AOPA Policy Forum 2016: Advocacy in Action

Duckworth addresses the attendees.
Photographs courtesy of AOPA.

The American Orthotic & Prosthetic Association (AOPA) 2016 Policy Forum was held in Washington April 26-28. New this year was an O&P legislation writing congress that former Senator Bob Kerrey led. Attendees broke into groups to discuss their priorities for legislation, then reconvened to write the Prosthetic and Orthotic Care Modernization Act of 2016, which would add language to the Social Security Act such that:

  • O&P shall be treated separately from durable medical equipment
  • The Centers for Medicare & Medicaid Services (CMS) shall only reimburse custom O&P care that is provided by credentialed O&P providers
  • Custom-fabricated O&P devices shall continue to be inappropriate for inclusion in competitive bidding
  • CMS shall rescind the Draft Local Coverage Determination (LCD) for Lower Limb Prostheses that was introduced in July 2015
  • Attendees were divided into five break-out groups to discuss the bill they jointly wrote as part of the legislation writing congress.

    Kerrey took the bill to meetings with senators on Capitol Hill, and the 150 attendees discussed the bill at more than 400 congressional appointments that had been arranged on their behalf as advocates for the O&P profession.

    Senator Warner and James Campbell

    Warner and James Campbell, president of the AOPA board.

    Representative Renee Ellmers (R-NC), the opening keynote speaker, set the stage for the advocacy briefings that followed throughout the afternoon program. Senator Mark Warner (D-VA) and Representative Tammy Duckworth (D-IL) joined Ellmers for the briefings. All three shared their own concerns about the proposed LCD and other restraints imposed by CMS that hinder the most advanced patient care. Additionally, it was announced that the day prior to Policy Forum, Ellmers had introduced a bill in the house, H.R. 5045, Preserving Access to Modern Prosthetic Limbs Act of 2016, which places a moratorium on implementing the draft LCD until June 30, 2017, and also requires CMS and its contractors to remove the policy from their websites.

    As part of each Policy Forum, AOPA leadership provides specific talking points to be discussed during the congressional visits. This year's agenda asked members of Congress for support with the following issues:

  • Join as a cosponsor and advocate for the Wounded Warrior Workforce Enhancement Act (S. 1021 and H.R. 1904), a bill to require the secretary of the U.S. Department of Veterans Affairs to award grants to establish or expand O&P master's degree programs, among other things. The bills authorize $15 million over three years in short-term grants.
  • Do not support the president's proposed budget as it includes expanding the competitive bidding program to include O&P. In addition, support is requested for regulatory refinements to ensure the term "off-the-shelf orthoses" is appropriately defined and only those items that meet the definition are included in competitive bidding by supporting the Medicare Orthotics and Prosthetics Improvement Act of 2015 (S. 829, H.R. 1530), the Medicare Audit Improvement Act of 2015 (H.R. 1526), and the Protecting Access through Competitive-pricing Transition (PACT) Act of 2015 (H.R. 4185).
  • Join as a cosponsor and advocate for the Medicare Orthotics & Prosthetics Improvement Act (S. 829; H.R. 1530), a bill to amend the Social Security Act to refine how Medicare pays for O&P and to improve beneficiary experience and outcomes with O&P care, and for other purposes.

Dates for next year's Policy Forum have not been determined.