The National Association for the Advancement of Orthotics and Prosthetics (NAAOP) has released a new video webcast in which General Counsel Peter Thomas, JD, discusses three recent O&P policy developments, as follows:
Medicare, Medicaid, and SCHIP (State Children’s Health Insurance Program) Benefits Improvement and Protection Act of 2000 (BIPA) Section 427: BIPA includes Section 427, which prohibits the Medicare program from paying for custom O&P devices unless they are provided by qualified practitioners and suppliers. A supplier can qualify by being O&P licensed or accredited by the American Board for Certification in Orthotics, Prosthetics and Pedorthics (ABC), the Board of Certification/Accreditation (BOC), or an accreditor whose standards are “essentially equivalent.” However, the Centers for Medicare & Medicaid Services (CMS) never implemented this section of the law through regulation. NAAOP and the O&P Alliance have been fighting for years to get these regulations issued. Now, the proposed regulations on BIPA Section 427 are pending at the White House, which is the final step before being issued for public comment. Once issued, NAAOP will analyze and respond forcefully to these regulations. The link between qualifications and Medicare payment of custom O&P care remains a priority of the profession, especially in the age of alternative payment models.
Moratorium Legislation Introduced for Draft Local Coverage Determination (LCD) for Lower Limb Prostheses: On April 25, Congresswomen Renee Ellmers (R-NC) and Jan Schakowsky (D-IL) introduced H.R. 5045, the Preserving Access to Modern Prosthetic Limbs Act of 2016. This bipartisan bill would impose a moratorium on issuance of the draft LCD, or any part thereof, until at least July 2017, instruct CMS and its contractors to remove the draft LCD from their websites, and clarify that CMS has authority to oversee the development of LCDs. NAAOP worked alongside the American Orthotic & Prosthetic Association (AOPA) and the Alliance organizations to get this bill introduced and strongly supports passage of the bill.
Veterans Access to Provider of Choice: Senators Richard Burr (R-NC) and John McCain (R-AZ) are promoting legislation to allow veterans to access private providers, outside of the U.S. Department of Veterans Affairs system, on a permanent basis. NAAOP met with Burr’s office to help ensure that his bill applies to veteran choice of prosthetists and orthotists. NAAOP submitted specific language to amend the bill, which would accomplish one of the key goals in H.R. 3408, the Injured and Amputee Veterans Bill of Rights. NAAOP will continue to update the profession as developments occur.
The webcast is posted on the NAAOP website and on oandp.com, shared with members via e-mail, and made available through the NAAOP page on Facebook.