Please see our video link below and update on Medicare Bill Enacted as O&P
Community Storms Capitol Hill.
Enacted as O&P Community Storms Capitol Hill
Congress recently enacted a significant Medicare bill that accomplishes many
health care objectives and spares O&P providers from further policy changes
or reimbursement cuts. It also preserves physician payments, sparing them a
24% cut as of April 1st. The current treatment of therapy services under the
Medicare outpatient therapy benefit is also kept in place, thereby not
imposing therapy caps for Medicare beneficiaries. In addition, “post-acute
care” was largely spared as the mechanism to offset the cost of these policy
changes. For instance, Congress did not include bundling provisions that may
have impacted the way O&P care is delivered for Medicare beneficiaries after
they are hospitalized and undergo an episode of post-acute care.
Competitive bidding was not expanded or accelerated in the recent bill, nor
were other harmful policies included.
All things considered, the Medicare bill delayed until next year the tough
decisions that will inevitably come when Congress finally decides to fix the
Medicare physician fee schedule permanently, rather than revisiting the
policy each year. The O&P community will, therefore, spend the remainder of
this year and much of next year building support for its legislative agenda
and bolstering our arguments to protect O&P care from a variety of harmful
proposals.
In the wake of passage of this Medicare legislation, the O&P community
converged on Washington, DC for AOPA’s Annual O&P Policy Forum. Over 100 O&P
professionals, consumers, and students participated in several days of
briefings on priority issues and hill visits to advocate for the profession.
Among the most important legislative priorities from NAAOP’s perspective
were the following:
1. O&P Access Act: This draft bill is being promoted by the entire O&P
Alliance and is designed to dramatically improve the audit and appeals
process impacting O&P Medicare claims. The draft bill would definitively
establish that an O&P clinician’s notes are part of the medical record for
purposes of determining the medical necessity of a claim for Medicare
payment. It would also reform the appeals process to expedite consideration
of denied claims, and reform the Recovery Auditors to level the playing
field for legitimate providers.
2. Injured and Amputee Veterans Bill of Rights (H.R. 3408): With the list of
cosponsors of this legislation growing to 36, NAAOP and numerous O&P
advocates pressed for movement on this bill in the House and Senate. The
bill is designed to educate injured and amputee veterans to enable them to
be their own best advocate for quality O&P care that is consistent
throughout the country. Key meetings were held with House VA Committee staff
and progress continues to be made.
3. O&P Medicare Improvement Act: This legislation would direct CMS to
implement what federal law already requires it to do; link the right to bill
the Medicare program for O&P care with the qualifications of the
practitioner or supplier providing that care. The bill is bipartisan and is
a key goal of the O&P community.
Please visit our website at: www.naaop.org
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