The National Association for the Advancement of Orthotics and Prosthetics (NAAOP) has released a webcast in which NAAOP General Counsel Peter Thomas, JD, discusses O&P policy priorities that command attention from the industry, as follows:
Medicare’s Draft Local Coverage Determination (LCD) for Lower Limb Prostheses: NAAOP and its O&P Alliance partners will soon meet with the Centers for Medicare & Medicaid Services (CMS) to discuss their plans for the work group being convened to study and recommend a consensus statement on lower-limb prostheses. The Draft LCD was placed on hold by CMS last fall, but it is not clear what will occur when the work group makes its recommendations. By law, the work group comprises federal employees only, so stakeholder input by the O&P and rehabilitation communities is critical as the work group deliberates on this important issue.
Prior Authorization of Prostheses: The final rule on prior authorization may impact as many as 84 lower-limb prosthetic codes, but CMS will issue additional guidance before implementing this program. NAAOP and the O&P Alliance members will continue to work with CMS as it determines which prosthetic codes, if any, will be subject to prior authorization and how they will implement this new process. NAAOP and the Alliance’s first approach is to dissuade CMS from imposing prior authorization on prosthetic limbs and components at all. This new process is supposed to be targeted to Medicare benefits that are overutilized, but recent Medicare data suggests a significant decrease in Medicare spending for prosthetic care in the past several years. If CMS does impose prior authorization on certain prostheses, NAAOP and the Alliance will stress to CMS that delays and denials are unacceptable for patient care and that transition to this new system must be as seamless as possible.
Injured and Amputee Veterans Bill of Rights: NAAOP is requesting e-mails about your current experience with the U.S. Department of Veterans Affairs (VA) as you provide services to veterans in need of prostheses; to send e-mails, visit www.naaop.org and click on the Contact NAAOP button in the upper-right corner on the website home page. Congresswoman Renee Ellmers (R-NC) intends to soon reintroduce the Injured and Amputee Veterans Bill of Rights, which has been a long-standing priority of NAAOP. NAAOP needs to hear your current experience in treating veteran patients as it finalizes its policy proposals to address problems and concerns in the O&P field. NAAOP offered the following questions for consideration: Do you confront barriers in gaining access to veterans in need of prosthetic care? Do you have an O&P contract with the VA? Do you experience long delays in gaining approval to provide prosthetic care to veterans?
O&P Congress and Policy Forum: NAAOP is encouraging you to attend this year’s O&P Policy Forum, April 26-27. The policy forum is an annual event where leaders in the O&P profession come to Washington to learn about O&P policies and advocate on behalf of patients and the providers who serve them. While the American Orthotic & Prosthetic Association organizes the event, all Alliance organizations participate. This year, former U.S. Senator Bob Kerrey, a longtime friend of NAAOP, will lead an O&P Congress, where all attendees will help draft legislation to address O&P policy priorities. The bill will be brought to the legislators and key priorities will be promoted.