The National Association for the Advancement of Orthotics and Prosthetics (NAAOP) has released a webcast in which General Counsel Peter Thomas, JD, discusses two issues that are heating up in Washington: veterans’ right to choose their O&P practitioner and the Centers for Medicare & Medicaid Services (CMS) competitive bidding of an expanded range of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS). A summary of the webcast follows:
The Department of Veterans Affairs (VA) published a proposed rule in October to make the VA the only authority in choosing the O&P practitioner who will provide services to veterans, eliminating the “right” veterans have had for five decades when choosing the O&P practitioner who would best meets their needs. NAAOP opposes the change and will work with its O&P Alliance partners to maintain veteran choice. This right is included in the Injured and Amputee Veterans Bill of Rights (H.R. 2322), bipartisan legislation introduced by congressman Tim Walberg (R-MI). NAAOP is working with Walberg to advance the bill or to try to impact the pending VA Choice 2.0 legislation, a bill that would make the VA Choice Program, which was enacted several years ago, permanent. The bill would expand veterans’ choice of private healthcare providers.
In terms of expanding CMS competitive bidding, the Medicare Payment Advisory Commission (MedPAC) hosted a meeting on November 2, “Medicare payment policy for non-competitively bid DMEPOS,” where it reviewed spending trends and pricing accuracy of non-competitively bid DMEPOS items. MedPAC’s staff indicated that across its top 25 DME items, Medicare spending rates had decreased about 50 percent since 2010 while, during the same period, Medicare spending that is not part of the Competitive Bidding Program (CBP) had increased by 24 percent, with no significant negative changes in beneficiary health outcomes. MedPAC’s staff stated that Medicare could have saved about $47 million in 2015 if Medicare rates were equal to median private payer rates for off-the-shelf orthotics alone, according to NAAOP. The meeting concluded with the issuance of two policy options for the commission to consider: to expand the use of CBP to more DMEPOS items and to reduce payment rates annually for some non-CBP products until they are in line with private rates. To protect beneficiaries from adverse balance billing practices, MedPAC recommended placing a cap on balance billing and paying non-participating suppliers 5 percent less than participating suppliers.