The National Association for the Advancement of Orthotics and Prosthetics (NAAOP) has released a webcast in which NAAOP General Counsel Peter Thomas, JD, discusses significant developments in healthcare issues. A summary of the webcast follows:
The U.S. Senate was unable to pass the Graham-Cassidy bill to replace the Affordable Care Act (ACA), which means that for the foreseeable future, people who need O&P care can continue to access coverage under Medicaid and private, individual insurance, as part of the ACA’s essential health benefits. In related news, the House and Senate are moving closer to reauthorizing the Children’s Health Insurance Program (CHIP) for a five-year period. CHIP covers more than nine million children with health insurance that includes O&P care coverage.
With respect to Benefits Improvements and Protection Act (BIPA) Section 427, the Centers for Medicare & Medicaid Services (CMS) announced that it is withdrawing the proposed rule published on January 12, 2017, comments for which were due in March. CMS received more than 5,000 comments with the strongest objections coming from physicians, physical therapists, and occupational therapists, who arguably were exempted from the rule by statute. By mandating that these providers obtain state licenses to provide O&P care or get certified by American Board for Certification in Orthotics, Prosthetics and Pedorthics or the Board for Certification/Accreditation, CMS generated tremendous opposition to the proposed rule. Ultimately, these organizations convinced CMS and the Trump Administration to pull the rule in the name of regulatory relief.
There is no way paint a rosy picture of this development. After years spent trying to get CMS to issue these regulations in final form, this is a significant step backward.
However, there are a few glimmers NAAOP hopes to build on. First, the announcement about Section 427 stated that the rule was being withdrawn to “assure agency flexibility in re-examining the issues and exploring options and alternatives with stakeholders.” NAAOP has already communicated with CMS and plans to meet to discuss how to proceed. Second, this development heightens the need to rally behind passage of the Medicare O&P Improvement Act of 2015 (S. 1191 and H.R. 2599), which includes provisions compelling CMS to finally issue regulations interpreting Section 427 of BIPA. The bill explicitly exempts physicians, physical therapists, and occupational therapists, which would remove the majority of the opposition to the rule. NAAOP will continue to work for passage of the O&P Medicare Improvement Act and seek alternative ways to implement the letter and spirit of BIPA Section 427.