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NAAOP Webcast: Prosthetic Coverage Gains and Improving VA Amputee Care

by The O&P EDGE
June 25, 2015
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The National Association for the Advancement of Orthotics and Prosthetics (NAAOP) released a webcast with updates about New York State’s one-limb-per-lifetime cap and the Injured and Amputee Veterans Bill of Rights.

The one-limb-per-lifetime policy limited beneficiaries to one prosthesis per amputated limb, per lifetime, which advocates said violated the Affordable Care Act (ACA). In the webcast, NAAOP General Counsel Peter Thomas, JD, said that last month, after sustained advocacy efforts by a coordinated group of state and federal advocates, which included Thomas, NAAOP President Dave McGill, Dan Bastian, CP, and Dan Ignaszewski of the Amputee Coalition, the state announced that it would change its one-limb-per-lifetime policy in 2016. This was a victory, but concern arose when the revised coverage language maintained the one-limb-per-life language but clarified that repairs and replacements will be covered due to “wear and tear” or when prostheses are “outgrown.” Most of the problematic language was removed from the 2016 Plan Invitation, Thomas said, which means that individuals with amputations in New York State will have prosthetic coverage next year that they lack today.

The New York Assembly unanimously passed a bill in mid-June to ensure coverage in private plans of medically necessary prosthetic care, but the bill was held pending additional review in the Senate, which is scheduled to adjourn soon. It is unclear whether the bill will “make it across the finish line” before adjournment, but NAAOP will report the outcome as soon as possible and work with the existing advocacy coalition next year if necessary to pass the bill, said Thomas.

With regard to the Injured and Amputee Veterans Bill of Rights (formerly H.R. 3408), Thomas said that Congresswoman Renee Ellmers (R-NC) is likely to reintroduce the legislation. Ellmers is expected to first send a letter to U.S. Department of Veterans Affairs (VA) Secretary Robert McDonald requesting that he implement many of the provisions of the Bill of Rights on his own authority. At last count, Ellmers had the support of approximately 13 of her House colleagues who have agreed to co-sign the letter. Once sent, NAAOP will post the letter to the NAAOP website.

The webcast is posted on the NAAOP website and on oandp.com, shared with members via e-mail, and made available through the NAAOP page on Facebook.

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