The National Association for the Advancement of Orthotics and Prosthetics (NAAOP) has released the following statement regarding healthcare reform legislation:
Congress returns from its holiday break this month to continue negotiating healthcare reform legislation. After months of debate and missed deadlines in 2009, the U.S. Senate voted Christmas eve morning to pass its version of healthcare reform legislation-HR 3590-by a partisan vote of 60 to 39. This vote sets up a conference process where the House and Senate versions of the bill are negotiated into one piece of legislation before being sent to the President’s desk for enactment. This process has already begun.
While both bills dramatically expand insurance coverage and reform insurance market rules, significant differences between the House and Senate versions of the bill remain. For instance, the House bill includes a national “public insurance option” to be offered through a new health insurance “exchange,” as well as a new tax on wealthy Americans to help pay for the bill’s expansion of coverage. The Senate takes a very different approach. It omits the public option entirely and imposes a tax on high-premium health plans, not on individuals’ incomes.
Impact on O&P
The health bills are each more than 2,000 pages long, so the direct impact on orthotics and prosthetics needs to be teased out. However, there are clearly important differences between the House and Senate bills that NAAOP is engaged in supporting or opposing, along with the O&P Alliance organizations.
First and foremost is the standard benefits package, which all private health plans that participate in the health insurance “exchange” must offer. The House bill explicitly states that such plans must offer insurance coverage of “durable medical equipment, prosthetics, orthotics, and related supplies.” The Senate bill is less specific. It states that the standard benefits package must include coverage of “rehabilitative and habilitative services and devices.” NAAOP will be working to ensure that orthotics and prosthetics is specifically included in the standard benefits package in the final health reform bill.
The House bill also omits orthotics and prosthetics from a new “productivity adjustment” that stands to reduce annual Medicare reimbursement updates for many types of Medicare providers. While the House productivity adjustment provision does not apply to O&P, the provision in the Senate bill does. This is a significant threat to O&P reimbursement in future years, and NAAOP is actively opposing its application to O&P and supporting the House approach.
Finally, NAAOP joins the O&P Alliance organizations in supporting Senator Ron Wyden’s (D-OR) amendment offered during the Senate’s health-reform debate that would explicitly link provider qualifications with Medicare payment. This provision was not adopted by the Senate but still remains viable in that the bill would save the federal government Medicare dollars while improving the quality of care and reducing the risk of fraud and abuse.
NAAOP will continue to keep its membership informed of developments as they occur. For more information, visit www.naaop.org or e-mail info@naaop.org
