O&P Medicare Pay Freeze Could Be Finalized This Week

Legislation that could result in a ten-year freeze on Medicare O&P payments could land on President Bush's desk before the Memorial Day recess, according to Walt Gorski, Director of Legislative Affairs for the American Orthotic & Prosthetic Association (AOPA).

"Because the Medicare O&P payment freeze will now be debated by this [a] conference committee, we have no time to spare and must let our lawmakers know that this provision will be devastating to the O&P field and the patients we treat," according to AOPA. "Therefore, we ask you to promptly contact your lawmakers and oppose this provision."

The Medicare O&P payment freeze is a provision in the Senate-passed version of the Jobs and Growth Tax Reconciliation Act and would mean a zero payment update for 10 years. "The O&P payment freeze was included in this legislation in order to create additional funds for increased payments to rural healthcare providers (not O&P practitioners)," AOPA explained. The version of the Jobs and Growth Tax Reconciliation Act passed by the House of Representatives does not include the Medicare O&P payment freeze provision.

Both the House of Representatives and the Senate have passed very different versions of the Jobs and Growth Tax Reconciliation Act--the Senate version includes a 10-year O&P payment freeze, the House version does not, AOPA noted.

Differences in these two bills now must be resolved by a conference committee, which is made up of senior lawmakers from both the House and Senate. Once the differences in the two versions are resolved, the legislation will be sent back to the House and Senate for a final vote. If the legislation is approved by each chamber, it will be sent to the President to be signed into law.

A portion of a sample letter AOPA urges O&P providers to send includes these points: "While the intent of H.R. 2 is to encourage job creation, there is no question that this provision will lead to job loss-a direct contradiction of the intent of this legislation. Since 1989, Medicare orthotic and prosthetic payments have increased only 24 percent while the consumer price index (CPI) has increased 45 percent. This disparity has placed tremendous financial distress on O&P facilities during a period when material and input costs have been increasing at a rate of more than 4 to 5 percent. If a 10-year freeze is implemented, orthotic and prosthetic provider payments will have increased only 24 percent during the period of 1989-2013, while the CPI will increase by nearly 90 percent over the same period. Therefore, eliminating Medicare O&P updates for the next ten years is certain to force many O&P facilities, most of which are small businesses, to cut more jobs or even force some into bankruptcy.

"Also certain to experience increased hardships are the Medicare beneficiaries who require orthotic and prosthetic services. If this provision is enacted, access to vital and necessary orthotic and prosthetic care will surely suffer and the quality of care will decline as practitioners are forced to substitute lower quality materials in order to make ends meet.

"Finally, a payment freeze of this magnitude is simply unprecedented. No analysis has shown that Medicare pays too much for orthotic and prosthetic services. Moreover, there have been no formal deliberations either by Congress or its advisory bodies indicating that a payment freeze is warranted. In fact, the evidence shows that Medicare payments for orthotic and prosthetic services should be increased above the annual CPI update mandated by law since Medicare orthotic and prosthetic payments have lagged the CPI by such a substantial margin."

Gorski noted that practitioners can access a website designed to help practitioners contact their lawmakers. The website is: http://capwiz.com/aopa/home/ .

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