Medicare Corner: Important Legislative Update

In keeping with our goal to continually provide you with important information for you and your business, we will begin including occasional legislative affairs updates from other organizations in the Facilitator. In this issue, we wanted to let you know about activities that ABC and the O&P Alliance are undertaking as well as those championed by the American Orthotic and Prosthetic Association (AOPA).

In May, Congress introduced the Alliance supported Wounded Warrior Workforce Enhancement Act which would authorize $5 million per year for three years to provide limited, one-time competitive grants to qualified universities to create or expand accredited advanced education programs in prosthetics and orthotics.

AOPA worked with Congress to secure a 50 percent increase (to $15 million) in the Department of Defense’s funding bill for the Congressionally Directed Medical Research Program (CDMRP) to advance research in prosthetic and orthotic outcomes, and priorities for research to fill those gaps. AOPA will work closely with CDMRP to ensure they’re receiving high quality grant proposals and funding the best available research opportunities.

On November 22, the House introduced H.R. 5262, the Medicare Orthotics and Prosthetics Patient-Centered Care Act. A high priority for the Alliance, this bill would:

  • Restore congressional intent by revising the overly expansive regulatory interpretation of the meaning of "off-the-shelf" orthotics to clarify that competitive bidding may only apply to orthoses that require minimal self-adjustment by patients themselves, not the patient's caregiver or a supplier. 
  • Distinguish the clinical, service-oriented nature in which O&P is provided from the commodity-based nature of the durable medical equipment benefit.
  • Reduce the likelihood of waste, fraud and abuse in the Medicare program by prohibiting the practice of "drop shipping."
If you are interested in getting involved in AOPA’s advocacy or have any questions, contact Justin Beland, AOPA Director of Government Affairs at  jbeland@AOPAnet.org.

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