The National Association for the Advancement of Orthotics and Prosthetics (NAAOP) released a new webcast about what the 114th Congress, which is set to convene next week, means for the healthcare and O&P communities. NAAOP General Counsel Peter Thomas, JD, said that as new leadership takes the helm in the U.S. Senate, this change in leadership from Democrat to Republican has major implications on the policy agenda for the last two years of President Obama’s tenure. There will be fissures within both political parties, but the likelihood that Congress will more routinely send the President bills on which he either must compromise or veto, is far greater than in years past, Thomas said.
The following is a summary of the points Thomas made in the webcast:
Affordable Care Act (ACA) Repeal: The Republican-led Congress will most certainly make repealing the ACA, in whole or in part, a major goal over the next two years. But without a 60-vote Republican margin in the Senate, and the President already warning Congress not to attempt to repeal the ACA, it is unlikely this policy will make it past the finish line, at least over the course of the next two years. The U.S. Supreme Court review of the ACA is another matter.
Piecemeal ACA Repeal: A more likely and successful strategy may be the selective repeal of certain parts of the ACA. For instance, a primary target for early action is the repeal of the medical device tax. While this device tax does not significantly affect orthotics and prosthetics, repeal is strongly supported by medical device manufacturers, suppliers, importers, and their trade associations. It also shares bipartisan support for repeal. The problem is that when passed, it saved the federal government more than $20 billion over ten years. Congress would have to pass a series of provisions offsetting the cost of this repeal in order to attract enough
Medicare and Medicaid Reform: The ascension of Congressman Paul Ryan (R-WI) to chairman of the House Committee on Ways and Means, coupled with the annual budgeting process scheduled to begin in February, is expected to generate a major debate about the future of Medicare and Medicaid. There will be serious proposals to reform these programs significantly, which will undoubtedly have the effect of reducing the long-term federal commitment to funding these programs at current levels. In addition, the current “fix” to the Medicare physician fee schedule expires at the end of March, which means that Congress will have to pass an extension, whether short term or long term, to eliminate a cut in reimbursement to physicians of over 25 percent on April 1. This effort creates a must-pass Medicare vehicle that will bring both threats and opportunities to O&P. Threats will come in the form of cuts to reimbursement while opportunities will present themselves to add favorable legislative provisions to the bill.
O&P Legislation: Legislative provisions that impact the O&P profession in a positive way include explicit recognition that practitioners’ notes will be included in the patient’s medical record for purposes of determining medical necessity. Other provisions include the linking of Medicare payment with provider qualifications, and the separate accounting of denials and appeals impacting O&P, separate and distinct from durable medical equipment denials and appeals.
The webcast is posted on the NAAOP website, shared with members via e-mail, and made available through the NAAOP page on Facebook.