However, we continue to believe that the draft LCD should be rescinded and that CMS should provide patient and provider stakeholders with a meaningful role in the development of future coverage policies for lower-limb prostheses.”
