The National Association for the Advancement of Orthotics and Prosthetics (NAAOP) released a webcast about its attendance at a hearing held April 30 by the U.S. House of Representatives Ways and Means Subcommittee on Health in response to a report that stated that fraud, waste, and abuse costs Medicare more than $50 billion annually.
In the webcast, NAAOP General Counsel Peter Thomas, JD, discussed the federal government’s strict view of waste and abuse, which often includes claims with errors in documentation. It is this definition, Thomas said, which is “at the heart of the appeals problem,” and behind the delayed Administrative Law Judge (ALJ) hearings and Recovery Audit Contractor (RAC) audits that deny claims that are then often overturned in favor of the provider.
NAAOP has legislative proposals to resolve the problems in regard to auditing and appeals, which would also target Medicare fraud and abuse, Thomas continued. House Resolution (H.R.) 3112, the Medicare Orthotics and Prosthetics Improvement Act of 2013, would implement regulations mandated by existing federal law prohibiting unqualified providers and suppliers from receiving Medicare payment for custom orthotic and prosthetic devices. Draft legislation known as the Ensuring Beneficiary Access to Orthotics and Prosthetics Act of 2014 would improve the Medicare administrative appeals process, reform Medicare RACs, and recognize O&P practitioners as professional providers of O&P care, “leveling the playing field for legitimate providers,” he said.
The webcast is posted on the NAAOP website, shared with members via e-mail, and made available through the NAAOP page on Facebook.
