The National Association for the Advancement of Orthotics and Prosthetics (NAAOP) issued a breaking news alert about three new developments impacting the O&P profession, which occurred February 9:
- Rehabilitation Research Bill Advances in Senate Committee: On February 9, the U.S. Senate Committee on Health, Education, Labor & Pensions (HELP) reported favorably on a bipartisan bill introduced by Senators Kirk (R-IL) and Bennet (D-CO) to advance rehabilitation research, including O&P research and development, at the National Institutes of Health (NIH). The bill, the Enhancing the Stature and Visibility of Medical Rehabilitation Research at the NIH Act, S. 800, would enhance coordination and improve the stature and visibility of this research at the National Institutes of Health’s (NIH’s) 27 institutes and centers, particularly in the National Center for Medical Rehabilitation Research (NCMRR). NCMRR’s mission includes O&P research and development. This is the first major piece of legislation to address the NCMRR at NIH since the law was created in 1990, and should spark additional attention at NIH in this area. The bill now goes to the full Senate for consideration. A companion House bill has already been introduced by Congressman Langevin (D-RI) and Congressman Harper (R-MS)
- DC Appeals Court Ruling Offers Hope to Providers on ALJ Backlog: The U.S. Court of Appeals for the District of Columbia Circuit ( DC Circuit) issued an important opinion in the American Hospital Association’s lawsuit regarding the delay in Administrative Law Judge (ALJ) hearings, which is the third level in the Recovery Audit Contractors appeal process. The DC Circuit reversed the district court’s decision and determined that the district court has jurisdiction over this case because the U.S. Department of Health and Human Services (HHS) has a clear duty to issue ALJ decisions in 90 days, and “escalation” to the next level of administrative review is not an adequate remedy for HHS’ failure to issue ALJ decisions in a timely manner. The DC Circuit remanded the case to the district court for it to consider whether to compel HHS to comply with the deadline in light of the worsening ALJ backlog. The decision gives some hope to Medicare providers, including O&P practices, that the intolerable delay in ALJ appeals will begin to be resolved, but the DC Circuit did not yet actually step in and solve the problem. A decision by the district court is expected late this year.
- President’s Budget Proposes to Expand Competitive Bidding to All O&P Care: For the first time, the president’s budget (the fiscal year 2017 budget was released February 9) proposes to expand the Medicare Durable Medical Equipment, Prosthetics, Orthotics, And Supplies (DMEPOS) Competitive Bidding Program to include all prosthetics and orthotics, in addition to a number of other types of DMEPOS. The proposal is expected to save $38 billion over ten years. This is bad news in that NAAOP and the O&P Alliance organizations will have to mount a strong defense against this proposal, but it is important to put this development into perspective. Competitive bidding for anything more than off-the-shelf orthotics is currently illegal, so Congress would have to pass a law authorizing the Centers for Medicare & Medicaid Services (CMS) to expand it to all O&P care. This is the last year of the current president’s budget. The budget represents a grab bag of policies that the administration throws out to gather reaction, and to pad the savings it can achieve in order to pay for its other proposed priorities. In this calendar year, there is no chance this proposal will become law absent titanic developments in Congress, which are not expected. Congressional Republicans declared the budget “Dead on Arrival” and have shown no interest in this specific proposal. NAAOP will work with its Alliance partners to strongly oppose this proposal, but it is certainly not imminent.