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’s separation from durable medical equipment (DME) and the American Orthotic and Prosthetic Association’s (AOPA’s) O&P Policy Forum, as follows:
Separation From DME: NAAOP, in conjunction with the O&P Alliance, submitted formal comments last week on the proposed federal regulations to create a definition of the term “orthotics and prosthetics” in the Uniform Glossary of Medical Terms. This definition will be separate and distinct from the term, “durable medical equipment.” The Uniform Glossary is a collection of commonly used insurance and medical terms that is intended to help inform the general public about insurance plans and insurance options. Defining O&P separately from DME does not guarantee coverage of all O&P care in private insurance policies, but it will help consumers understand these benefits and will alert them to potential coverage and coverage limitations and exclusions.
Not only will this separate O&P definition increase awareness of orthotics and prosthetics in private insurance, but it also breaks the connection between O&P and DME in these health plans. If the final rule is consistent with the proposed rule, strong arguments will exist to no longer apply DME limitations and exclusions on O&P services. And once consumers better understand what constitutes O&P care, they are likely to pressure insurers to define coverage under this benefit. While this victory does not impact the Medicare program, it represents the achievement of a longstanding goal that NAAOP has been waging, both independently and in concert with the O&P Alliance, since 2009, during Congress’ consideration of the Affordable Care Act.
O&P Policy Forum: The O&P Policy Forum is approaching and NAAOP joins its Alliance partners in encouraging leaders in the O&P profession to attend. It is an opportunity for the O&P community to come to Washington to learn about the policies that impact the O&P professionals, and advocate on behalf of themselves and their patients. Among the challenges are the Draft Local Coverage Determination for Lower Limb Prostheses, competitive bidding, and prior authorization.
This year, the Policy Forum will include an opportunity to help write legislation. Former U.S. Senator Bob Kerrey, who has a lower-limb amputation, will participate in the forum by leading the effort to draft a bill, and will help advocate for this bill on Capitol Hill.