Orthotics & Prosthetics
on June 16, 2021
At OPGA, we take pride in keeping our members updated on regulatory issues affecting the O&P profession. We offer expertise and guidance through what may seem like a complex process, and most professionals find it to be extremely beneficial and easier to advocate than they originally thought. We strive to help members work with federal agencies and interpret new regulations. That is why we work closely with organizations like VGM Government Relations and the National Association for the Advancement of Orthotics & Prosthetics (NAAOP) to ensure that issues affecting O&P are brought to the forefront of our members of Congress. OPGA, alongside of organizations like NAAOP and VGM Government Relations, is relentlessly fighting for you and the profession every day. The team helps members navigate the complexities of the legislative process and regulatory rules, so you have the freedom to focus on your practice with the peace of mind that OPGA is making sure your voice is heard.
NAAOP is a non-profit trade association dedicated to educating the public and promoting public policy that is in the interest of the O&P patient. Their mission statement is below:
“Our story of advocacy, education, and unity has shaped a 34-year history of positive results in healthcare legislation and regulation. NAAOP invites all those participating in comprehensive O&P patient care to become informed, involved, and join in our mission to educate the public and promote public policy that is clearly in the interest of the O&P patient.”
OPGA’s President, Todd Eagen, is on the NAAOP executive board, and this provides a major value to OPGA members.
“My role on the NAAOP executive board makes it easier to keep members informed of legislative/regulatory issues that impact the profession. We can provide a clear translation of regulatory/legislative changes and how it will impact their practice, as well as have a voice at the table for the independent O&P community with NAAOP and the O&P Alliance. We work with other federal organizations, like the VA, to solve local issues they may be having. We also facilitate both state and federal meetings with representatives.”
OPGA and NAAOP were pleased to learn about the House re-introducing the bipartisan Medicare Orthotics and Prosthetics Patient-Centered Care Act (H.R 1990). The bill is identical to the House version of the bill (H.R. 5262) that was introduced last year. You can watch the announcement video from NAAOP here.
What does this bill do for O&P?
- Distinguish durable medical equipment (DME) from clinical, service-oriented O&P care in the Medicare statute and regulations, leading to recognition of the clinical care O&P practitioners provide. In other words, this provision would lead to recognition of orthotists and prosthetists as medical professionals and allow for more appropriate regulations.
- Limit the definition of “off-the-shelf” (or “OTS”) orthotics to devices that truly require only “minimal self-adjustment” by the beneficiary him- or herself. This would help ensure that patients continue to have access to the clinical orthotic services they need. This provision would restore congressional intent of the definition of OTS and ensure that patients in need of custom fit orthoses will continue to have the clinical care necessary to achieve proper orthotic fit and function.
- Ban drop-shipping to patients’ homes of custom fit and custom prefabricated orthoses and prostheses to prevent fraud and abuse and ensure patient access to clinical O&P care. This provision would help ensure patients are receiving the best quality care by licensed, credentialed, and trained professionals as well as protect the O&P Medicare benefit.
- Exempt licensed and certified O&P practitioners from OTS competitive bidding, treating them similarly to physicians and therapists by allowing them to provide OTS orthoses to their patients—without a contract—at the competitive bidding rate (not the higher fee schedule amount). This provision supports the first one by recognizing certified and/or licensed practitioners as the medical professionals that they are.
We highly encourage you to reach out to your members of Congress and ask them to co-sponsor this important legislation! You can do so by clicking here.
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- Enter your zip code.
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- Submit the message.
Take action today!
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