Wednesday, July 24, 2024

VIEW NAAOP VIDEO – Spring Brings Fever Pitch to O&P Policy Developments


Please see the link below to view our video webcast and update.

Spring Brings Fever Pitch to O&P Policy

There is no shortage of O&P issues on which NAAOP and its Alliance partners
are actively engaged including publication of regulations on BIPA Section
427, separation of O&P from DME, implementation of prior authorization, the
draft LCD for Lower Limb Prostheses, and the Administration’s proposal to
expand competitive bidding to all O&P patient care. Recently, there has been
major progress on moving our agenda. Former Senator Bob Kerrey, an amputee
himself, has personally invested himself in preserving access to
prosthetic/orthotic care and his support is helping to focus Congress and
CMS on our priorities.

BIPA Section 427: The Benefits Improvement and Protection Act of 2000 (BIPA)
included Section 427, which prohibits the Medicare program from paying for
custom orthotics and prosthetics unless they are provided by qualified
practitioners and suppliers. A supplier can qualify by being O&P licensed or
accredited by ABC, BOC or an accreditor whose standards are “essentially
equivalent.” The problem is that CMS never implemented this section of the
law through regulation. NAAOP and the O&P Alliance have been fighting for
years to get these regulations issued. But finally, the proposed regulations
on BIPA 427 are pending at the White House, the final step before being
issued for public comment. Once issued, we will analyze and respond
forcefully to these regulations. The link between qualifications and
Medicare payment of custom O&P care remains a priority of the profession,
especially in the age of alternative payment models.

LCD Moratorium Legislation Introduced: On Monday, April 25th, Congresswomen
Renee Ellmers (R-NC) and Jan Schakowsky (D-IL) introduced H.R. 5045, the
Preserving Access to Modern Prosthetic Limbs Act of 2016. This bipartisan
bill would impose a moratorium on issuance of the draft LCD, or any part
thereof, until at least July 2017, instruct CMS and its contractors to
remove the draft LCD from their websites, and clarify that CMS has authority
to oversee the development of LCDs. NAAOP worked alongside AOPA and the
Alliance organizations to get this bill introduced and strongly supports
passage of the bill.

Veterans Access to Provider of Choice: Senator Burr and Senator McCain are
promoting legislation to allow veterans to access private providers, outside
of the VA system, on a permanent basis. NAAOP met with Senator Burr’s office
to help ensure that his bill applies to veteran choice of
prosthetists/orthotists. NAAOP submitted specific language to amend the
bill, which would accomplish one of the key goals in H.R. 3408, the Injured
and Amputee Veterans Bill of Rights. We will continue to update the
profession as developments occur.

Please visit our website at:


1501 M Street, NW

7th Floor

Washington, DC 20005-1700

e-mail: [email protected]

(800) 622-6740

(202) 624-0064 Phone

(202) 785-1756 Fax


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