Saturday, April 13, 2024

US Politics/Medicare

Jim DeWees

I have a serious question, and maybe someone on this list can answer this for me.

I have read a lot of the Healthcare Reform bill that passed, and in the PDF format, I used the search tool to find information on “Prosthetics” and “Orthotics”. There were 5 matches that appeared, and they are all related to surety bonds, accreditation, mostly related to pharmacies that provide DMEPOS items.

But I did not find anywhere in the bill that specifically includes O&P as “covered benefits” or any language that states that O&P will continue to be provided as the current CSM standards and rules are written.

The former bill DID specifically state that O&P was “covered”. But I cannot find this in this new bill that did pass.

Does anyone know for SURE if O&P are covered, or not???

While I was at Disneyworld, I ran into several amputees and spoke with some of them. This topic came up over and over, and these amputees understand this bill to basically cut out ALL DME benefits for Medicare, which is also the same standards that the private healthcare insurance companies will follow. Somewhere these amputees have been told that their prosthetic limbs will not be paid for after Jan. 1, 2014.

I have researched this, and looked through the healthcare reform bill, and I cannot find anywhere that states that O&P are covered.

If this is the case, we are all doomed….I mean we (as amputees) are doomed, and will have to find thousands of dollars to pay for our limbs. And we (as prosthetists) are also doomed. In my practice, I don’t know any patients that have that kind of cash laying around to pay for their prosthetic limbs.

Anyway, if anyone has an answer, please educate me on this issue. At this point, I have to believe that these amputees are correct and that O&P are NOT covered since I cannot find anything in the bill that states otherwise.


Jim DeWees, CP


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