The following individuals shared their thoughts with The O&P EDGE about the public Open Comment
Meeting to discuss the Medicare Draft Local Coverage Determination (LCD) for Lower Limb Prostheses
and the rally following it that was held in front of the U.S. Department of Health and Human Services
building to protest this set of policies.
TAMMIE HIGGINBOTHAM has a left transtibial
amputation, the result of a car accident. She
participated in the Open Comment Meeting
via teleconference, and shared the story of how
she sustained her amputation and what it took
for her to receive a well-fitting and comfortable
prosthesis and liner.
"How can we do what we do to be productive
society members if they cut us back to prehistoric
times as far as prosthetics? Are the people
deciding this amputees? Would they stand for
it? I heard many good people speak that day
that were calm, cool, and rational; not blaming,
just saying, 'Don't take my leg away. Limbs are
not a luxury....'"
BRUCE DAUGHERTY underwent a right
transtibial amputation in 2010 at the age of
40-a decision that was made after living with
the pain and limitations of a club foot and
undergoing multiple surgeries to try to correct
it. He drove from Colorado Springs, Colorado,
to Washington to participate in the rally.
"If we go backwards to the 1970s way of
care, then where is that going to leave me? My
whole reasoning for having an amputation was
because of the enhancements of technology
and the higher functioning prosthetic limb,
because I've had to adapt my whole life. That's
not the case anymore. Snowboarding and
things like that were never on my list of things
to do before my amputation. [I]f more Americans
would stand up and let their voices be
heard, then maybe things can be better when
an injustice is done."
JAMES H. CAMPBELL, PHD, CO, FAAOP,
AOPA's President Elect, testified at the meeting.
"The O&P community came together in
unprecedented fashion to advocate for the
patients we serve. I was privileged to testify at
the public hearing. Specifically, I addressed the
absence of any scientific base and evidence
to support the changes in the draft LCD; the
articles referenced by CMS claimed to support
the changes [but] actually had no bearing on
any of the policy changes described within the
proposal. In fact, I was able to point out that
the evidence that does exist could be used to
refute the changes. I stressed that the current
standard of practice is fully supported by
sound, peer-reviewed scientific evidence."
JEFFREY BRANDT, CPO, CEO and founder of
Ability Prosthetics & Orthotics, headquartered
in Exton, Pennsylvania, attended the meeting.
"I don't know that I've seen the profession
more unified than right now, nor as passionate.
The hearing was about as raucous as it could
be without being unprofessional. To be those
medical directors hearing those stories...,
listening to professionals and amputees talk
about the potential ramifications of the policy
in person, they all had to be concentrating
pretty hard not to show some emotion.
"We submitted an official comment for
the record from our company, [and]...were
actually able to supply CMS with real data that
we thought they should have looked at before
they wrote such a policy...and we were able to
show them that...44 percent of our patients
would not be in the leg they are currently in;
they would not have access to the prostheses
they are currently wearing if the policy went
into effect. That [policy] would hence move
everyone down a functional level, essentially."
THOMAS (TOM) WATSON, CP, owner and
president of Tom Watson's Prosthetics &
Orthotics Lab, headquartered in Owensboro,
Kentucky, spoke at the meeting. He has a transfemoral
"I've been in the field over 40 years, and I
have never been so proud to be an amputee
and a prosthetist as I was the morning [of the
Open Comment Meeting]. The outpouring of
heartfelt testimony from all walks of life was
astounding. For so many people to come
together for a common goal that being an
amputee was not an end but a beginning
brought tears to my eyes more than once. The
prosthetic industry is a true American success
story and should not treated as a luxury. And
what was even more astounding was the medical
directors present never seemed to take note,
make a statement, or ask a question over the
entire public comment period. I guess silence
can be interpreted as either golden or embarrassment.
Hopefully the LCD will be rescinded
and we could come together for a common goal
to write a policy that could work for all parties."
ADRIENNE WALKER-PITTMAN has a left
transfemoral amputation and a traumatic brain
injury, which were the result of having been
hit by a teenager driving a stolen vehicle. She
spoke at the Open Comment Meeting and
attended the rally.
"The meeting was so important, and it was
amazing to hear the different stories from
people and how their devices had impacted
and changed their lives. The right prosthetic fit
means that physically, medically, and emotionally,
it will give an amputee their life back, and
that is what my Genium prosthesis by Ottobock
does for me. The appropriate prosthetic device
allows you to...achieve and inspire and excel
despite what you have gone through, so you
can get your life back and be an inspiration to
others. You cannot fix a problem and be successful
with a partial diagnosis. An amputation
affects a person's total life as does the right
prosthetic device! The family, the caregiver,
and community are affected as well!"