Attached is a recent published article as to the status of the now defunct
Neg Reg Committee.
After 10 months and 19 meetings in Pikesville Maryland, the Centers For
Medicare, Medicaid Service’s Negotiated Rule Making Committee (21 member)
failed to reach consensus on criteria that would establish educational
guidelines and qualify practitioners and suppliers of comprehensive O&P in
order to bill and receive reimbursement from Medicare.
The Barr Foundation closing statement was presented to all committee members
and CMS on the last meeting of July 14,2003.
An effort is being made by several of the participants of the committee and
perhaps a combination of participants and other disability organizations,
to submit aproposal for qualification language to CMS prior the August
If any of the recipients of this message is unable to open the attachment or
access the link
which the article appears,or would like a copy of the Barr Foundation’s
statement, please e-mail to me and I will cut and paste or send by fax.
Kim Doolan,Barr Foundation board member and alternate committee member
and I have been assigned to help recruit national disability organizations
whom would have an interest in supporting a post Neg Reg proposal for CMS to
consider prior to their submission of a proposed rule to The Secretary of
Since our organization’s mission statement focuses on amputees and
prosthetics, we would appreciate receiving suggestions from
anyone as to whom we could contact within the national organizations, such
as the National Spina Bifida Association ,National Multiple Scoliosis
Assoc., Cerebral Palsy and other national disability organizations whose
members require custom orthotic (braces) treatment to function on a daily
I would like to take this opportunity to thank Kim for attending every
meeting with me and providing great input to the many difficult and
frustrating issues we were faced with.
Kim is a patient/consumer of orthotic AND prosthetic treatment and was
justifiably concerned about protecting the interests of users of custom
orthotic(Braces)devices as well as those of amputees.
No compromise could be made between the twelve O&P groups, two Medical
professionals organizations i.e.. AAOP and AAOS(American Academy of
Orthopedic Surgeons and American Academy of Physical Medicine and
Rehabilitation), the three patient organizations,ie. Barr
Foundation,PVA(Paralyzed Veterans of America) and AIE (Amputee Information
Exchange) and three organizations the APTA(American Physical Therapists
Association) ,the AOTA(American Occupational Therapists) and NOMA(National
Orthotic Manufactures Assoc.)
NO ORGANIZATIONS OF ORTHOTIC USERS WERE REPRESENTED AT THE MEETINGS.
No patient organization to safeguard the interests of the millions of
require qualified comprehensive orthotic treatment were participating in the
The primary obstacle in reaching consensus was the result of the PTs/OTs and
NOMA organizations offer to agree to exclude prosthetics from exemption of
qualification/education IF every other of the 18 members on the
committee agreed to allow them,the Pts and Ots to practice, fabricate and
orthotic devices without any requirement to further educational guidelines
i.e ABC ,BOC certification or third pathway as determined by the Secretary
of Health.This was disturbing to many whom attended since although compotent
delivery would be better assured by reaching agreement, delivery of quality
would not be.
Without being able to resolve the O&P practitioner qualification issue no
attempt was made to further negotiate manufacture(supplier) qualification
criteria and the meetings were ended without consensus on any issue we were
Only 9 states are currently regulated to deliver O&P services and there
remains no federal guidelines to regulate the delivery of O&P services.
Anyone with a medicare provider number can receve reimbursement from
Medicare for delivering O&P services.
As a consequence, 26 states are targeted to eliminate Medicaid benefits for
O&P.Four states have already eliminated or drastically reduced their