On September 17, Representatives Mike Thompson (D-CA) and Glenn Thompson (R-PA) introduced House Resolution (H.R.) 3112, the Medicare Orthotics and Prosthetics Improvement Act of 2013. This bill is designed to reduce federal spending by eliminating fraudulent payments from Medicare while ensuring that adequate O&P services are provided to Medicare beneficiaries. It would further require the Centers for Medicare & Medicaid Services (CMS) to reimburse only accredited or licensed O&P providers; an exception is made for physicians and occupational and physical therapists who are licensed or regulated by the state in which they practice and receive payment.
“When unlicensed and unaccredited providers deliver prosthetic and orthotic services, both Medicare beneficiaries and the American taxpayer are shortchanged,” said Glenn Thompson. “Despite previous Congressional mandates, not enough has been done to ensure that legitimate and licensed practitioners are providing these items and services….”
The Benefits Improvement and Protection Act (BIPA), legislated by Congress in 2000, mandated that a “practitioner” or “supplier” had to be certified in order to be paid for certain O&P services under Medicare. According to an American Orthotic & Prosthetic Association (AOPA) report, the Centers for Medicare & Medicaid Services (CMS) has not enforced these provisions.